Lamb Promotion, Research and Information Board Remittance Report

Lamb Promotion, Research and Information Board Remittance Report

Information is required by 7CFR § 1280.223. Failure to report can result in a fine. Information provided in this report is held confidential under 7CFR § 1280.227.
Note: 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 0MB control number. The valid 0MB control number for this information collection is 0581-0093. The time required to complete this information collection is estimated to average 1 hour 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, age, disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part of an individual's income is derived from any public assistance program (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 USDA's TARGET Center at (202) 720-2600 (voice and TDD). To file a complaint of discrimination, write to USDA, Director, Office of Civil Rights, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.
REPORT AND REMITTANCE OF AMOUNT COLLECTED AND DUE ON SHEEP AND LAMBS

FOR THE PURPOSE OF THIS PROGRAM: A Lamb is defined as an ovine animal of any age, including ewes and rams.
Name

First NameLast Name
Company
Business Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area CodePhone Number
CLICK ONTHE APPROPRIATE TRANSACTION(S):

Live sheep or lambs purchased for slaughterExported sheep or lambsCustom slaughter or direct marketing of sheep or lambs
ASSESSMENTS ON LIVE SHEEP OR LAMBS DURING THE MONTH OF , 20 20 .
NUMBER OF SHEEP OR LAMBS ASSESSED
Enter the total number of head.
TOTAL POUNDS OF LIVE SHEEP OR LAMBS
Number of sheep or lambs x weight.
TOTAL (POUNDS X ASSESSMENT RATE OF $.007)
This field populates automatically.
TOTAL SHEEP OR LAMBS SLAUGHTERED
(First handler fee, rate of $0.42 per head.)
TOTAL
This field populates automatically.
TOTAL ASSESSMENTS
This field populates automatically.
LATE PAYMENT
Total assessments x.02 = Late Payment
TOTAL REMITTANCE
This field populates automatically.
If the assessment is less than the total pounds of live weight sold, explain:
CERTIFICATION STATEMENT

I declare under the penalties provided by law, that this report has been examined by me and to the best of my knowledge and belief is a true, correct and complete report. I also certify that I am authorized to sign this report.
RESPONDING OFFICIAL'S NAME

First NameLast Name
SIGNATURE

Clear
DATE

MonthDayYear
Date

My Products

USDTOTAL REMITTANCE AMOUNT

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Should be Empty:

Lamb Promotion, Research and Information Board Remittance Report

REPORT AND REMITTANCE OF AMOUNT COLLECTED AND DUE ON SHEEP AND LAMBS

CERTIFICATION STATEMENT