No Form number (989) RAC CA. Raisins - Assignment of Pool Equity

OMB No. 0581-0178

ASSIGNMENT OF POOL EQUITY

Assignor (producer, etc.):		Assignee (handler, processor, etc.):
Name:		Name:
Address:		Address:

Date: __________________, 20___ Quantity and Type of Raisins:

Crop Year: 20___ ___________________________________________

TO: RAISIN ADMINISTRATIVE COMMITTEE ___________________________________________

2445 Capitol Street, Suite 200 ___________________________________________

Fresno, California 93721 ___________________________________________

For valuable consideration, the receipt of which is hereby acknowledged, the above-named Assignor hereby assigns to the above-named Assignee that portion of his interest, as hereafter set forth, in any net proceeds distributed by the Raisin Administrative Committee (RAC) pursuant to section 989.66(h) of Marketing Order No. 989, with respect to raisins delivered to the RAC by Assignor during the crop year specified above, including refunds or credits accruing with respect to expenses incurred in connection with such raisins.

This is an assignment of _________________________ interest in said interest. (Specify assignment in either quantity or money if this is less than complete delivery to Assignee).

The RAC is authorized to pay the proceeds as hereinabove described to said Assignee.

The Assignor warrants that said raisins are his sole and absolute property, free from all encumbrances, except _____________________________________________________________________________________________.

The above assignment is hereby assented to: (Note: Assignor’s signature must be witnessed).

Name
Name		Assignor
Other persons holding an interest in the raisins		Witness

THE RAC HAS NOT ASCERTAINED WHETHER THERE MAY BE OTHER LIENS OR SECURITY INTERESTS ON SAID RAISINS OR THEIR PROCEEDS, AND CANNOT GUARANTEE THE PRIORITY OF THIS ASSIGNMENT. ASSIGNEE IS SOLELY RESPONSIBLE FOR PERFECTING THIS ASSIGNMENT UNDER APPLICABLE LAW.

A copy of the assignment has been received on this date: ________________________, 20___

RAISIN ADMINISTRATIVE COMMITTEE

By: _______________________________________

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.

(Exp. x/xxxx) Destroy previous editions.