CDAC-5 (987) CA Dates--Report of Handler Carry-over

OMB No. 0581-0178

Send one signed copy no later than March 10/October 10 to:

CALIFORNIA DATE ADMINISTRATIVE COMMITTEE

P.O. Box 1736

Indio, CA 92202-1736

Tel: (760) 347-4510 Fax: (760) 347-6374

REPORT OF HANDLER CARRYOVER

The following quantities of dates were held by me for my account (whether or not sold) on:

□ March 1, 20___ □ October 1, 20___

	Deglet Noor	Halawy	Khadrawy	Zahidi
	State in terms of whole dates (divide quality of pitted dates by .83 to determine whole date equivalent quantity)
Marketable Dates
Certified Dates on Hand
Certified Domestic and Canadian (DAC)
Certified Further Processing (FP)
Certified Export (EXP)
Certified Products (report only certified product still in whole date form, not finished product. Include certified products acquired for manufacturing from other handlers)
Graded Dates on Hand
Graded for Domestic and Canadian, Further Processing
Graded for Export
Graded for Products
Field Run Held
Estimate of Domestic and Canadian, Further Processing content
Estimate of Export content
Estimate of Products content
Marketable Sub-total
Non-Marketable Dates
Culls awaiting pick-up
Estimate of field run culls
Non-Marketable Sub-total
Total Dates Held

I hereby certify to the U.S. Department of Agriculture and to the California Date Administrative Committee that the information contained in this report is complete and accurate.

Handler: ___________________________________________ Date: _______________________________

By: _______________________________________________ Title: _______________________________

The making of false statement or representation on this form, knowing it to be false, is a violation of title 18 section 1000 of the United States Code, which provides for the penalty of a fine or imprisonment, or both. This report is required by law (7 USC 608(d), 7 CFR 987.51, 987.151). Failure to report can result in a fine for each violation and each day during which such violation continues shall be deemed a separate violation.

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 30 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) 690-7442; or (3) email: program.intake@usda.gov. USDA is an equal opportunity provider, employer, and lender.

CDAC-5 (Rev. 01/2017) Destroy previous editions.