RAC-500 (989) Mthly. Rept. of Receipt of Raisins Produced from G

OMB No. 0581-0178

RAISIN ADMINISTRATIVE COMMITTEE

2445 Capitol Street, Suite 200

Fresno, California 93721

Phone: (559) 225-0520

MONTHLY REPORT OF RECEIPT OF RAISINS PRODUCED FROM

GRAPES GROWN OUTSIDE OF THE PRODUCTION AREA

Report No. ________________

The undersigned certifies to the Raisin Administrative Committee (RAC) and the Secretary of Agriculture of the United States that as of the month ending _________________, 20___, the following quantities of raisins produced from grapes grown outside the “area” were received at ____________________, California (plant location), and that copies of substantiating weight certificates, door tags, receipts etc. attached are true and correct.

Varietal Type	Current Month’s Receipts		Cumulative Quantity from August 1
	Pounds	Area of Origin	Pounds	Area of Origin
TOTALS

Handler _____________________________________________ Date ____________________________________________

By _________________________________________________ Title _____________________________________________

The making of any false statement or representations in any matter within the jurisdiction of any agency of the United States, knowing it to be false, is a violation of title 18, section 1001 of the United States Code, which provides for a penalty of a fine or imprisonment of not more than five years, or both.

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 4 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.

INSTRUCTIONS FOR COMPLETING FORM RAC-500

1. Reports covering the applicable month shall be submitted not later than the eighth day of the following month, by 10:00 am IT IS IMPORTANT THAT THE REPORTS COVER ALL RAISINS PRODUCED FROM GRAPES GROWN OUTSIDE THE “AREA” (STATE OF CALIFORNIA).

2. All quantities on the report shall be in pounds.

3. Reports shall be certified by a responsible official of the reporting handler.

4. Each report should be numbered consecutively, beginning with No. 1 for the first month of the crop year during which such raisins were received.

5. The total receipts of the raisins during the current month, as shown on the report in the first two columns, shall be supported by a copy of a door receipt or weight certificate covering each and every receipt of raisins. These door receipts or weight certificates shall clearly show the name of the tenderer from whom received, the varietal type of raisins, the net fruit weight, the number and type of containers in the lot, and the date of delivery. Form RAC-510 should also be attached with required documentation for other U.S. (non-California) and imported raisins.

6. Consult RAC Staff on any points that are not clear.

This report is required by law (7 U.S.C. 608d, 7 CFR 989.173(b)(7)). Failure to report can result in a fine of $2,750 for each such violation, and each day during which such violation continues shall be deemed a separate violation.

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.

RAC-500 (Exp. x/xxxx) Destroy previous versions.