California FMMO Producer Payroll Rept.

UNITED STATES DEPARTMENT OF AGRICULTURE
Address: XXX

Form Approved, OMB No. 0581-0032

AGRICULTURAL MARKETING SERVICE
DAIRY PROGRAM

XXX
Phone: XXX
Fax: XXX

XXX FEDERAL MILK ORDER XXX

E-mail: XXX

CALIFORNIA FMMO 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

City, State, Zip

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

Organic
Month & Year
Rate

Value

Deductions

Rate

Value

PPD/Skim Blend

$

$

Hauling

$

$

Butterfat Price/Blend

$

$

Stops

$

$

Producer Protein Price

$

$

Marketing Service

$

$

Other Solids Price

$

$

National DPC

$

$

Somatic Cell Count

$

$

State DPC

$

$

$

Assignments

$

$

Value of Milk Production
Premiums

Rate

Value

Coop Dues

$

$

Cap. Retain

$

$

Bonus

$

$

CDFA Quota Assessment

$

$

rBST-Free

$

$

Other

$

$

Quality

$

$

Other

$

$

Volume

$

$

Other

$

$

Other

$

$

Other

$

$

Other

$

$

Total Deductions

$

Other

$

$

Other

$

$

Net Payment for Month

$

Other

$

$
Less Partial Payment

$

Less A/P Advance

$

Total Premiums

Gross Payment for Month

$

$

Net Check

$

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
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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.
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(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, DC 20250-9410, or call (800) 795-3272
(voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.