PEC-AAE Application for Exemption from Assessments

Form Approved OMB 0581-NEW

AMERICAN PECAN PROMOTION BOARD

APPLICATION FOR EXEMPTION FROM ASSESSMENT

As stated in Section 1223.53 of the Pecan Promotion, Research and Information Order (Exemption Procedures):

“Any producer who produces or importer who imports less than 50,000 pounds of in-shell pecans (25,000 pounds shelled pecans) on average for four fiscal periods may request an exemption from the American Pecan Promotion Board (APPB), on a form provided by the APPB, for a certificate of exemption. Such producer shall certify that the producer’s production of pecans shall be less than 50,000 pounds of in-shell pecans (25,000 pounds for shelled pecans) on average for four fiscal periods(the fiscal period for which the exemption is claimed and previous three fiscal periods) for which the exemption is claimed. Any importer who imports less than 50,000 pounds of in-shell pecans (25,000 pounds for shelled pecans) on average for four fiscal periods (the fiscal period for which the exemption is claimed and previous three fiscal period) for which the exemption is claimed.

CERTIFICATION

(To Be Signed and Dated by Applicant)

I hereby certify that my total level of pecan production or imported pecans to the United States is less than 50,000 pounds in-shell pecans (25,000 pounds shelled pecans) for fiscal years _____. I therefore request a certificate of exemption from the American Pecan Promotion Board for the year _____.

Signature ____________________________________ Date: ________________

Please Print

Name of Applicant: _________________________________________________

Company Name (if applicable): _________________________________________

Street Address: ______________________________________________________

City: ________________________________ State: ________________________

Zip Code: __________ Phone:_________________ E-mail:___________________

Please send your completed Certificate of Exemption Application and supporting documentation to verify previous year production or importation to the American Pecan Promotion Board (APPB) at the following address:

APPB

Street

City, State Zip

Telephone: xxx.xxx.xxxx

E-mail:

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PEC-AAE

Exp. Date XX/XX/XXXX