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pdfOMB No. 0581-0178
SAMPLE LETTER
Date:
California Date Administrative Committee
P. O. Box 1736
Indio, California 92202-1736
Re: Request for Handler Exemption - Donations
This is to request an exemption from marketing order regulations for a donation of marketable dates.
I wish to donate
poundsof "C" grade datesto the
u_
(Name of organization)
is
The address of the
(Adctess)
(Name of organization)
If you have any questions, please feel free to call me.
Sincerely,
John Doe
Date Handling Company
P. O. Box 17
Indio, California 92202
(phone #)
According
wid
to the Papermrk Reduction Act of 1995,an agency may not conduct or sponsor,and a per.;onis not requirad to respond to a colection of informationuness rt displaysa wid OMS control number The
OMS control number for this information
instructions,
searching
The U.S. Deparbnent
colection
is 0581-0178.
The time required to compete
this information
eXisting data sources, gathering and maintaining the data needed, and competing
d Agriculture
(USDA)
prohibits
di&Crimination
in all its programs
and activities
colBctian is estimated
and reviewing the
to average 12 minutes per response, inciJding the time for reviewing
colBctian of information.
on the basis d race, color, national
origin, age, disability,
and where applicable,
sex. marital
status, fam~ial status,
parentll
status, religion, sexual orientation, genetic infonnation,
political beliefs, reprisal, or because all or part of an individuars income is derilled from any public assistance program (Not an prohibited bases apply to
all programs.) Persons with disabilities who require alternative means for communication
of program infonnation (Braille, large print, audiotape, etc.) should contact USDA's TARGET Center at (202) 720-2600 (voice
and TDD).
To file a complaint d discrimination,
write to USDA, Director,
an equal opportunity pnMcIer and employer.
Office
d Civil Rights, 1400 Independence
Awmue,
SW.,
Washinglon,
D.C. ~10.
or cal (600) 7115-3272 (IIoice) or (202)
720-6382
(TDD). USDA is
File Type | application/pdf |
File Modified | 2007-08-01 |
File Created | 2007-08-01 |