RAC-100 Export Program Application/Deposit

RAC - 100			EXPORT PROGRAM					Office of Management & Budget
			APPLICATION / DEPOSIT					OMB No. 0581-0178
Revised 4/09			RAISIN ADMINISTRATIVE COMMITTEE
			P.O. Box 5217
			Fresno, CA 93755-5217
	The undersigned Packer hereby requests approval by the Raisin Administrative Committee of this application. It is understood that upon such approval the Packer has agreed to purchase and the Raisin Administrative Committee has agreed to sell the quantity of natural condition raisins specified herein for use in fulfilling the sales contract described below, such purchases and sales to be subject to the terms and conditions of the above named agreement and offer.
	VARIETAL TYPE: NATURALS
	Pack Style			# Cases	Packed Weight	Replacement	Total Qualified
						Factor *	Packed Weight
			TOTAL QUALIFIED PACKED WEIGHT
			NATURAL CONDITION WEIGHT
				SHRINKAGE ALLOWANCE
				TOTAL PACKED WEIGHT		0.94509		LBS.
				GROSS AMOUNT @ $ .			$
				LESS: STATE ADVERTISING @ $ .01			$
				AMOUNT DUE:			$
				PROGRAM # (*):
				COUNTRY:
				EXPORTER / IMPORTER:
INTENDED SHIPMENT DATE/RAC 21 MONTH & REPORT NUMBER
PACKER REFERENCE NO./USDA CERTIFICATE NUMBER OR MEMO REPORT OF INSPECTION NUMBER
					(Must agree with Reference No. on Truck & Ocean Bills of Lading)
	The making of any false statement or representations in any matter within the jurisdiction of any agency of the
	United States, knowing it to be false, is a violation of Title 18, Section 1001, United States Code, which provides
	for a penalty of a fine of $10,000 or imprisonment of not more than five years, or both.
	PACKER:					By:	DATE:
	FOR RAC use only:				DATE:		Check No.