LP-29 Certificate of Organic Exemption (Seller) (Beef)

CERTIFICATE OF ORGANIC EXEMPTION (FOR THE SELLER)

Failure to pay the beef checkoff is a violation of federal law. This form must be properly completed and signed to be valid. By law, you can be fined up to $10,000, imprisoned up to 5 years, or both for knowingly or willfully making false statements within this official document (18 U.S.C. §1001).

I CLAIM ORGANIC EXEMPTION ON____________ HEAD OF CATTLE WHICH I AM SELLING ON TO:

(number) (date)

BUYER’S NAME/ADDRESS:

I certify that I am a producer who operates under an approved National Organic Program (7 CFR part 205) system plan and produce cattle that are eligible for slaughter as “organic” or “100 percent organic” beef. I also certify that the Cattlemen’s Beef Board has granted me an exemption from paying the Federal

$1-per-head Beef Checkoff Program assessment on qualified cattle transactions in accordance with 7 CFR part 1260.302. I understand that an original of this “Certificate of Organic Exemption” form must be provided to the purchaser (collecting person) at the time of sale to document that the $1-per-head assessment is not due in this transaction or I will be required to pay the assessment. Copies, scans/emails or Facsimiles WILL NOT be accepted. I also understand that the $1-per-head beef checkoff assessment is due on any conventionally raised or non-organic cattle that I sell at any time. In addition, I may still be subject to any applicable State-specific beef checkoff assessments that might be due, according to individual State requirements.

Person who owns these cattle at the time of sale and is claiming Organic Exemption from the Beef Checkoff Program assessment.

SELLER’S NAME:

ADDRESS:

CITY:

STATE/ZIP:

SIGNATURE OF SELLER:

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 6 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.

BUYER: Send this copy in with your monthly Remittance Report when required by your State beef council or the Cattlemen’s Beef Board (White)

BUYER’S COPY: Retain for your files (Yellow)

SELLER’S COPY: Retain for your files (Pink)

LP-29 (Expiration Date XX/XX/XXXX)