ACP-6 Inter-Handler Transfer

OMB No. 0581-0215
ADMINISTRATIVE COMMITTEE FOR PISTACHIOS
4938 East Yale Avenue, Suite 102, Fresno, CA 93727
Tel (559) 255-6480; Fax (559) 255-6485
Email: [email protected]

INTER-HANDLER TRANSFER REPORT
This form is submitted to the Administrative Committee for Pistachios (ACP) in order to track inter-handler transfers within the production
area, in compliance with section 983.150 of the FMO. The transferring handler must complete this form, sign Part A, and send one copy to the
ACP, and send the original and one copy to the receiving handler within 30 days. The receiving handler must sign part B, and send the original
to ACP within 30 days. Handlers are responsible for keeping a copy of the completed forms for their records.

Date of transfer: _______________________________________________________________________
Transferring handler: _____________________ From Plant at: _________________________________
Receiving handler: _______________________ To Plant at: ___________________________________
Description of inventory transferred:
Lot description:______________________________________________________________________
Lot ID marks:_________________________ Weight: ____________Lbs. Lot inspected (yes/no): ___
Container size/description:_____________________________________________________________
Aflatoxin Certificate No.:__________________ Minimum Grade Certificate No.:_________________
Lot description:______________________________________________________________________
Lot ID marks:_________________________ Weight: ____________Lbs. Lot inspected (yes/no): ___
Container size/description:_____________________________________________________________
Aflatoxin Certificate No.:__________________ Minimum Grade Certificate No.:_________________
Lot description:______________________________________________________________________
Lot ID marks:_________________________ Weight: ____________Lbs. Lot inspected (yes/no): ___
Container size/description:_____________________________________________________________
Aflatoxin Certificate No.:__________________ Minimum Grade Certificate No.:_________________
Part A:
Transferring Handler Signature:__________________________________ Date: __________________
Name:______________________________________________________ Title: __________________
Part B:
Receiving Handler Signature: ___________________________________ Date: __________________
Name:______________________________________________________ Title: __________________

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 05810215. The time required to complete this information collection is estimated to average 12 minutes 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.

ACP-6 (Rev. 05/2014. Destroy previous editions.)