ACP-3 FMO Exempt Handler Notification Form

1.

OMB No. 0581-0215

Federal Marketing Order 983 - Administrative Committee for Pistachios

FMO Exempt Handler Notification
Federal Marketing Order Exemption: §983.92 -- handlers are free of the
requirements in §§983.50 through 983.58 and §983.71 if such pistachios
are handled in quantities not exceeding 5,000 dried pounds during any
production year.

Submit to:

Administrative Committee for Pistachios
499 West Shaw Avenue, Suite 140
Fresno, California 93704

Phone: (559) 255-6480 Fax: (559) 255-6485
Email: [email protected]

Handler: complete this form and submit to the Administrative Committee for Pistachios (ACP) each production year you
receive 5,000 pounds or less of assessed weight of pistachios. Handler is responsible for keeping a copy of the completed form
on file for 3 years following the production year in which the pistachios were shipped.

Handler Name

Assessed Pounds

Crop Year

City

State

Zip

Email

Phone

Prepared By

Title

Signature

Signature Date

Address

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- 0215. 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, 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.

ACP-3 (Exp. 07/31/2027. Destroy previous editions.)