Amendment to Assessment -CIF yellow - Idaho

CIFA - 2-2004

AMENDMENT FORM

Commodity Indemnity Fund Warehouse Control Program

P.O. Box 7249 Boise, ID 83707 warehouse@isda.

Gross Dollar Payments

Year Quarter

Commodity

Gross Payments $ $ $ $ $ $ $ $

Multiplier x .002 x .002 x .002 x .002 x .002 x .002 x .002 x .002

TOTAL

Stored for Withdrawal

Year Quarter Commodity

CWT Withdrawn

Multiplier x .01 x .01 x .01 x .01 x .01 x .01 x .01 x .01 x .01

TOTAL

Pursuant to 69-258 (6), Idaho Code, the department shall collect, on assessments unpaid within the time limits specified in this chapter, interest at the rate of ten percent (10%) per annum until the assessments are remitted together with a penalty of five percent (5%) each month on the unpaid assessment due until the maximum penalty of twenty-five percent (25%) is reached.

SEND TO: Idaho State Department of Agriculture, Warehouse Control Program, with payment payable to the Idaho State Department of Agriculture.

I certify that the figures on this report are true and correct to the best of my knowledge and belief, and that they reflect all assessments due the Commodity Indemnity Fund collected by our company.

Signature______________________Position_________________Date_____________

Company Name_________________________________________________________

Submit

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