H-2 Producer Payroll Report

UNITED STATES DEPARTMENT OF AGRICULTURE
1930-220th St. SE, Ste. 102
Bothell, WA 98021
Phone: (425) 487-6009
Fax: (425) 487-2775
E-mail: [email protected]

AGRICULTURAL MARKETING SERVICE
DAIRY PROGRAMS
FEDERAL MILK ORDERS 124 & 131

4835 E Cactus Rd., Ste. 365
Scottsdale, AZ 85254
Phone: (602) 547-2909
Fax: (602) 547-2906
E-mail: [email protected]

H-2
Producer Payroll Report

Note: This cover page is for information purposes only and does not need to be submitted to the market administrator's office.

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to
a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection
is 0581-0032. The time required to complete this information collection is estimated to average 1.5 hours per response, including the
time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and
reviewing the collection of information.
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color,
national origin, age, disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation,
genetic information, political beliefs, reprisal, or because all or part of an individual's income is derived from any public assistance
program. (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication
of program information (Braille, large print, audiotape, etc.) should contact USDA's TARGET Center at (202) 720-2600 (voice and
TDD). To file a complaint of discrimination, write to USDA, Director, Office of Civil Rights, 1400 Independence Avenue, S.W.,
Washington, D.C. 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and
employer.

UNITED STATES DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE
DAIRY PROGRAMS

Form H-2
1930-220th St. SE, Ste. 102

Form Approved, OMB No. 0581-0032
4835 E Cactus Rd., Ste. 365

Bothell, WA 98021

Scottsdale, AZ 85254

Phone: (425) 487-6009

Phone: (602) 547-2909

FEDERAL MILK ORDERS 124 & 131

Fax: (425) 487-2775
E-mail: [email protected]

Fax: (602) 547-2906
E-mail: [email protected]

PRODUCER PAYROLL REPORT
Handler

Month's Production Results

Producer No.

Tank No.

Total Pounds of Milk

Producer Name

Pounds of Butterfat

Address

Pounds of Protein 1/

City, State, Zip

Pounds of Other Solids 1/
Average Butterfat Test
Average Protein Test 1/
Average Other Solids Test 1/

Month & Year
Daily Weights
1

Rate

16

Value

PPD 1/; Uniform Skim 2/

$

$

Producer Protein Price 1/

$

$

2

17

Other Solids Price 1/

$

$

3

18

Butterfat Price

$

$

4

19

Value of Milk Production

5

20

6

21

Premiums

7

22

Bonus

$

$

8

23

Hardship

$

$

Total Premiums

$

Gross Payment for Month

$

9

24

10

25

11

26

12

27

$
Rate

Value

Rate

Value

13

28

Deductions

14

29

Hauling

$

$

15

30

Stops

$

$

31

Marketing Service

$

$

National DPC

$

$

State DPC

$

$

Other

$

$

Other

$

$

Totals

Average Tests

Total Deductions

$

B.F.
Pro 1/

Net Payment for Month

$

OS 1/

Less Partial Payment

$

Less A/P Advance

$

1st half

1/ FO 124 handlers only.
2/ FO 131 handlers only.

2nd half

Net Check

$

UNITED STATES DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE
DAIRY PROGRAMS

1930-220th St. SE, Ste. 102
Bothell, WA 98021

4835 E Cactus Rd., Ste. 365
Scottsdale, AZ 85254

Phone: (425) 487-6009

Phone: (602) 547-2909

FEDERAL MILK ORDERS 124 & 131

Fax: (425) 487-2775
E-mail: [email protected]

Fax: (602) 547-2906
E-mail: [email protected]

PRODUCER PAYROLL REPORT
Handler
Producer No.

Tank No.

Producer Name
Address
City, State, Zip

Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31

Pounds

Total
1/ Percent Test.
2/ FO 124 handlers only.

Butterfat 1/

Protein 1/ 2/

Other Solids 1/ 2/