CDAC-1 CA Dates--Interhandler Transfer of Dates

CDAC Form #1

Within 24 hours of transfer send one signed copy to:

California Date Administrative Committee
P.O. Box 1736,lndio, CA 92202-1736
Facsimile:760.347.6374

INTERHANDLER TRANSFER OF DATES
(Section 987.51 and 987.151) approlled Ibr OM8II05BI-0178

located at
(Address)

(Selling Handler)

does hereby notify the Committee of a transfer of the dates described below to:

located at
(Address)

(BuyIng Haneler)

on
(Date)

Variety

Classification

Lot # or Lot
Code

Inspection
Certification

Number of
Containers

or Report
Grading#

I hereby certify to the U.S. Department ,Q1Awjculture and thlj Califpmia Date Administrative
complete and accurate and that I will-L-.L
or will not --L-.lassume all withholding

Type of
Containers

Net Weight

Committee that the information contained in this report is
and assessment obligations on the above described dates.

Selling Handler:
By:
Title:
This notification

has been accepted

and recorded

by the California

Date Administrative

Committee.

By:

Date:

Your signature certifies !hat you have the authority to take such action and w~1submit supplementary evidence of such authority at the request of an agent of the Secnetary of Agriculture. The
infom1ation provided in this ballot is required to delam1ine volar eligibility and \IOIe of potato producers. Falsification of infom1ation on this govemment document may resuit in a fine of not more
than $10,000 or imprisorvnent of not more than five (5) years, ()( both (18 U.S.C. 1001).
According to the PapelWOrk Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of infom1ation unless it displays a valid OMB

control number. The validOMScontrolnumberforthis infom1atiion
collectionis 0581-0178. The time requiredto completethis infom1ationcollectionis estimated to average 15 minutes per
response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the conection of infom1ation.
The U.S. Department of Agricutture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, disability, and where applicable, sex,
status,
lamlia! status, parental status. religion, sexual orientation,
genetic information,
political beliefs, neprisa~ or because
all or part of an individuafs
income is deriIIed from any pubic
assistance
program
(Not aU prohibited
apply to aU programa.)
Persons
with disabilities who require aitemative
means for communication
of program infom1ation (Braille, large print
audiotape, e1c.)
should
contact USDA's bases
TARGET Center at (202) 720-2600 (voice and TDD).

To file a
720-6382

complaint
of discrimination,
write to USDA,
Director,
Office of Civil Rights, 1400 Independence
(TDD). USDA
is an equal opportunity
provider
and employer.

Avenue,

S.W., Washington,

D.C. 20250-9410,

or call (800) 795-3272

(voice)

marital

or (202)