F/H Form 1(f) Hazelnuts Receipt & Disposition Produced Outside U.S.

Revised

F/H Form 1 f
OMS CO NT. NO.
0581-0178

413/01

Handler
Period

Receipt and Disposition of Hazelnuts Produced Outside the U.S.A.

Receipt of Product
Date of
Inspection
Certificate No.
Receipt

Total
Last Period
Total

Country of
Origin

Pounds
Inshell

Pounds
Kernels

Total Pounds

Country

Pounds
Inshell

Pounds
Kernels

Total Pounds

Current Period
Yr-To-Date
Yr-To-Date

Disposition
.
of Product
Date of
Shipment

Total
Last Period
Total

Inspection
Certificate No.

Current Period
Yr-To-Date
Yr-To-Date

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