ABC 14 (981) CA Almonds Completion of Disposition of Reserve Al

OMB No. 0581-0178

ALMOND BOARD OF CALIFORNIA

1150 9th Street, Suite 1500

Modesto, CA 95354

Tel: (209) 549-8262 Fax: (209) 550-5494

COMPLETION OF DISPOSITION OF RESERVE ALMONDS

PARTIAL SHIPMENT REPORT

Shipment No. ________________

Notice is hereby given of inspection, lot stamping, and shipment of reserve almonds to:

Name, address, and phone number of manufacturer, outlet, or other user:

Attached are □ invoice, if applicable, □ bill of lading, if applicable, □ inspection certificate, and □ Canadian certificate, if applicable. NO PHOTOCOPIES MAY BE USED

Certificate Numbers		Lot Stamp Numbers		Pounds Shipped		Date Shipped

_________________________ _____________________________________ _____________________

Handler Signature Date

MANUFACTURER CERTIFICATION

I hereby certify to the Almond Board of California (ABC) and the U.S. Secretary of Agriculture, that we did manufacture/use the almonds described and identified above in the quantity and on the date specified. I hereby agree that ABC employees and/or USDA representatives may enter our premises at any reasonable time to observe the storage or disposition of the almond material, and to examine and audit our records of almond transactions.

_________________________ _____________________________________ _____________________

Handler Signature Date

FEDERAL OR FEDERAL-STATE INSPECTION SERVICE CERTIFICATION

I hereby certify that the almonds described in form ABC-14 have been made into the produce described in form ABC-13.

_________________________ _____________________________________ _____________________

Manufacturer/User Signature Date

_________________________

Phone Number

INSTRUCTIONS: The handler must file the yellow copy with the ABC when the shipment is made. Attach a copy of the inspection certificate. Either the manufacturer of the product (if other than the handler) or the user of the reserve almonds must file the pink copy with the ABC after the Federal or Federal-State Inspection Certification is completed. The handler retains the gold copy for his files.

This report is required by law (7 U.S.C. 608(d), 7 C.F.R. 981.67, and 7 C.F.R. 981.467). Failure to report can result in a fine for each such violation, and each day that such violation continues shall be deemed a separate violation.

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 12 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.

ABC-14 (Exp. x/xxxx) Destroy previous editions.