No Form No. (989) RAC- Door Receipt or Weight Certificate

OMB No. 0581-0178

RAISIN ADMINISTRATIVE COMMITTEE

2445 Capitol Street, Suite 200

Fresno, California 93721

Phone: (559) 225-0520

____________________, 20___

TO: All Handlers of Raisins Produced from Grapes Grown in California

SUBJECT: Handler Weight Certificates

Section 989.158(a)(1)(iii) of Marketing Order No. 989, regulating the handling of raisins produced from grapes grown in California (Order), requires each handler to substantiate the weight of each lot of raisins tendered for receiving, storage, reconditioning, acquisition, or disposition on an official “State Certificate of Weights and Measures” issued by a public weigh master on a form approved by the Raisin Administrative Committee (RAC). Section 989.158(a)(3) of the Order also requires handlers to issue a “door receipt” or weight certificate on a serially pre-numbered form. These requirements are usually met by using the same form.

For each lot of raisins tendered for receiving, storage, reconditioning, acquisition, or disposition, please provide the following information to the RAC:

1. The name and address of the tenderer;

2. The weight of the lot;

3. The number and type of containers in the lot; and

4. Any other information necessary to identify the lot.

If you have any questions, please contact your RAC field representative.

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 0581-0178. The time required to complete this information collection is estimated to average 10 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.

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.

(Rev. 01/2017) Destroy previous editions.