SC-34 (958) Appl. to make SPS Certificate of Privilege

REPRODUCE LOCALLY. Include form number and date on all reproductions. OMB No. 0581-0178

IDAHO-EASTERN OREGON ONION COMMITTEE

P.O. Box 909, PARMA, ID 83660

PHONE: 208-722-5111 FAX: 208-722-6582

CERTIFICATE OF PRIVILEGE

APPLICATION TO MAKE SPECIAL PURPOSE SHIPMENTS

The Marketing order for onions requires that handlers desiring to make shipments outside the production area to canners, dehydrators, extractors, freezers, and/or pickers, which do not meet the requirements for fresh shipments, shall prior to making such a shipment apply to the Idaho-Eastern Oregon Onion Committee (Committee) for permission. A shipment may be made to a receiver without a COP Permit number, if the sale occurs after 5 pm, on a holiday, or weekend; provided, that both the handler and receiver have had prior approval and this Application is faxed to the Committee prior to shipment.

Receiver & Agent								Phone
Contact Person(s)
Address
City					State			Zip
Purpose of Shipment(s)				Canning Dehydration Experimentation Extracting Freezing Pickling
Type of Sale			Spot Sale Volume Sale				Total cwt.
Shipment Date(s)
Container(s)		50 lb bags Totes Bins Bulk Other:

I, the undersigned, hereby certify to USDA and to the Committee, that I have read, fully understand, and agree to comply with 7 CFR § 958.328 which governs the handling of onions, and further agree that none of these special purpose onions will be diverted to any fresh market outlet(s). To the best of my knowledge all statements in this Application are true and complete. In addition, I will prepare an Onion Diversion Report for each Application and submit it to the Committee. The Committee reserves the right to audit the receiver or their agent randomly to verify shipments. Falsification of information on this government document may result in a fine, imprisonment, or both (18 U.S.C. 1001).

Signature				Name
Title				Date
Firm						Phone:
Address
City		State				Zip

COMMITTEE ACTION

APPROVED NOT APPROVED Reason not approved: _________________________________________

COP Permit No. __________________ Date Approved: ________________ Manager: _____________

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 8 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.

SC-34 (Exp. x/xxxx) Destroy previous editions.