MAN-BAL National Mango Board domestic Producer Nomination Ballot

Approved OMB No. 0581-0093

NATIONAL MANGO BOARD (7 CFR 1206)

DOMESTIC PRODUCER NOMINATION BALLOT

The nominees listed on this ballot are seeking a seat on the National Mango Board (NMB). As a domestic producer, you are asked to vote for xxx candidates. Please mark your selection and completely fill in the information requested.

Mail this ballot in time for it to be received by NMB on or before XX, 20XX. Submissions received after this date will not be counted.

NATIONAL MANGO BOARD

Street

City, State Zip Code

Please select XXX names from the list of nominees:

 XXX

 XXX

 XXX

 XXX

Certification Statement:

I certify that I produced Mangos at the location listed below during the twelve-month period of January 1, 20XX through December 31, 20XX.

Signature: __________________________________ Date: ___________________

Print Name: __________________________________________________________

Address: _____________________________________________________________

City: ________________________ State: ______ Zip code: ____________________

Phone: ________________________

(Continued on Back Page)

MAN-BAL (09/07)

(Domestic Producer)

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 0581-0093. The time required to complete this information collection is estimated to average 15 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.

MAN-BAL (09/07)

(Domestic Producer)

Approved OMB No. 0581-0093

NATIONAL MANGO BOARD (7 CFR 1206)

FIRST HANDLER NOMINATION BALLOT

The nominees listed on this ballot are seeking a seat on the National Mango Board (NMB). As a first handler, you are asked to vote for xxx candidates. Please mark your selection and completely fill in the information requested.

Mail this ballot in time for it to be received by NMB on or before XX, 20XX. Submissions received after this date will not be counted.

NATIONAL MANGO BOARD

Street

City, State Zip Code

Please select XXX names from the list of nominees:

 XXX

 XXX

 XXX

 XXX

Certification Statement:

I certify that I handled Mangos at the location listed below during the twelve-month period of January 1, 20XX through December 31, 20XX.

Signature: __________________________________ Date: ___________________

Print Name: __________________________________________________________

Address: _____________________________________________________________

City: ________________________ State: ______ Zip code: ____________________

Phone: ________________________

(Continued on Back Page)

MAN-BAL (09/07)

(First Handler)

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 0581-0093. The time required to complete this information collection is estimated to average 15 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.

MAN-BAL (09/07)

(First Handler)

Approved OMB No. 0581-0093

NATIONAL MANGO BOARD (7 CFR 1206)

IMPORTER NOMINATION BALLOT

The nominees listed on this ballot are seeking a seat on the National Mango Board (NMB). As a mango importer, you are asked to vote for candidates in each of the four Districts. Please mark your selections and completely fill in the information requested.

Mail this ballot in time for it to be received by NMB on or before XX, 20XX. Submissions received after this date will not be counted.

NATIONAL MANGO BOARD

Street

City, State Zip Code

Please select XXX names from the list of nominees for District I:

XXXX  XXXX 

XXXX  XXXX 

Please select XXX names from the list of nominees for District II:

XXXX  XXXX 

XXXX  XXXX 

Please select XXX names from the list of nominees for District III:

XXXX  XXXX 

XXXX  XXXX 

Please select XXX name from the list of nominees for District IV:

XXXX  XXXX 

XXXX  XXXX 

Certification Statement:

I certify that I imported Mangos at the location listed below during the twelve-month period of January 1, 20XX through December 31, 20XX.

Signature: __________________________________ Date: ___________________

Print Name: __________________________________________________________

Address: _____________________________________________________________

City: ________________________ State: ______ Zip code: ____________________

Phone: ________________________

(Continued on Back Page)

MAN-BAL (09/07)

(Importer)

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 0581-0093. The time required to complete this information collection is estimated to average 15 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.

MAN-BAL (09/07)

(Importer)

NATIONAL MANGO BOARD (7 CFR 1206)

FOREIGN PRODUCER NOMINATION BALLOT

The nominees listed on this ballot are seeking a seat on the National Mango Board (NMB). As a foreign producer, you are asked to vote for xxx candidates. Please mark your selection and completely fill in the information requested.

Mail this ballot in time for it to be received by NMB on or before XX, 20XX. Submissions received after this date will not be counted.

NATIONAL MANGO BOARD

Street

City, State Zip Code

Please select XXX names from the list of nominees:

 XXX

 XXX

 XXX

 XXX

Certification Statement:

I certify that I exported Mangos to the United States at the location listed below during the twelve-month period of January 1, 20XX through December 31, 20XX.

Signature: __________________________________ Date: ___________________

Print Name: __________________________________________________________

Address: _____________________________________________________________

City: ________________________ State: ______ Zip code: ____________________

Phone: ________________________

(Continued on Back Page)

MAN-BAL (09/07)

(Foreign Producer)

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 0581-0093. The time required to complete this information collection is estimated to average 15 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.

MAN-BAL (09/07)

(Foreign Producer)