CIAB Form #1 Weekly Raw Product Report

W

CIAB

FORM #1

OMB # 0581-0177

Week Ending:

Final Report:

eekly Raw Product Report

C

herry Industry Administrative Board

P.O. Box 388, DeWitt, MI 48820-0388

Tel: 517/669-1070 Fax: 517/669-1260

Report receipts of fruit starting with the first week of harvest and pack and continue until the harvest is completed. The reporting week ends on Saturday. The report is due in the CIAB office by close of business Eastern time on Monday following each week of harvest. Please indicate the completion of harvest for each district from which you receive cherries when you are done in the district and the Final Report when you have completed your harvest.

Handler: Handler ID#

Address:

City, State Zip:

Telephone No.:

RAW PRODUCT RECEIVED By District of Production			WEEKLY PRODUCTION Total of Fruit Received		YEAR to DATE Total of Fruit Received		Harvest from District Completed
01	NW Michigan
02	WC Michigan
03	SW Michigan
04	New York
05	Oregon
06	Pennsylvania
07	Utah
08	Washington
09	Wisconsin
	TOTAL RECEIPTS:

The undersigned hereby certifies to the CIAB and the Secretary of Agriculture that this is a true and correct report of product received by the Handler for the indicated period.

By:

Title:

Date:

(see other side for additional information)

(REV 2013)

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