CIAB Form 4 Handler Reserve Plan & Final Pack Rept.

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

CIAB

FORM #4

FRONT

Crop Year

HANDLER RESERVE PLAN and

FINAL PACK REPORT

Cherry Industry Administrative Board

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

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

The report is required of all handlers processing tart cherries. It is due by close of business Eastern time October 1. Please note: appropriate certificates will be required for each diversion activity. Complete both sides of this form.

Handler: Handler ID#

Address, City, State, Zip:

Telephone No.:

HANDLER RESERVE PLAN

TREATMENT or ALLOCATION of RED TART CHERRIES	REGULATED DISTRICTS (actual pounds)	UNREGULATED or EXEMPT DISTRICTS (actual pounds)	TOTAL ALL DISTRICTS (actual pounds) (Sum of Col. 1 & 2)
CHERRIES HANDLED:
FRUIT PROCESSED
AT-PLANT DIVERSION (certificates required) +
GROSS POUNDS HANDLED1 =			1
RESTRICTED VOLUME:
RESTRICTION % x
RESTRICTED POUNDS (Gross Pounds Handled x Restriction %) =
COMPLIANCE PLAN:
AT-PLANT
IN-ORCHARD +
EXPORTS +
NEW MARKET/NEW PRODUCT +
RESERVE INVENTORY 2, 3 +
TOTAL, COMPLIANCE ACTIVITIES (Must equal “Restricted Pounds”, above.) =

The sum of “Fruit Processed” + “At-Plant Diversion” must equal the total for all Form 1’s, Weekly Raw Product Report, submitted for the season.

1. Each handler’s default inventory reserve obligation is the “Restricted Pounds” calculated above. This amount of product that must be in inventory reserves until the planned diversion activities are completed and submitted to the CIAB for diversion credits.

2. Forms 5A, Inventory Reserve Summary, and 5B, Inventory Location Report, must accompany this report and document the locations and the specific products placed into inventory reserves.

The undersigned hereby certifies to the CIAB and the Secretary of Agriculture that this is a true and correct Handler Reserve Plan and Final Pack Report for the undersigned Handler of the indicated crop year.

By:

Title:

Date:

According to 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.

CIAB

FORM #4

BACK

Crop Year

FINAL PACK REPORT

FINAL INVENTORY FULFILLMENT

Handler ID#: _____________

FORM and TYPE of PRODUCT	SIZE of UNITS	# of UNITS	CONVERSION FACTORS	RPE OF PRODUCT (actual pounds)
FROZEN
(5 + 1) 1.	30#
Variants of sugar pack
2. _________
3. _________
IQF 1.	40#
2. _________
3. _________
DRYING STOCK
(5 + 1) 1.	30#
Variants of sugar pack
2. _________
3. _________
IQF 1.	40#
2. _________
3. _________
Other (describe)
OTHER
1. ________________
2.
WATERPACK	6/#10
	24/#300
Other (Describe)
PIEFILL	6/#10
	12/#2
Other (Describe)
DRIED	Pounds
PUREE
Concentrated (30° Brix)
Single strength
JUICE
Concentrate (68° Brix)	Gallons
Concentrate (0, 68° Brix)	Gallons
Juice Stock	Pounds
Juice Stock (0 RPE)	Pounds
Single Strength
OTHER (Describe)
1. _______________
2. _______________
3.
TOTAL:

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 #4 (Rev. 12/2016)