CAC Form 301

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CITRUS ADMINISTRATIVE COMMITTEE
P.O. Box 24508
Lakeland, FL 33802-4508
Phone: (863) 682-3103
Fax: (863) 683-9563
Email: [email protected]

REPORT OF RED GRAPEFRUIT SHIPMENTS BY DAY AND REGULATION WEEK
SIZE 48 AND SMALLER RED GRAPEFRUIT

The Citrus Administrative Committee (Committee) regulation governs the reporting of the quantity of size 48 and smaller red grapefruit, as regulated by a percentage of shipments.  Each handler shipping red grapefruit interstate and to export markets must report the daily quantity shipped of size 48 and smaller grapefruit, and all regulated red grapefruit shipments, on this form.

Handler Name: 	

Phone No. (_____) ________________________ 	Fax No. (_____)  ________________________

    1. Circle regulation week of shipments: 
12	13	14	15	16	17	18	19	20	21	22

    2. Circle the day the grapefruit was shipped:  Mond.    Tues.    Weds.    Thurs.    Fri.    Sat.    Sun.

    3. For interstate shipments of red grapefruit:
Number of cartons of size 48 and smaller red grapefruit shipped: _________
total shipments (all sizes): __________

    4. For export shipments of red grapefruit
Number of cartons of size 48 and smaller red grapefruit shipped: _________
total shipments (all sizes): __________

Sign and fax this form to the Committee.  This form must be completed and received by the Committee no later than 2:00 p.m. on the business day following the shipments.

I (we) certify to the Committee and the Secretary of Agriculture that this fruit is shipped in accordance with the current Marketing Order regulations.  I (we) realize that the making of a false statement, knowing it to be false, is a violation of title 18, section 1001, of the United States Code, among other statutes, which provide for fine and imprisonment.

Handler’s Name: ___________________________ Authorized Signature _________________________












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 OMB 0581-0189.  The time required to complete this information collection is estimated to average 5 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.