CWB 6 (984) CA. Walnuts - Report of Merchantable Wallnuts Ship

California Walnut Board OMB NO. 0581-0178

101 Parkshore Drive, Suite 250 CWB Form #6

Folsom, CA 95630 Due Date:

Ph (916) 932-7070 Fax (916) 932-7071 Month:

REPORT OF MERCHANTABLE WALNUTS

RECEIVED, COMMITTED, AND SHIPPED

This report of merchantable walnuts received, committed, and shipped is submitted in compliance with the requirements of the Federal Marketing Order No. 984, as amended. In executing this form, the handler respectively certifies to the California Walnut Board and to the U.S. Department of Agriculture as to the correctness and completeness of their statement.

Instructions: 1. Report walnut receipts (received from growers) for the month in Inshell pounds.

2. Report walnut purchase commitments (sales/not yet shipped) in Inshell and Shelled pounds.

3. Report inshell and shelled by domestic and export shipments (in pounds).

4. Report all export shipments by country of destination on the attached page.

5. If you did not have any receipts, commitments, or shipments, write “NONE” on the form.

6. Fax or email a copy to the California Walnut Board (CWB) office on or before______.

1. WALNUT RECEIPTS (received from growers)

Inshell Pounds

Received for the month of:

PURCHASE COMMITMENTS (sales/not yet shipped)
Inshell Pounds	Shelled Pounds

3. WALNUT SHIPMENTS

Inshell Pounds

Shelled Pounds

Domestic

Export

TOTAL

Handler: ___________________________________________________________________________

By: _______________________________________________________________________________

Title: _________________________________________ Date: _______________________________

The making of any false statements or representations in any matter within the jurisdiction of any agency of the United States, knowing it to be false, is a violation of Title 18, Section 1001, United States Code, which provides for a penalty of a fine of $250,000 for individuals and $500,000 for organizations or imprisonment of not more than five years, or both.

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.

OMB NO. 0581-0178

Handler Name:_______________________________________ CWB Form #6

Due Date:

Month:

SHIPMENTS BY COUNTRY OF DESTINATION

	INSHELL (lbs)	SHELLED (lbs)		INSHELL (lbs)	SHELLED (lbs)
MIDDLE EAST/AFRICA			NORTH AMERICA
Algeria			Canada
Bahrain			Mexico
Egypt			CENTRAL & SOUTH AMERICA
Iraq			Chile
Israel			Ecuador
Jordan			ASIA / PACIFIC RIM
Kuwait			Australia
Lebanon			China
Morocco			Hong Kong
Pakistan			India
Qatar			Japan
Saudi Arabia			Korea
Tunisia			Malaysia
Turkey			New Zealand
U.A.E.			Philippines
EUROPE			Singapore
Austria			Taiwan
Belgium			Thailand
Denmark			Vietnam
France
Germany			OTHER (please list):
Greece
Italy
Netherlands
Norway
Portugal
Spain
Sweden
Switzerland
U.K.
			TOTALS

The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part of an individual’s income is derived from any public assistance program. (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact USDA’s TARGET Center at (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, D.C. 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.

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