FV-136A Cooperative Association Referendum Ballot (Hazelnuts)

VOTING INSTRUCTIONS AND RULES GOVERNING PRODUCER ELGffiIL TV TO VOTE

I.

VOTING PERIOD:

through

II.

REPRESENTATIVE PERIOD:

III.

PRODUCTION AREA:

IV.

PERSONS ELIGIBLE TO VOTE: Any cooperative association engaged in the handling of hazelnuts
grown in the production area during the representative period. Section 608c(l2) of the Agricultural Marketing
Agreement Act of 1937 provides, in part, that the Secretary of Agriculture shall consider the approval or
disapproval by any cooperative association, bona fide engaged in the marketing of the commodity covered by
the subject marketing order, as the approval or disapproval of the producers who are members of, stockholders
in, or under contract with, such cooperative association. Cooperative associations are defined in the CapperVolstead Act (7 U.S.C. 291, 292). Each separate business unit, partnership, LLC, family enterprise,
corporation, association, estate, or firm that is a member of the cooperative association is entitled to one
vote.

through

States of Oregon and Washington

"Producer" means any individual, partnership, LLC, corporation, association, institution, estate, or other
business unit who:

··
·

V.

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

HOW TO VOTE:
A. Indicate your vote by placing an "X" in the appropriate box.
B. Print or type the information requested under the eligibility statement. All information must be provided
to ensure the validity of the ballot.
C. Sign below the certification. Incomplete or unsigned ballots cannot be counted.
Attach to the ballot a list of hazelnut producers in the production area who are currently members of,
stockholders in, or under contract with the cooperative association named herein as of the date this ballot is
cast, and who produced hazelnuts for market during the representative period. For each such producer provide
the following:
a. Address (street and house number, rural route number, city, state, zip code).
b. Volume of hazelnuts produced for fresh market during the representative period in tons.
Attach to the ballot a certified copy of the resolution of the Board of Directors authorizing the individual
signing this ballot to cast the ballot on behalf of the cooperative association.
Mail the completed ballot, producer list, and corporate resolution in the enclosed envelope and return to
Referendum Agent, USDA-AMS-FV-NWMFO, 1220 SW 3RD AVE STE 385, PORTLAND, OR 972042807. For further information, please call (503) 326-2724.

BaUots must be postmarked by

REPRODUCE LOCALLY. Include form number and date on all reoroductions

OMB No. 0581-0178

COOPERATIVE ASSOCIATION REFERENDUM BALLOT
Marketing Order No. 982: Hazelnuts Grown in Oregon and Washington
Please read the attached V011NG INSlRUC110NS AND RULES GOVERNING PRODUCER ELlGIBIUIY
TO VOTE before completing this ballot. This referendum is being held to determine producer support for the
feperal marketing order regulating the handling of hazelnuts grown in Oregon and Washington. The
Secretary of Agriculture will consider termination of this order if less than two-thirds of those voting and less
th~ two-thirds of the volume represented in the referendum favor continuance.
A.

Do you favor continuance of the Marketing Order No. 982, regulating the handling of hazelnuts
grown in Oregon and Washington?

DYES

DNO

COOPERATIVE ASSOCIATION ELIGmILITY
B.

Contact Name

STATEMENT

Phone Number

Name of Cooperative Association
Mailing Address
City

State

Zip

What is the total tons of hazelnuts produced in the production area by the
member producers of this cooperative association during the representative
period of
through
?
What is the total number of producers for which this cooperative association
is casting this ballot?
C.

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 baJlot is required to determine voter eligibility and vote of hazelnut 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 a 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 ftom 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, andiotape, 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.

FV-136A(I2106)