SC-215 915-Avocado Handler's Weekly Report Form

REPRODUCE LOCALLY. Include form number and date on all reproductions. OMB No. 0581-0189

U.S. DEPARTMENT OF AGRICULTURE AGRICULTURAL MARKETING SERVICE SPECIALTY CROPS PROGRAM

AVOCADO HANDLER’S WEEKLY REPORT

Avocado Administrative Committee P.O. Box 900188 Homestead, FL 33090-0188 Tel: (305) 247-0848

WEEK BEGINNING SUNDAY

WEEK ENDING SUNDAY

NAME

ALL AVOCADOS RECEIVED DURING THE WEEK ABOVE, INCLUDING THOSE PICKED FROM YOUR OWN GROVE (Enter each regulated variety separately, all seedling, all in 55 # boxes). If avocados were sold to another handler, only the first handler reports.

VARIETY

QUANTITY

VARIETY

QUANTITY

VARIETY

QUANTITY

DISPOSITION OF AVOCADOS NOT PACKED IN REGULATED CONTAINERS (Please list date and method of disposition of fruit, such as: returned to grower, dumped, sold locally, etc.)

DATE

DISPOSITION

QUANTITY

DATE

DISPOSITION

QUANTITY

INSTRUCTIONS: Complete, and return this form to the Avocado Administrative Committee. Check here □ if more forms are needed. This information is necessary to verify compliance with provisions of the Marketing Order. Failure to report can result in a fine of not less than $50.00 and not more than $5,000 for each such violation, and each day during which such a violation continues shall be deemed a separate violation.

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 OMB 0581-0189. The time required to complete this information collection is estimated to average 6 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-215 (Exp. X/XXXX) Destroy previous editions.