CWB 6 (984) CA. Walnuts - Report of Merchantable Wallnuts Ship

California Walnut Board OMB NO. 0581-0178

101 Parkshore Drive, Suite 250 CWB Form #6

Folsom, CA 95630 Due Date:

Ph (916) 932-7070 Fax (916) 932-7071 Month:

REPORT OF MERCHANTABLE WALNUTS

RECEIVED, COMMITTED, AND SHIPPED

This report of merchantable walnuts received, committed, and shipped is submitted in compliance with the requirements of the Federal Marketing Order No. 984, as amended. In executing this form, the handler respectively certifies to the California Walnut Board and to the U.S. Department of Agriculture as to the correctness and completeness of their statement.

Instructions: 1. Report walnut receipts (received from growers) for the month in Inshell pounds.

2. Report walnut purchase commitments (sales/not yet shipped) in Inshell and Shelled pounds.

3. Report inshell and shelled by domestic and export shipments (in pounds).

4. Report all export shipments by country of destination on the attached page.

5. If you did not have any receipts, commitments, or shipments, write “NONE” on the form.

6. Submit a copy to the California Walnut Board (CWB) office on or before______.

1. WALNUT RECEIPTS (received from growers)

Inshell Pounds

Conventional

Inshell Pounds

Organic

Received for the month of:

PURCHASE COMMITMENTS (sales/not yet shipped)
Inshell Pounds Conventional	Inshell Pounds Organic	Shelled Pounds Conventional	Shelled Pounds Organic

3. WALNUT SHIPMENTS

Inshell Pounds

Conventional

Inshell Pounds

Organic

Shelled Pounds

Conventional

Shelled Pounds

Organic

Domestic

Export

TOTAL

Handler: ___________________________________________________________________________

By: __________________________ Title________________________ Date: ___________________

The making of any false statements or representations in any matter within the jurisdiction of any agency of the United States, knowing it to be false, is a violation of Title 18, Section 1001, United States Code, which provides for a penalty of a fine for individuals and for organizations or imprisonment, or both.

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 5 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.

OMB NO. 0581-0178

Handler Name: _______________________________________ CWB Form #6

Due Date:

Month:

CONVENTIONAL SHIPMENTS BY COUNTRY OF DESTINATION

	INSHELL (lbs)	SHELLED (lbs)		INSHELL (lbs)	SHELLED (lbs)
MIDDLE EAST/AFRICA			NORTH AMERICA
Algeria			Canada
Bahrain			Mexico
Egypt			CENTRAL & SOUTH AMERICA
Iraq			Chile
Israel			Ecuador
Jordan			ASIA / PACIFIC RIM
Kuwait			Australia
Lebanon			China
Morocco			Hong Kong
Pakistan			India
Qatar			Japan
Saudi Arabia			Korea
Tunisia			Malaysia
Turkey			New Zealand
U.A.E.			Philippines
EUROPE			Singapore
Austria			Taiwan
Belgium			Thailand
Denmark			Vietnam
France
Germany			OTHER (please list):
Greece
Italy
Netherlands
Norway
Portugal
Spain
Sweden
Switzerland
U.K.
			TOTALS

OMB NO. 0581-0178

Handler Name:_______________________________________ CWB Form #6

Due Date:

Month:

ORGANIC SHIPMENTS BY COUNTRY OF DESTINATION

	INSHELL (lbs)	SHELLED (lbs)		INSHELL (lbs)	SHELLED (lbs)
MIDDLE EAST/AFRICA			NORTH AMERICA
Algeria			Canada
Bahrain			Mexico
Egypt			CENTRAL & SOUTH AMERICA
Iraq			Chile
Israel			Ecuador
Jordan			ASIA / PACIFIC RIM
Kuwait			Australia
Lebanon			China
Morocco			Hong Kong
Pakistan			India
Qatar			Japan
Saudi Arabia			Korea
Tunisia			Malaysia
Turkey			New Zealand
U.A.E.			Philippines
EUROPE			Singapore
Austria			Taiwan
Belgium			Thailand
Denmark			Vietnam
France
Germany			OTHER (please list):
Greece
Italy
Netherlands
Norway
Portugal
Spain
Sweden
Switzerland
U.K.
			TOTALS

CWB 6 (EXP. XXXX) Destroy Previous Versions