Avocado Administrative Committee Handler Ballot to Nomin

REPRODUCE LOCALLY. Include form number and date on all reproductions.

OMB No. 0581-NEW

UNITED STATES DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE
FRUIT AND VEGETABLE PROGRAMS

Avocado Administrative Committee, Marketing Order 915
Handler Ballot to Nominate Members and Alternate Members
for District I or District II
(please circle the applicable District)

I hereby cast my ballot for ( ) of the following nominees to serve as member ( ) and alternate member ( ) to represent Handler(s)
from District I or District II on the Avocado Administrative Committee, Marketing Order 915 during the term of office
(please circle the applicable District)

that begins April 1, 20
and ends March 31, 20 ___. Mark the ballot for no more than ( ) of the nominees listed below by
voting your volume of shipments from the calendar year 20___ as supplied by the Committee in the volume box next to the
nominee's name.
Nominee Name

Volume

Nominee Name

Volume

**PERSONS VOTING BY MAIL MUST SIGN THIS BALLOT FOR IT TO BE VALID.
I certify that I am a District I or District II Handler registered with the Avocado Administrative Committee in Homestead,
Florida.
(please circle the applicable District)

____________________________________________________________________________________
(Name of person voting - please print)

_______________________________________________________________________________
(Signature of Person Voting)
Return ballots must be postmarked by no later than _______. Ballots received, postmarked after ________will not be considered.
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-NEW. The time required to complete this information collection is estimated to average
5 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.
The U.S. Department of Agriculture (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 means for communication of program
information (Braille, large print, audiotape, etc.) should contact USDA’s TARGET Center at (202) 720-2600 (voice and TDD). To file a complaint of discrimination, write to USDA,
Director, Office of Civil Rights, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal
opportunity provider and employer.