920-Kiwifruit Official Ballot

~

OMB No. 0581-0189

KIWIFRUIT

ADMINISTRATIVE

COMMITTEE

DISTRICT
VOTING INFORMATION
The KAC and the USDA are selectingmembers and alternates on the KAC. If you
are currently a producer of California kiwifruit in the district noted above, you may
vote for one of the producer candidateslisted in each category on the attached
ballot, or you may write in a candidate of your choice in the spaceprovided (who
must be an eligible kiwifruit producer). Indicate your choice of candidate by
marking the appropriate box.
After completing the ballot and the certification of voter eligibility ~please mail
them to:
u.s. DEPARTMENT OF AGRICULTURE
AGRICULTURAL
MARKETING SERVICE
MARKETING FIELD OFFICE
2202 MONTEREY STREET ~# 102-B
FRESNO, CA 93721

BY

.

Your ballot and certification will be treated with confidentiality. Please call the
KAC at (559) 638-5951 or USDA at (559) 487-5901 if you have any questions
concerning this election procedure.

KAC

BALLOT
ENCLOSED
OFFICIAL

KAC BALLOT

DISTRICT

AL'

Ballots must be ostmarked no later than

SEAT!
MEMBER CANDmATE
0
CandidateNam~ City, State

0
Write-in Candidate, if desired
AL TERNA TE MEMBER CANDIDATE

0

Candidate Name, City, State

0
Write-in Candidate, if desired

SEAT 2
AL TERNA TE MEMBER CANDIDATE
0
CandidateNam~ City, State

0
Write-in Candidate, if desired
CERNATE MEMBER CANDIDATE

0
0

Candidate Name, City, State
Write-in Candidate, if desired

Seeback of ballot for candidate statements. The "Certification of Voter Eligibility" below ~
comoleted to validate this ballot.
CERTIFICATION OF VOTER ELIGmILITY
Pleaseprovide the information requestedbelow. This ballot may be invalidated if this certification is not complete.

I,

(print name)

,of

(print complete address)

do hereby certify that I am currently a producer of kiwifruit.
Name(s)of handler(s) who have marketed my kiwifruit during the current season:

---

be

Signature

Date

According to the Paperwork Reduction Act of 1995, an age1K:Ymay 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 0581-0189. 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 ofinformation.
The U.S. Department ofAgriculture (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 meansfor communication ofprogram information (Braille, large print, audiotape, etc.) should contact USDA's TARGET Center at (202) 720-2600 (voice
andTDD). Tofile a complaintofdiscrimination,
write to USDA, Director, Office ofCivil Rights, 1400 Independence Avenue, S.w:, Washington, D.C. 20250-9410, or
call (800) 795-3272 (~ice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.

Candidate Name~ Alternate Member Candidate~ Seat 2
Statement)