PMC 2.21 (993) CA Dried Prunes Application for Permission to Disp

OMB No. 0581-0178

APPLICATION FOR PERMISSION TO DISPOSE OF

UNDERSIZED PRUNES FOR NON-HUMAN USAGE

TO: Prune Marketing Committee Date: _____________________

3840 Rosin Court, Suite 170

Sacramento, CA 95834

Fax: (916) 565-6237

HANDLER

ADDRESS

The undersigned hereby applies for permission to dispose of undersized prunes, to the person, and for the non-human usage shown below:

	NAME	ADDRESS
(1) Our Vendee (customer):
(2) Consignee (if other than Vendee or User):
(3) User, Manufacturer, or Converter (if other than above):
(4) Non-Human Usage (specify):	(5)Period of Shipment:	(6) Approximate Tons to be Shipped:

If a broker is not involved, it is the handler’s responsibility to inform the actual user about the paperwork (forms PMC 4.71A and 4.71B) involved in complying with the undersized regulation. Failure of the actual user to complete the paperwork involved can result in refusal to issue future undersized approvals.

Signature: __________________________________

Title: ______________________________________

AUTHORITY: This report is required by law (7 U.S.C. 608(d), 7CFR 993.49, 993.50(g), 993.108 and §993.150(g)(1)).

FAILURE TO REPORT can result in a fine for each such violation and each day during which such violation continues shall be deemed a separate violation.

DEFINITIONS: Vendee: The Actual Buyer (Broker or User)

Consignee: One who takes possession of the load, (ie., holding area warehouse, etc.) if other than the actual user.

User: The feeder or feed dealer if its ground or mixed with other feed stuff.

Note: Prior to making any shipment or in any way disposing of undersized prunes, handlers are required to file a written application on form PMC 2.21 with the Prune Marketing Committee (Committee) for permission to make such shipment or disposal and receive the Committee’s approval thereof on form PMC 2.31. Disposal of undersized prunes shall be only in non-human consumption outlets and during the crop year received.

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 15 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.

PMC 2.21 (Exp. x/xxxx) Destroy previous editions.