CMC-CONF Third Party Confirmation

Filing Date:

OMB Control #: 0581-0189 CMC Form: CONF

THIRD-PARTY CONFIRMATION OF RECEIPT OF EXCESS FRUIT

In accordance with the Cranberry Marketing Order (CMO) (§929.57 Outlets for excess cranberries), handlers of cranberries must notify the Cranberry Marketing Committee of any cranberries that are withheld from handling by completing a separate form titled “Handler Application for Outlets for Excess Fruit,” and receive committee approval for such diversion. Where such fruit is received by a third party (such as approved charities, foreign customers of whole fruit in undeveloped markets, or institution conducting cranberry research), handlers must submit this form – and have the recipient third party complete the “Transfer Confirmation” section.

Handler Name:	Handler Contract #:
Address:
Contact Name: Phone: Email: Project Name: Project Type: Charitable Institution Research & Development Noncompetitive Outlets Nonhuman Food Use Other Product Form: Fresh Fruit Processed Fruit Concentrate/Juice How many equivalent barrels of excess fruit will be utilized: Documents provided to support this delivery
Transfer Confirmation: Transferred To: _ Address: Quantity transferred: Product Form: Fresh Fruit Processed Fruit Concentrate/Juice Name: Title: Signature: Date:

HANDLER CERTIFICATION
I, hereby certify to the CMC and the Secretary of Agriculture that this is a true and correct record of information regarding the undersigned Handler for the current crop year, and that the undersigned handler has a good faith intent to withhold cranberries in accord with the Marketing Order as described herein. I further certify that I have the authority to make such representation on behalf of the undersigned handler.
Name:	Title:
Signature:	Date:

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