REPRODUCE LOCALLY. Include form number and date on all reproductions. OMB No. 0581-0291

APC Form 4 (Rev. 6/2018)

REPORT OF INTER-HANDLER TRANSFERS OF PECANS - FORM 4

Instructions

This report is submitted pursuant to 7 CFR 986.77 and 986.78 and is subject to audit verification by the American 

Pecan Council (7 CFR 986.79).

The completed form must be delivered to the American Pecan Council no later than the tenth day of the month.

Please note: If completing electronically, you need only to insert data in the blank WHITE cells. The form will

calculated any information in the SHADED cells. Once the information is entered, the column will be calculated 

automatically. If completing the form by hand, please calculate the total.

The following are instruction for completing APC Form 4 - Report of Inter-Handler Transfer of Pecans:

Month: Enter the month being reported upon.

Handler Number: Leave blank. APC staff will complete this section.

Inter-Handler Transfers (in pounds): 

1. Enter the weight of inshell pecans transferred for each type of pecan transferred.

2. If completing the form by hand, total the amount of assessment for each type transferred.

3. Check the box indicating which handler is responsible for paying the assessment.

UPON COMPLETION: Read the Certification Statement at the bottom of the form and write in/type the 

Handler/Company name. Sign and date the form in the spaces provided. Each party to the transfer is to retain a 

copy of the form and then fax or email it to the American Pecan Council.

§986.81 Confidential information. All reports and records submitted by handlers to the Council staff, which 

include data or information constituting a trade secret or disclosing the trade position, or financial condition or 

business operations of the handler, shall be kept in the custody of one or more employees of the Council and shall be 

disclosed to no person except the Secretary of Agriculture.

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 

0581-0291. The time required to complete this information collection is estimated to average 10 minutes per response, including the time for 

reviewing the instructions, searching existing data sources, gathering and maintaining the data needed, and completing and review 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.
REPRODUCE LOCALLY. Include form number and date on all reproductions. OMB No. 0581-0291

APC Form 4 (Rev. 6/2018)

This report is submitted is submitted pursuant to 7 CFR 986.62 and the reporting requirements of 986.77 and 

986.78, and is subject to audit verification by the American Pecan Council (7 CFR 986.79).

Month: _____________ Crop Year: _____________ Handler Number: _____________ 

(office use)

INTER-HANDLER TRANSFERS (in pounds)

Type of Pecans Assessment Rate Inshell Pounds 

Transferred

Assessment/Amount 

Owed

Improved 0.03 $0.00

Native/Seedling 0.02 $0.00

Substandard 0.02 $0.00

TOTALS 0.00 $0.00

Who is responsible for paying the assessment (check appropriate box)

Transferring Handler □ Receiving Handler □

This report of pecans transferred between handlers is submitted in compliance with the requirements of 7 CFR 

986.62. In executing this form, both handlers respectively certify to the Council, and to the U.S. Department of 

Agriculture, the correctness and completeness of their statements.

To be completed by Transferring Handler To be completed by Receiving Handler

___________________________________

(Name of Handler/Company)

______________________________

(Name of Handler/Company)

______________________________

Signature

__________________________

Signature

___________

Date

___________

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, of the United States Code, which 

provides for a penalty of a fine for individuals and for organizations or imprisonment, or both.