FV-34 Certificate of Privilege

REPRODUCE LOCALLY. Include form number and date on all reproductions.

OMB No. 0581-0178

IDAHO-EASTERN OREGON ONION COMMITTEE
PO Box 909, PARMA, ID 83660
PHONE: 208-722-5111 FAX: 208-722-6582
CERTIFICATE OF PRIVILEGE
APPLICATION TO MAKE SPECIAL PURPOSE SHIPMENTS
The Marketing Order for onions requires that handlers desiring to make shipments outside the production area to
canners, dehydrators, extractors, freezers, and/or pickers, which do not meet the requirements for fresh shipments,
shall prior to making such a shipment apply to the Idaho-Eastern Oregon Onion Committee (Committee) for
permission. A shipment may be made to a receiver without a COP Permit number, if the sale occurs after 5 pm, on a
holiday, or weekend; provided, that both the handler and receiver have had prior approval and this Application is
faxed to the Committee prior to shipment.
Receiver &
Phone
Agent
Contact Person(s)
Address
City
Shipment Purpose
Type of Sale

State
Canning

Dehydration

Spot Sale

Zip

Extracting

Freezing

Contract Sale

Pickling

Experimentation

Total cwt.

Shipment Date(s)
Container(s)

50 lb bags

Totes

Bins

Bulk

Other:

I, the undersigned, hereby certify to USDA and to the Committee, that I have read, fully understand, and agree to comply with 7
CFR § 958.328 which governs the handling of onions, and further agree that none of these special purpose onions will be
diverted to any fresh market outlet(s) except as expressly authorized by the Committee. To the best of my knowledge all
statements in this Application are true and complete. In addition, I will prepare an Onion Diversion Report for each Application
and submit it to the Committee. The Committee reserves the right to audit the receiver or their agent randomly to verify
shipments. Falsification of information on this government document may result in a fine, imprisonment, or both (18 U.S.C.
1001).

Signature

Name

Title

Date

Firm

Phone:

Address
City

APPROVED

State

Zip

COMMITTEE ACTION
NOT APPROVED Reason not approved: _________________________________________

COP Permit No. __________________

Date Approved: ________________

Manager: _____________

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 0581-0178. The time
required to complete this information collection is estimated to average 8 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.
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age,
disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs,
reprisal, or because all or part of an individual’s income is derived from any public assistance program (Not all prohibited bases apply to all programs.)
Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact
USDA’s TARGET Center at (202) 720-2600 (voice and TDD).
To file a complaint of discrimination, write to USDA, Director, Office of Civil Rights, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410,
or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.

FV-34 (Rev. 11/2011. Destroy previous editions.)