Cranberry Marketing Committee
Growers Notice of Intent to Produce & Qualifying for Annual Allotment Form
CMC Form AL 1 OMB: 0581-0103
Name: ___________________________________________________________
Company Name: ___________________________________________________________
Address: ___________________________________________________________
___________________________________________________________
Phone #: (____) __________________________________
________________ Acres.
harvest-season: _________ acres.
(Name of Handler)
Handler Name Amount (in barrels)
______________________________ ____________________
______________________________ ____________________
______________________________ ____________________
__________________________ _____________________
__________________________ _____________________
If someone holds title to the cranberry producing property, other than the individual/company selling the crop, by what arrangement is this accomplished?
_______________________________________________________
Trust, Lease, Etc.
I certify to the best of my knowledge that the information contained herein is complete and correct.
Signature:
_____________________________________ Date: _______________
Submitted in accordance with §929.49(d), Cranberry Marketing Order
BURDEN AND NONDISCRIMINATION STATEMENTS
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 0581-0103. 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. The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, gender, religion, age, disability, political beliefs, sexual orientation, and marital or family status. (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact USDAs TARGET Center at 202-720-2600 (voice and TDD). To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, Room 326-W, Whitten Building, 14th and Independent Avenue, SW, Washington, DC 20250-9410 or call (202) 720-5964 (voice and TDD). USDA is an equal opportunity provider and employer.