CDGAC-1 925-CA Desert Grapes Organically Grown

OMB No. 0581-0189

CALIFORNIA DESERT GRAPE ADMINISTRATIVE COMMITTEE

82901 Bliss Avenue

Indio, CA 92201

Phone: (760) 342-4385

Fax: (760) 342-0485

Email: desertgrape@verizon.net

ORGANICALLY GROWN GRAPES

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The marketing of organically produced grapes below minimum size requirements shall be permitted only if the producer or shipper of such grapes has registered the organically certified vineyard with this the California Desert Grape Administrative Committee (Committee) prior to April 1 of each year. The producer or shipper must certify to the Committee the location of the grapes being grown by completing and returning this form to the Committee.

Name of Firm or Business

Mailing Address

City State Zip Code

Owner or Representative of Firm

Telephone Number

Actual Location of Vineyards Producing Organic Grapes

Number of Acres of Each Variety Being Grown

County Organic Registration Number County Organic Certification Number (required after 1992)

DEFINITION OF ORGANICALLY PRODUCED GRAPES: For the purpose of administering Marketing Order No. 925, regulating California desert grapes, organically produced grapes have been defined as those grapes produced and handled in accordance with the National Organic Program standards and labeled as “organic” or “100 percent organic” grapes.

INSPECTION REQUIREMENTS: The Federal-State Inspection Program office located in Coachella, California, is designated by the Committee as the official shipping point inspection agency. All organically produced grapes must be inspected by the agency prior to shipment for market and must meet a “U. S. NO. 1, TABLE GRAPE STANDARD” (except for size). The handler is required to deliver the grapes to the shipping point agency for inspection, or make arrangements for other inspection locations.

CONTAINER REQUIREMENTS: All grape shipments must be in new unused boxes or RPC’s, and labeled in accordance with National Organic Program regulations.

I certify that the above report is true and correct to the best of my knowledge and that I will abide by all regulations issued by the Committee in the harvest of my organically produced grapes.

_____________________________________________ _____________________________ ________________________

Signature Title Date

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 OMB 0581-0189. The time required to complete this information collection is estimated to average 10 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.

CDGAC-1 (Exp. X/XXXX) Destroy previous editions.