CIAB Form #1 Weekly Raw Product Report

REPRODUCE LOCALLY. Include form number and date on all reproductions. OMB No. 0581-0177

W

CIAB

FORM #1

eekly Raw Product Report

Cherry Industry Administrative Board

P.O. Box 388, DeWitt, MI 48820-0388

Tel: 517/669-1070 Fax: 517/669-1260

Here is general information about the Form 1. Please input the cells marked in green on the forms.
Note that the cells in the Form 1's with these colors:
	Requires data input from handler
	Should calculate automatically.
Posting of information
Week 1 -	Week ending date. Please post the first week of harvest for the entire industry.
	If your harvest began later than Week 1 of the year, use the appropriate
	week's tab for your starting production.
	Handler name, address and CIAB identifying number [H____].
	Post production for each district from which you received tonnage.
Weeks 2 through 10	Post your weekly production by district
	NOTE: The other information should flow from the Week 1 entries
Production figures
Weekly total	Will be calculated automatically
Year to date production	Will be calculated automatically
Total year to date production	Will be calculated automatically
Final week of Production	Please check the box with an "x" indicating the week that you finish production -
NEW in 2013	1. in each district and
	2. for the year.
Corrections:	If you need to make corrections, do so in the appropriate week,
	but please notify the CIAB about the week and district in which
	the correction is being made.
Printing week's report	File, Print, OK
Use of spreadsheet	Input data for the week
	Save to your hard drive
	Attach as e-mail to CIAB sent to [email protected]

According the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number to this information collection is 0581-0177. The time required to complete this information collection is estimated to average 15 minutes per response, including the time for reviewing the collection of information.

W

CIAB

FORM #1

Week

Ending:

Final

Report:

eekly Raw Product Report

Cherry Industry Administrative Board

P.O. Box 388, DeWitt, MI 48820-0388

Tel: 517/669-1070 Fax: 517/669-1260

Report receipts of fruit starting with the first week of harvest and pack and continue until the harvest is completed. The reporting week ends on Saturday. The report is due in the CIAB office by close of business Eastern time on Monday following each week of harvest. Please indicate the completion of harvest for each district from which you receive cherries when you are done in the district and the Final Report when you have completed your harvest.

Handler: __ Handler ID# ______

Address, City, State, Zip:

Telephone No.:

RAW PRODUCT RECEIVED By District of Production			WEEKLY PRODUCTION Total of Fruit Received		YEAR to DATE Total of Fruit Received		Harvest from District Completed
01	NW Michigan
02	WC Michigan
03	SW Michigan
04	New York
05	Oregon
06	Pennsylvania
07	Utah
08	Washington
09	Wisconsin
	TOTAL RECEIPTS:

The undersigned hereby certifies to the CIAB and the Secretary of Agriculture that this is a true and correct report of product received by the Handler for the indicated period.

By:

Title:

Date:

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex, gender identity (including gender expression), sexual orientation, disability, age, marital status, family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all programs). Remedies and complaint filing deadlines vary by program or incident.

Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.) should contact the responsible Agency or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.

To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at http://www.ascr.usda.gov/complaint_filing_cust.html and at any USDA office or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: (1) mail: U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue, SW Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email: [email protected]. USDA is an equal opportunity provider, employer, and lender.

CIAB Form #1 (Rev. 12/2016)