Transcription of Grain Commodity Vendor deClaration - GTA
1 Grain Commodity Vendor deClarationVendor S detailSname: _____address: _____town : _____tel : _____Fax: _____email: _____national Grower registration (nGr) no: _____BUyer S detailSname: _____address: _____town : _____tel : _____Fax: _____email: _____Grain detailS represented by this declarationCommodity: _____Variety: _____Quantity: _____Variety: _____Quantity: _____Variety: _____Quantity: _____Variety: _____Quantity: _____delivery Period: _____Contract number (where applicable) _____a I certify that the property on which the Grain is grown or storage facility in which the Commodity has been stored carries accreditation under an independently audited QA program which includes chemical residue management and that the name of the program is as follows: Quality assurance Program _____accreditation/Certification number _____OrB I certify that the Grain delivered against this receipt: has not been treated with a pickling compound or other seed treatment;And/or has not been treated with any fumigant/pesticide/insecticide.
2 Or has been treated as detailed below: in accordance with the registered label of those chemicals; at rates not exceeding the maximum rates set out on the label; the withholding period for those chemicals has been appliedrateapplication datethe Grain represented on this Commodity Vendor deClaration is: 1. free from GMO s as defined by 99% GMO free; or 2. Is free from GMO s as defined by 95% GMO free; 3. Contains greater than 5% s signature: _____ date: _ _ /_ _ /_ _ _ _ BdoCUment id: GTA. For GTA member use only.
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