Form No. 2 (956) Walla Sweet Onions Handler Registration Form

OMB No. 0581-0178

WALLA WALLA SWEET ONION MARKETING COMMITTEE

6601 W. Deschutes Ave., Suite C-2

Kennewick, WA 99336

Phone: (509) 585-5460 or Fax: (509) 585-2671

HANDLER REGISTRATION FORM

If you plan to HANDLE Walla Walla Sweet Onions grown in the designated production area of Southeast Washington and Northeast Oregon during the 20___ season, you are REQUIRED to submit the following information to the Walla Walla Sweet Onion Marketing Committee (Committee) prior to May 31, 20___. The terms “production area,” “Walla Walla Sweet Onions,” and “handle,” are defined in Marketing Order No. 956 (7 C.F.R 956). Copies are available at the Committee office.

COMPANY NAME: ___________________________________________________________________

CONTACT NAME: ____________________________________________________________________

SIGNATURE: ____________________________________ Date ____________________________

MAILING ADDRESS: _________________________________________________________________

PHYSICAL ADDRESS: ________________________________________________________________

PHONE: ______________________ FAX: ____________________ CELL: __________________

LIST OF BRAND NAMES OR LABELS: __________________________________________________

_____________________________________________________________________________________

WILL YOU BE INDIVIDUALLY LABELING YOUR PRODUCT? _____________________________

PLEASE LIST producers from whom you expect to procure the Walla Walla Sweet Onions you anticipate packing during the 20___ season. Include anticipated acreage from each producer. Use extra sheet if necessary.

Producer _____________________ Fall Plant _________ Spring Plant ________

Producer _____________________ Fall Plant _________ Spring Plant ________

Producer _____________________ Fall Plant _________ Spring Plant ________

Producer _____________________ Fall Plant _________ Spring Plant ________

Producer _____________________ Fall Plant _________ Spring Plant ________

Producer _____________________ Fall Plant _________ Spring Plant ________

Producer _____________________ Fall Plant _________ Spring Plant ________

Producer _____________________ Fall Plant _________ Spring Plant ________

Producer _____________________ Fall Plant _________ Spring Plant ________

Producer _____________________ Fall Plant _________ Spring Plant ________

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.

Form 2 (Exp. x/xxxx) Destroy previous editions.