CMC Trf-20XX-20XX 929-Cranberries Acreage & Sales History Transfer (Seller

OMB No. 0581-0189

C RANBERRY MARKETING COMMITTEE

219A Main Street

Wareham, MA 02571

Phone: (508) 291-1510

Fax: (508) 291-1511

SELLER’S TRANSFER FORM

20___ CROP YEAR

SELLER INFORMATION Grower No. _________________

Name:

Business Name (or D/B/A):

Address:

Telephone No.:

BUYER INFORMATION Grower No. _________________

Name:

Business Name (or D/B/A):

Address:

Telephone No.:

1. Effective date of the transfer: ____________________________ (day/month/year)

2. □ If this if a TOTAL transfer of the Seller’s cranberry acreage, ALL of the Seller’s cranberry-producing acreage and the prior year’s cranberry production used in calculating sales history, will be automatically transferred to the Buyer. Sign, date, and return this form to the Cranberry Marketing Committee. In addition, legal documentation must accompany the Leased Acreage Form, showing the transfer/sale of the cranberry acreage. Transfers will not be processed without attached legal documentation.

3. □ If this is a PARTIAL transfer of the Seller’s cranberry acreage, complete (1) through (4) below. NOTE: Whenever there is a partial transfer of cranberry-producing acreage, the Buyer and Seller must denote on their respective transfer forms: (1) the amount of cranberry-producing acreage being transferred; and (2) the amount, in barrels, of sales history attributable to the acreage being transferred for each of the crop years shown below. In addition, legal documentation must accompany the Leased Acreage Form showing the transfer/sale or the cranberry acreage. Transfers will not be processed without attached legal documentation.

   1. Total amount of cranberry-producing acreage owned by Seller: ________ acres

   2. Amount of cranberry-producing acreage being transferred to Buyer: ________ acres

   3. Remaining amount of cranberry-producing acreage retained by Seller after transfer: ________ acres

   4. Indicate below, the amount of production, in barrels, attributable to the acreage received for each of the crop years shown.¹

Crop Year	20___	20___	20___	20___	20___	20___
Barrels

I hereby certify that to the best of my knowledge, the information contained herein is true and accurate.

Seller’s signature ________________________________ Date __________________

¹ Note: Prior crop years’ production must be transferred by the Buyer.

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 12 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.

CMC Trf-20___/20___ (Exp. X/XXXX) Destroy previous editions.