FTC-102-75 (966) Application for Registration as tomato handler (FL

Vegetable and Specialty Crops

FTC-102-75 Handler Registration(5-2)

OMB: 0581-0178

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OMB No. 0581-0178

For Office Use Only

Date Received _______

RH Code _______

RH # _______
LORIDA TOMATO COMMITTEE

800 Trafalgar Court, Suite 300  Maitland, FL 32751

Phone (407) 660-1949  Fax (407) 660-1656

www.floridatomatoes.org

APPLICATION FOR REGISTRATION AS TOMATO HANDLER

I hereby apply for registration as a Tomato Handler for the 20___-20___ season. Each handler who handles tomatoes grown in the production area must be certified as a registered handler by the Committee in order to ship such tomatoes outside of the regulated area. A handler who is certified as a registered handler is a handler who has adequate facilities to meet the requirements of preparing tomatoes for market, obtains inspection on tomatoes handled, agrees to handle tomatoes in compliance with the marketing order’s grade, size and container requirements, pays applicable assessments on a timely basis, submits reports required by the Committee, and agrees to comply with other regulatory requirements on the handling of tomatoes grown in the production area. The Committee or its authorized agent shall inspect a handler’s facilities to determine if the facilities are adequate for preparing tomatoes for market. In order to be adequate for such purposes, the facilities must be permanent, non-portable buildings located in the production area with equipment that is non-portable for proper washing, grading, sizing and packing of tomatoes grown in the production area.

Company/individual address of all location(s) of grading and packing facilities in the production area:

______________________________________________________________________________________

Type of business (Individual, Firm, Partnership, Corporation, Co-operative, Association or other business unit): _________________________________________________________________________________

If other than individual, show below names and addresses of the officers, partners, or other individuals having a financial interest in the business with the applicant.

Name	Title	Address, City, State, Zip code

How many years have you been in the tomato business in Florida? ___________

Business Name of Applicant: ______________________________________________________________

Street Address: _________________________________________________________________________

City, State, Zip Code: ____________________________________________________________________

Mailing Address: _______________________________________________________________________

City, State, Zip Code: ____________________________________________________________________

Telephone Number: ___________________________ Fax Number: ________________________

Email address: __________________________________________________________________________

By: __________________________________________________ ____________________________________

Authorized Signature Title

__________________________________________________

Print name

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 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.

CRITICAL INFORMATION REQUEST

Please provide the information below for each grower who you expect will be shipping through your packing facility for the 20___- 20___ season. This information is needed to ensure that your growers are kept up-to-date on Florida Tomato Committee (Committee) activities and on subjects affecting the Florida tomato industry as a whole, such as: Medfly alerts; government regulations; labor situations; market conditions; etc. Return this form with your application for registration as a tomato handler.

GROWER NAME

CONTACT NAME

ADDRESS

CITY, STATE, ZIP CODE