ACP-5 Inter-Handler Transfer Report

OMB No. 0581-0215

Federal Marketing Order 983 - Administrative Committee for Pistachios

Inter-Handler Transfer Report
Handlers transferring pistachios to another handler within the production area shall complete this form for submission to the
Administrative Committee for Pistachios (ACP). The ACP uses this report to track compliance with FMO §983.150 (aflatoxin
regulations) and prevent duplication of reported shipments. Inter-handler transfers are also reported by transferring and
receiving handlers on line 5 of ACP-7 (Monthly Inventory/Shipment Report).
Instructions: Transferring Handler
Complete this form and sign as transferring handler. Forward the
original and a copy to the receiving handler. Submit a copy to the ACP
within 30 days of the transfer.

Submit to:

Instructions: Receiving Handler
Sign the original form provided by the transferring handler. Submit the
signed original ACP-5 to the ACP within 30 days of the transfer.

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

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

Handlers are responsible for keeping copies of the completed forms for their records.
Transferring Handler: record up to three transfers to the named receiving handler.
Date of Transfer

Lot Description

Lot ID/Marks

Weight (Pounds)

Inspected
(circle)
Yes
No

Date of Transfer

Lot Description

Lot ID/Marks

Weight (Pounds)

Inspected
(circle)
Yes
No

Date of Transfer

Lot Description

Lot ID/Marks

Weight (Pounds)

Inspected
(circle)
Yes
No

Transferring Handler Name

Receiving Handler Name

Handler Representative First and Last Name

Title

Transferring Handler Signature

Signature Date

Handler Representative First and Last Name

Title

Receiving Handler Signature

Signature Date

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 12 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-5 (Exp. 07/31/2027. Destroy previous editions.)