LP-6 AEB--(American Egg Board) Collecting Handler Report

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OMB No. 0581-0093

EGG RESEARCH AND PROMOTION ORDER COLLECTING HANDLER REPORT

merican Egg Board

NOTE: PLEASE COMPLETE AND RETURN THIS REPORT # WITHIN 15 DAYS OF THE END OF THE

ACCOUNTING PERIOD BEGINNING AND ENDING TO: AMERICAN EGG BOARD

I.D. NUMBER

CASES HANDLED

THIS REPORTING

PERIOD

______________________________

(1) TOTAL FROM

TOTAL A + B + C + D

LINE (1-2)

(1)

(2)

(3)

(4)

ALL SOURCES

2. LESS NONASSESSABLE CASES HANDLED AS FOLLOWS:

A	HATCHERY FLOCK		B	FLOCKS _______ OR LESS		C	IMPORTED		D	PREVIOUSLY ASSESSED
		+			+			+

(2)

(3) TOTAL CASES SUBJECT TO ASSESSMENT—MUST EQUAL LINE (5) BELOW

NOTE: PRODUCTION ELIGIBLE FOR EXEMPTION MUST HAVE EXEMPTION CERTIFICATES ON FILE WITH AEB OR THE HANDLER MUST ASSESS IT.

TOTAL ASSESSMENT DUE LINE (3) X

(4)

PRODUCERS’ NAMES, ADDRESSES AND NUMBERS FROM WHOM ASSESSABLE EGGS WERE PURCHASED LIST ANY CHANGES OR ADDITIONS BELOW OR ON REVERSE SIDE		NUMBER OF ASSESSABLE CASES
TOTAL CASES SUBJECT TO ASSESSMENT AS LISTED BY PRODUCER ABOVE → (5) THIS TOTAL MUST EQUAL LINE (3)
I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THIS REPORT IS TRUE AND COMPLETE. I UNDERSTAND THAT RECORDS FROM WHICH THIS REPORT WAS COMPILED ARE SUBJECT TO AUDIT.
_______________________________________________	_________________________________________________	____________________
AUTHORIZED SIGNATURE	TITLE	DATE

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INSTRUCTIONS FOR COMPLETING COLLECTION HANDLER REPORT

NOTE: THIS TWO-PART FORM NEEDS NO CARBON PAPER. COMPLETING IT WITH A BALL POINT PEN OR TYPEWRITER WILL AUTOMATICALLY FILL IN YOUR COPY (SECOND PART). AFTER COMPLETION, PULL SHEETS APART AND MAIL TOP COPY TO AEB.

1. Fill in the ending date of the accounting period covered by this report. To assist you in filing consistent reports, the beginning date is supplied based on the type accounting period you chose and should coincide with the beginning of your respective accounting period. If changes are necessary, please let us know. All reports are required to be returned, even if you did not handle any eggs during this period.

2. Verify name, address, and zip code. Make any changes necessary. Contact AEB if ownership has changed.

3. Section (1): Fill in total number of cases handled this period from all sources. “Handle” means to grade, carton, process, transport, purchase, or in any way place eggs or cause eggs to be placed in the current of commerce. (Includes eggs of your own production.) (Section 1250.500(h), Rules and Regulations.)

4. Section (2): Fill in number of non-assessable cases handled. Enter by category A, B, C, or D in the boxes provided. Enter the total of categories A, B, C, and D in Box (2).

* Non-assessable categories are:

1. Hatchery Flocks – Eggs from flocks utilized primarily for the

IMPORTANT:

Category A or B type eggs should be assessed in the producer does not have exemption certi-ficates on file with you and AEB effective for this current calendar year.

hatching of baby chicks. See restriction.---------------------→

2. Flocks _______ or less – Eggs from producers who have owned,

in total, less than _________ birds for a 3-consecutive-month

period immediately prior to the month in which assessments

are due and payable. See restriction.--------------------------→

3. Imported – Eggs imported from outside U.S. borders (such as Canadian Eggs).

4. Previously Assessed – Eggs purchased from another handler who has provided a statement with each load indicating the eggs have been assessed under his handler number.

5. Subtract Box (2) from Box (1) and indicate difference in Box (3). Box (3) must equal Box (5).

6. Multiply Box (3) times case rate printed between line 3 and line 4.

7. VERY IMPORTANT: List the number of assessable cases you purchased from each producer during this reporting period in the producer section. List additional producers in the spaces provided on the front or on the back of the first (AEB) copy. Address must be accurate and complete. (Section 1250.529 (a)(1) (v), Rules and Regulations.)

8. Add cases entered for each producer and indicate the total in Box (5). Box (5) should equal Box (3). If it does not, re-check calculations and make corrections so that Box (5) = Box (3). (Don’t forget producers on the back form.)

9. Write check for assessment due (Box (4)) and mail to AEB lock box address.

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 0581-0093. 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.

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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

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