CIAB 6 Grower Diversion Application & Tart Cherry Orchard Map

CHERRY INDUSTRY ADMINISTRATIVE BOARD
GROWER DIVERSION APPLICATION
Crop Year 20__

OMB No. 0581-0177

To divert cherries in your orchard for Crop Year 20__, this form must be filed at the CIAB
office no later than _____ __, 20__. Along with this application, new and/or updated
orchard maps for the diverted blocks must also be submitted.
Name of Grower:
Address:
City:
Phone number: (
Email:

Grower #:
State
Cell number: (
)

)

Zip

This section must be completed. (Indicate all appropriate responses.)
(If you do not have any changes to your maps on file with the CIAB, this form does NOT need to
be returned.)
A.
B.

Attached are
Attached are

C.

I have removed the following blocks

revised orchard maps. The rest are the same.
new orchard maps.

(Number of maps)

I agree by participating in this diversion program that I will abide by the rules and regulations
hereby established by the Board for diversion.

Grower Signature:

Date:

Return by ______ ___, 20__ to:

Cherry Industry Administrative Board
2900 West Rd., Ste 102
East Lansing, MI 48823

Phone: (517) 669-1070
Email: info@cherryboard.org

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 0581-0177. The time required to complete this information collection is estimated to average 10 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.
CIAB Form 6 (Exp. 4/30/2027) Destroy previous versions.

OMB No. 0581-0177

CHERRY INDUSTRY ADMINISTRATIVE BOARD
TART CHERRY ORCHARD MAP

GROWER NAME:
ADDRESS:
BLOCK NAME:
Township:

CIAB #:
CITY:
BLOCK #:

__________ Section #: _____

COUNTY:

PHONE:
STATE:

__ T: _____ R: _____ S: _____

NEAREST CROSSROADS:
LOCATION DIRECTIONS:

ZIP:

(Example: T2N, R1W, S12)

and

GENERAL INFORMATION ABOUT THIS BLOCK OF CHERRIES
ACRES:

___ . __

SPACING: ___ x ___

EST. OF LIVE TREES REMAINING: ____ %
ROW NO. 1 IS ON THE

North

South

VARIETY: Montmorency
Balaton
(optional) Other
East
West SIDE OF THE FIELD.

PLEASE NOTE: PLEASE MAP THE BLOCK AS IT WAS ORIGINALLY PLANTED.
ROW
NO.

TREES IN
ROW

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20

YEAR
PLANTED

ROW
NO.

TREES IN
ROW

21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40

YEAR
PLANTED

ROW
NO.

TREES IN
ROW

YEAR
PLANTED

41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60

IF THE BLOCK IS LARGER THAN 60 ROWS, USE ANOTHER MAP FOR THE CONTINUATION AND INDICATE THAT
THE SECOND MAP IS A CONTINUATION OF THE FIRST. ATTACH OR DRAW MAP(S) THAT SHOWS BLOCK
LOCATION USING SECTIONS, TOWNS, ROADS, and/or OTHER IMPORTANT LANDMARKS SO THAT THE BLOCK
CAN BE EASILY FOUND.
I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT MAPPING OF THE ORCHARD TO WHICH IT APPLIES.

Grower Signature:

Date:

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, 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.

CIAB Form 6 (Exp. 4/30/2027) Destroy previous versions.