APC Form 6 Pecans Purchased Outside of the U.S.

REPRODUCE LOCALLY. Include form number and date on all reproductions

OMB 0581-NEW

PECANS PURCHASED OUTSIDE OF THE UNITED STATES
APC Form 6 - Instructions

This report is submitted pursuant to 7 CFR 986.177 and is subject to audit
verification by the American Pecan Council (7 CFR 986.79)
The completed form must be delivered to the American Pecan Council no later than the tenth day of the month.
Please note:
You need only insert data in the blank WHITE cells. The APC staff will complete any information in the 'SHADED' cells. If
completing the form electronically, once the information is entered, the column totals will be calculated automatically. If completing the
form by hand, the amounts you provide will be added to the data submitted in the previous periord and totaled by the APC staff.
The following are instructions for completing APC Form 6 - Pecans Purchased Outside of the United States
Month: Enter the Month being reported upon.
Handler Number: Enter the Handler Number
Current Period - Pecans Purchased Outside of the United States
1. Enter the date the purchased Pecans entered the United States
2. Enter the Country of Origin for the Pecans entering the United States
3. Enter the amount of Inshell, or Shelled Meats, in pounds, entering the United States
4. Report the Variety of any Inshell Pecans entering the United States
UPON COMPLETION: Read the Certification statement at the bottom of the form and write in/type the Handler/Company name. Then
sign and date the form in the spaces provided and fax or email to __________: Fax - (___) _________; Email _______________@_________

§986.81   Confidential information.
All reports and records submitted by handlers to the Council staff, which include data or information constituting a trade secret or disclosing the trade position, or
financial condition or business operations of the handler, shall be kept in the custody of one or more employees of the Council and shall be disclosed to no
person except the Secretary of Agriculture.

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-NEW. The time required to complete this
information collection is estimated to average 20 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.

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and
employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex,
gender identity (including gender expression), sexual orientation, disability, age, marital status, family/parental status, income derived from a public assistance
program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all
programs). Remedies and complaint filing deadlines vary by program or incident. Persons with disabilities who require alternative means of communication for
program information (e.g., Braille, large print, audiotape, American Sign Language, etc.) should contact the responsible Agency or USDA’s TARGET Center at
(202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available
in languages other than English. To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found
online at http://www.ascr.usda.gov/complaint_filing_cust.html and at any USDA office or write a letter addressed to USDA and provide in the letter all of the
information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: (1) mail: U.S.
Department of Agriculture Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue, SW Washington, D.C. 20250-9410; (2) fax: (202) 6907442; or (3) email: program.intake@usda.gov. USDA is an equal opportunity provider, employer, and lender.

ACP Form 6 (11/2017)

REPRODUCE LOCALLY. Include form number and date on all reproductions
Month: ___________________

OMB 0581-NEW

Handler Number: ___________ (office use)

PECANS purchased outside the United States
This report is submitted pursuant to 7 CFR 986.177 and is subject to audit
verification by the American Pecan Council (7 CFR 986.79)

Date Imported

Country of Origin

TOTALS

Shelled Meats (lbs)*

0

Inshell (lbs)
+
+
+
+
+
+
+
+
+
+
+
+
+
+
+

Inshell Variety

0

=
=
=
=
=
=
=
=
=
=
=
=
=
=
=

Total (Inshell Basis)
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00

*NOTE: Shelled Meats are converted to inshell using a yield of 50% (multiplying the shelled meats by '2'.) The form automatically makes this calculation

Upon completion, fax or email form to ____________: Fax - (___) ___-____; Email -____________@_________

(Name of Handler/Company)

(Handler Address)

Signature:

Date:

The making of any false statements 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, of the United States Code, which provides for a penalty
of a fine for individuals and for organizations or imprsonment, or both.
APC Form 6 (11/2017)