Form 1 Report of Receipts & Utilization

United States Department of Agriculture

1325 Industrial Parkway North

AGRICULTURAL MARKETING SERVICE
DAIRY PROGRAMS
MIDEAST MARKETING AREA
Federal Order No. 33

P.O. Box 5102
Brunswick, Ohio 44212
Phone: 330/225-4758
Toll Free: 888/751-3220

OMB No. 0581-0032
Form 1

Fax: 330/220-6675

REPORT OF RECEIPTS AND UTILIZATION

Email: [email protected]

HANDLER __________________________________________________
For MA Use Only

MONTH _______________________________

This report is required by the order in accordance with 7 U.S.C. 608c and d. Failure to report can result in the assessment of a civil
penalty of up to $1,000 per day (7 U.S.C. 608c (14)(B)) or, upon conviction, in a fine of up to $5,000 per day (7 U.S.C. 608c (14)(A)).

RECEIPTS

Coop
Sec

Item O. Hdlr Code

001
001
003
004
005 621
006 621
007 621

Producer Milk:
Cooperative members:

Number

Product

Own Production
Nonmember
Total Producer Milk
Nonfluid - Class II Used to Produce Only
Nonfluid - Other Class
Reconstituted Labeled Products From Unreg. Supply Plants
Reconstituted Labeled Products From Any Order
Reconstituted Labeled Products From Any Order Per Sec. 43(d)
Other Receipts of Fluid Milk and Cream Products
Bulk

List in detail below:
Handler or Plant and Location

031
033

Prod.

POUNDS
Butterfat

Somatic Cell

Protein

Other Solids

Value + or -

NOTES:

Div.

or

FM

Pkg.

or TK

Class

Beginning Inventory - Packaged Fluid Milk Products
Beginning Inventory - Bulk Fluid Milk Products and Bulk Fluid Cream Products
Total Receipts From All Sources

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.

CLASS I ROUTE DISPOSITION

Page 2
BF

Product

Sec. Item
041

110

Whole Milk

041

140

Flavored Whole Milk Products

041

170 Organic Whole Milk Products

041

211

2% Reduced Fat Milk - No Solids Added

041

212

2% Reduced Fat Milk - Added Solids

041

221

1% Lowfat Milk - No Solids Added

041

222

1% Lowfat Milk - Added Solids

041

225

1/2% Lowfat Milk - No Solids Added

041

226

1/2% Lowfat Milk - Added Solids

041

231

Fat Free Milk - No Solids Added

041

232

Fat Free Milk - Added Solids

041

240

Flavored Lowfat & Skim Milk

041

240

Health Shake

041

250

Buttermilk

041

255

Drinkable Yogurt

041

270

Organic Fat-Reduced Milk Products

041

296

Lactose Reduced

041

149

Eggnog

5 Gallons

Gallons

Half-Gal.

Quarts

Pints

10 Ounces

1/2 Pints

4 Ounces

Test

POUNDS
Product

Butterfat

041
041

999

042

975

TOTAL CLASS I ROUTE DISPOSITION
Ending Inventory of Packaged Fluid Milk Products
Total Class I

CLASS II DISPOSITION
POUNDS
Sec. Item

REPORT VOLUME USED TO PRODUCE

049

310

Mixtures Half/Half - 9% or more B/F

049

321

Light Cream

049

322

Heavy Cream

049

330

Sour Cream

049

340

Yogurt

049

380

Cottage Cheese

049

385

Ricotta Cheese

049

912

Drinkable Yogurt

049

913

Other Class II Beverages

049

Other (Identify)

049

721

Ice Cream Mixes

049

722

Milkshake Mixes

049

934

Custards, Puddings, Pancake & Biscuit Mixes

049

590

Concentrated Product Used to Produce Class II

049

970

Skim Milk Equiv. of Nonfat Solids Added Cl. II - Used to Produce Items Only

049
Total Class II

Product

Butterfat

CLASS III DISPOSITION
For MA Use Only
Sec Item

Page 3
POUNDS

REPORT VOLUME USED TO PRODUCE

Product

Butterfat

071 810 Hard Cheese : American
071 830
Italian
071
Other : Identify

071

Other : Identify

Total Class III

CLASS IV DISPOSITION
POUNDS
Sec. Item
081 400

REPORT VOLUME USED TO PRODUCE

081 620
081 600

Butter
Milk Product in Dried Form:
Nonfat Dry Milk
Whole Milk Powder

081 590

Evaporated or Sweetened Condensed Milk

081 970
081 975

Skim Milk Equivalent of Nonfat Solids Added to Class I Products
Ending Inventory of Bulk Fluid Milk Products and Bulk Fluid Cream Products

Product

Butterfat

Total Class IV

BULK FLUID MILK PRODUCTS AND DIVERSIONS TO COMMERCIAL FOOD PROCESSORS
Sec. Item
069
069

O
Hdlr

Name and Location

Bulk

If Div.

or Div.

F or T

POUNDS
Product

Butterfat

Total to Commercial Food Processor

OTHER USES - Assigned to Lowest Price Class For Month
POUNDS
Sec. Item
941 Disposed of as Livestock Feed
950 Disposed of as Dumped
950 Lost in vehicular accident, flood, fire or similar occurrence beyond handler control
Total Other Uses

Product

Butterfat

MILK DIVERTED FROM FARMS TO OTHER PLANTS
For MA Use Only
Sec Item O Hdlr

HANDLER AND PLANT LOCATION

Coop
Code

F or T
Weight

Page 4
Class
Req.

POUNDS
Product
Butterfat

Total Milk Diverted From Farms

TRANSFERS OF FLUID MILK PRODUCTS AND BULK FLUID CREAM PRODUCTS TO OTHER PLANTS
For MA Use Only
Sec Item O Hdlr

HANDLER AND PLANT LOCATION

Total Transfers of Fluid and Bulk Fluid Cream Products

Product

Bulk
or Pkg.

Class
Req.

POUNDS
Product

Butterfat

RECONCILIATION OF NONFLUID PRODUCTS
Line
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15

Identify By Source

Powder

Plant Identification
Opening Inventory
Own manufacture
Purchases
Sales
(
Ending Inventory
(
TOTAL TO ACCOUNT FOR
Used in Class I - Fortify
Used in Class I - Reconstituted
Used in Class I - Labeled Reconstituted From Unregulated Supply Plants
Used in Class I - Labeled Reconstituted From Any Order
Used in Class II
Used in Class III
Used in Class IV
TOTAL ACCOUNTED FOR
Loss or (Gain) - Loss To Receipts

Page 5

Powder

Powder

) (
) (

)
)

Condensed 50% or more TMS

(
(

)
)

(
(

)
)

(
(

)
)

OTHER SOURCE NONFLUID MILK PRODUCTS TO RECEIPTS AND UTILIZATION
(1)
Product

(2)
Product Pounds

Powder - Line 7 Above
Condensed - Line 7 Above
Powder - Line 8 Above
Condensed - Line 8 Above
Powder - Line 15 (Loss Only)
Condensed - Line 15 (Loss Only)
TOTAL to Page 1; Sec. 004
Powder - Line 11 Above
Condensed - Line 11 Above
TOTAL to Page 1; Sec. 003 & to Page 2; Sec. 049 970
TOTAL of Line 9 Above - to Page 1; Sec. 005 621
TOTAL of Line 10 Above - to Page 1; Sec. 006 (or) 007 621

(3)
Conv. Factor
11.00

(4)
Equiv. Pounds (2) X (3)

(5)
Conv. Factor
10.36

Equiv. to Cl. IV
g. 3, Sec. 081 970 (2) X (5)

11.00
11.00

11.00

11.00

RECONCILIATION OF RECEIPTS AND UTILIZATION
Product Pounds

Skim Pounds

Butterfat Pounds

TOTAL RECEIPTS FROM ALL SOURCES - PAGE 1
Total Class I - Page 2
Total Class II - Page 2
Total Class III - Page 3
Total Class IV - Page 3
Total Bulk FMP and Diversion to Comm. Food Processors - Page 3
Total Other Uses, Page 3
Total Milk Diverted from Farms - Page 4
Total Transfers of Fluid Milk and Bulk Fluid Cream Products - Page 4
TOTAL UTILIZATION
OVERAGE
SHRINKAGE
I declare under the penalties provided by law, that this report (including any accompanying schedule and statements) has been examined by me and to the best of my knowledge and belief is a true, correct and complete report. I also certify that I am auth

Name of Handler _______________________________________________________

____________________________________________________________________
(PERSON AUTHORIZED TO SIGN FOR HANDLER)

Date __________________________________________________________________

(TITLE) ____________________________________________________________________

United States Department of Agriculture

Supplement A

AGRICULTURAL MARKETING SERVICE
DAIRY PROGRAMS

to Form 1

Mideast Marketing Area

Phone: 330/225-4758

1325 Industrial Parkway North

Toll Free: 888/751-3220

Federal Order No. 33

P.O. Box 5102

Fax: 330/220-6675

Brunswick, Ohio 44212

Email: [email protected]

HANDLER _______________________________________________

MONTH _____________________

ENDING INVENTORY OF PACKAGED FLUID MILK PRODUCTS
1/2
CODE

ITEM

5 GALLONS

110

Whole Milk

140

Flavored Whole Milk

170

Organic Whole Milk Products

240

Flavored Lowfat & Skim Milk

211

2% Lowfat Milk (No Solids Added)

212

2% Lowfat Milk (With Solids Added)

221

1% Lowfat Milk (No Solids Added)

222

1% Lowfat Milk (With Solids Added)

231

Skim Milk (No Solids Added)

232

Skim Milk (With Solids Added)

250

Buttermilk

255

Drinkable Yogurt

270

Organic Fat-Reduced Milk Products

GALLONS

GALLONS

1/2
QUARTS

PINTS

10 OUNCES

PINTS

4 OUNCES

BF

PRODUCT

BUTTERFAT

TEST

POUNDS

POUNDS

Other: Identify

TOTAL - TO FORM 1, PAGE 2, SEC. 042 975

ENDING INVENTORY OF BULK FLUID MILK PRODUCTS AND BULK FLUID CREAM PRODUCTS
ITEM

GALLONS

Bulk Starter
Bulk Skim Milk
Bulk Whole Milk
Bulk Whole Milk
Bulk Concentrated FMP
Bulk Concentrated FMP
Bulk Fluid Cream
Bulk Fluid Cream
Frozen Cream

TOTAL - TO FORM 1, PAGE 3, SEC. 081 975

BF

PRODUCT

BUTTERFAT

TEST

POUNDS

POUNDS