FV-50 Producer Referendum Ballot (CO Potatoes)

COLORADO POTATO BALLOT
UNITED STATES DEPARTMENT OF AGRICULTURE
Agricultural Marketing Service
Fruit and Vegetable Programs
Northwest Marketing Field Office
1220 SW 3RD AVE SUITE 385
PORTLAND OR 97204-2807

__________
TO COLORADO POTATO PRODUCERS:
The U.S. Department of Agriculture is conducting a referendum to determine whether potato producers in
Colorado favor continuance of Federal Marketing Order No. 948. As a consequence, an order directing that
a referendum be held was published in the Federal Register on __________.
A Producer Referendum Ballot is on the reverse side of this page. Also enclosed are:
1) Voting Instructions and Rules Governing Producer Eligibility to Vote;
2) News Release issued on the Referendum; and
3) Copy of the Referendum Order dated __________.
The voting period for the referendum is __________ through __________. Please vote promptly because
ballots postmarked later than __________, cannot be opened or counted. Each ballot will be held in
strict confidence.
__________, Referendum Agent
Phone: (503) 326-2724

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

OMB No. 0581-0178

PRODUCER REFERENDUM BALLOT
Marketing Order No. 948: Irish Potatoes Grown in Colorado
Please read the enclosed VOTING INSTRUCTIONS AND RULES GOVERNING PRODUCER ELIGIBILITY
TO VOTE before completing this ballot.
This referendum is being held to determine producer support for the federal marketing order regulating the
handling of potatoes grown in Colorado. The Secretary of Agriculture will consider termination of this order
if less than two-thirds of those voting and less than two-thirds of the volume represented in the referendum
favor continuance.

A.

Do you favor continuance of Marketing Order No. 948, regulating the handling of potatoes grown in
Colorado?

… YES

… NO

PRODUCER ELIGIBILITY STATEMENT
B.

I hereby certify that I am currently a producer of potatoes within the production area and that during
the representative period __________, through __________, I produced for the fresh market:
____________________ on _____________ in ___________________________________________
Hundredweight

Acres

County(ies)

C.
Name of Packing House(s) that
Handled your Potatoes

Hundredweight

Affiliation
(co-op or independent)

D.

Producer’s Name ________________________________ Phone Number _____________________
Name of Business __________________________________________________________________
Mailing Address ___________________________________________________________________
City _______________________________ State ________________________ Zip _____________

E.

If this ballot is cast by an officer or employee of a partnership, LLC, corporation, association or other
business unit, my signature below further certifies that I am duly authorized to vote on behalf of the
producing entity name on this ballot and that I will submit evidence of such authority at the request of
an Agent of the Secretary.
Partnership

LLC

Corporation

Association

Other ____________________

___________________________________

_______________________________________

Signature*

Title

_________________________________________________________________________________
If Partnership or Joint Venture, list name(s).

F.

I hereby certify that the information I provided on this ballot is accurate and correct to the best
of my knowledge.

___________________________________

_______________________________________

Signature*

Title

*Your signature certifies that you have the authority to take such action and will submit supplementary evidence of such authority
at the request of an agent of the Secretary of Agriculture. The information provided in this ballot is required to determine voter
eligibility and vote of potato producers. Falsification of information on this government document may result in a fine of not more
than $10,000 or imprisonment of not more than five (5) years, or both (18 U.S.C. 1001).
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to
respond to collection of information unless it displays a valid OMB control number. The valid OMB control number for this
information collection is 0581-0178. The time required to complete this information collection is estimated to average 20 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 USDA, Director, Office of Civil Rights, 1400 Independence Avenue, SW,
Washington, DC 20250-9410 or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider
and employer.
FV-50 (12/06)

COLORADO POTATO BALLOT
UNITED STATES DEPARTMENT OF AGRICULTURE
Agricultural Marketing Service
Fruit and Vegetable Programs
Northwest Marketing Field Office
1220 SW 3RD AVE STE 385
PORTLAND OR 97204-2807

Referendum Agent
USDA-AMS-F&V-NWMFO
1220 SW 3RD AVE STE 385
PORTLAND OR 97204-2807

¡FOLD HERE, TAPE AT THE TOP, AND MAIL PROMPTLY ¡

COLORADO POTATO
BALLOT

VOTING INSTRUCTIONS AND RULES GOVERNING PRODUCER ELIGIBILITY TO VOTE

I.

VOTING PERIOD: __________ through __________

II.

REPRESENTATIVE PERIOD: __________ through __________

III.

PRODUCTION AREA: State of Colorado.

IV.

PERSONS ELIGIBLE TO VOTE: Any person who is currently a fresh potato producer in the
production area and produced such potatoes during the representative period __________ through
__________, is entitled to cast one ballot. Each separate business unit, partnership, LLC, family
enterprise, corporation, association, estate, or firm is entitled to one vote.
“Producer” means any individual, partnership, LLC, corporation, association, institution, estate, or
other business unit who:
ƒ
ƒ
ƒ

V.

Owns and farms land resulting in ownership of the potatoes produced thereon;
Rents and farms land resulting in ownership of all or a portion of the potatoes produced thereon;
or
Owns land from which, as rental for such land, ownership is obtained of a portion of the potatoes
produced thereon. (A lien holder, cash landlord, or person having only a financial interest in the
potato crop is not eligible to vote.)

HOW TO VOTE:
A. Indicate your vote by placing an “X” in the appropriate box.
B. Certify your fresh potato production by listing the volume in hundredweight that you produced,
the number of acres in production, and the county or counties in which such potatoes were
produced during the representative period __________ through __________. If you are renting
on a share-crop basis, you should show only that part of the crop represented by your share.
C. List the names of packing houses that handled your potatoes, the hundredweight, and affiliation
(co-op or independent).
D. Print or type your name, phone number, business name, and address.
E. Proxy voting is not authorized. If ballot is cast by an officer or employee of a partnership, LLC,
corporation, association or other business unit, check box to indicate your business designation,
and sign to indicate authority to vote. If partnership or joint venture, list names of partners.
F. Sign below the certification. Incomplete or unsigned ballots cannot be counted. Fold your ballot
so the Referendum Agent’s address is displayed, seal with tape and mail to Referendum Agent,
USDA-AMS-FV-NWMFO, 1220 SW 3RD AVE STE 385, PORTLAND, OR 97204-2807. For
further information, please call (503) 326-2724.

Ballots must be postmarked by __________.