CMC AL-1 929-Cranberries Growers Notice of Intent to Produce & Qu

OMB No. 0581-0189

C RANBERRY MARKETING COMMITTEE

219A Main Street

Wareham, MA 02571

Phone: (508) 291-1510

Fax: (508) 291-1511

GROWERS NOTICE OF INTENT TO PRODUCE

AND QUALIFY FOR ANNUAL ALLOTMENT

Name: ________________________________________ Grower No.: ____________________

Address:

Phone No.:

Will you be harvesting a crop during the 20___ crop year? □ YES □ NO

I you answered “yes,” please complete questions 1 through 9 below, sign, date, and return the form. If you answered “no,” disregard questions 1 through 9, sign, date, and return form.

1. How many existing, previously harvested cranberry producing acres will be harvested during the 20___ crop year? ___________________ acres

2. How many new acres, not previously harvested cranberry producing acres will be harvested during the 20___ crop year? _________________ acres

3. What is the total acreage, existing and new, that will be harvested during the 20___ crop year? _____________________ acres

4. Is all the existing and/or new acreage denoted in Question 3 owned, leased, or owned and leased?

□ Owned □ Leased □ Owned & Leased

5. Is any of the existing acreage denoted in Question 1, which will be harvested during the 20___ crop year, five or less years old? □ Yes □ No

6. If your answer to Question 5 is “yes,” indicate the number of acres that are five years old or less. _______________________ acres. Break down this acreage figure by “year planted” and by “year of first harvest” below.

Year Planted	Year of First Harvest
	Crop year	Crop year	Crop year	Crop year	Crop year	Crop year	Crop year
Crop year
Crop year
Crop year
Crop year
Crop year
Crop year

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 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.

7. I will deliver all of my 20___ crop year allotment (crop) to ______________________________ (Name of Handler.)

8. If you will be splitting your 20___ crop year allotment among more than one handler, provide the name of each handler below, to whom your crop will be delivered.

9. Who holds the title to the property where the cranberries are being produced?

□ I do □ Other (specify) __________________________________________________

*If someone hold the title to the cranberry producing property other than the individual/company selling the crop, by what arrangement is this accomplished?

□ Lease □ Trust □ Other (specify) ______________________________

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

________________________________________________ __________________________

Signature Date

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 AL 1 (Exp. X/XXXX) Destroy previous editions.