REPRODUCE LOCALLY. Include form number and date on all reproductions. OMB No. 0581-0177
CIAB
FORM
3
Cherry Industry Administrative Board
P.O. Box 388, DeWitt, MI 48820-0388
Nov.____
Dec. 10 Feb.
_____ Mar. 10
Period
Due
End
May
_____June 10
June
_____ July 10
Tel: 517/669-1070 Fax:
517/669-1260
Reports are due the 10th day of the month following each reporting period.
Place a check mark in the appropriate month.
Handler: Handler ID#
Address, City, State, Zip: Telephone No.:
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UTILIZATION |
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UNITS |
INVENT |
PACKED |
IH
TRANS. |
REPACKS |
SALES |
ENDING |
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FROZEN |
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5+1 1. |
30# |
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Variants of Sugar Pack |
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2. |
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3. |
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IQF 1. |
40# |
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2. |
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3. |
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DRYING STOCK |
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5+1 1. |
30# |
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Variants of Sugar Pack |
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2. |
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3. |
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IQF 1. |
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2. |
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3. |
40# |
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Other (describe) |
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OTHER |
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1. |
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2. |
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WATERPACK |
6 / #10 |
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24 / #300 |
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Other (describe) |
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PIFILL |
6 / #10 |
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12 / # 2 |
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Other (describe |
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DRIED |
Pounds |
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PUREE |
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Concentrated (30 Brix) |
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Single strength |
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JUICE |
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Concentrate (68° Brix) |
Gallons |
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Concentrate (0, 68° Brix) |
Gallons |
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*Juice Stock |
Pounds |
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Juice Stock (0 RPE) |
Pounds |
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Single Strength |
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OTHER (Describe and list) |
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1. |
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2. |
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TOTALS |
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- |
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Please provide additional information on the reverse side for IH-transfers and/or repacks.
The undersigned hereby certifies to the CIAB and the Secretary of Agriculture, USDA, that this is a true and correct statement of the sales
activity of this Handler for the relevant period.
By: 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 0581-0177. The time required to complete this information collection is estimated to average
23 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.
Transfers of product between handlers – Please post any inter-handler transfers of products in which you were involved during the reporting period. If you are the receiving handler in this transaction, your entry should show an increase in the “IH Trans. +/-” for the item purchases. The seller in the transaction should show a decrease in their inventory for this item. |
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Product Bought or sold |
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Selling Handler |
Receiving Handler |
Form |
Type |
Units |
1 |
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2 |
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3 |
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4 |
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5 |
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Repacks and Re-manufactures – Please account for any remanufacturing of cherry products in which you were involved during the reporting period. The products you manufactured should be reflected as an increase to the “Repacks” as a positive figure when compared to your report from the prior period. The products from which you manufactured the new product should be reflected as a negative entry in the “Repacks” column |
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FROM |
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INTO |
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Source Product |
# of Units |
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End Product |
# Units |
1 |
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3 |
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4 |
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5 |
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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.
CIAB Form 3 (Exp. 1/31/2024) Destroy previous versions.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Zeng, Weiya - AMS |
File Modified | 0000-00-00 |
File Created | 2023-08-24 |