FV-177 CA. Almonds (Handler Nominee Questionnaire)

OMB No. 0581-0178

REPRODUCE LOCALLY. Include torm lUunber and date on all reproductions.
UNITED STATES DEPARTMENT OF AGRICULTIJRE
AGRICULTURAL MARKETING SERVICE
FRUIT AND VEGETABLE PROGRAMS

CONFIDENTIAL ALMOND BOARD OF CALIFORNIA
HANDLER NOMINEE QUESTIONNAIRE
The Secretary of Agriculture needs the following information for consideration in connection with your nomination to serve on the Almond
Board of California under Federal Marketing Order No. 981. Statutory authority to obtain such information is provided in 7 U.S.C. 608.
Failure to provide this information may hinder your selection by the Secretary.
PLEASE FILL IN ALL SPACES AND SIGN YOUR NAME

I.

Name

2.

Mailing Address
(Street)

3.

Telephone Nwnber (include area code)

4.

Almond handler with which you are associated:

(Cily)

(Slate)

(Zip)

(a) Name and address of firm

(b) Your position with firm:

(c) Number of years experience in position
5.

Nwnber of years experience in almond industry
I am willing to serve on the Almond Board of California if selected by the Secretary of Agriculture.
{Signafure)

(Date)

Marketingorder committee members, in their offidal capacities, are prohibited from taking any action specificallydesigned to influencelegislation,includingany
attempt to influencepublicopinionconcerninglegislation. Committee members may not communicatewith any officialof a State or Federal legislativebody for
the purpose of attempting to influencelegislation. Committee members are also prohibitedfrom attempting to influence State or Federalgovernmentactions
or policiesor those of foreign governments, except as specificallyauthorized under the marketing order or expressly approved by the Secretary.
Committee members are specificallyprecluded from authorizingthe expenditureof marketingorder funds for the purpose of attempting to influencelegislation
or government actions. These same prohibitionsapply to committee managers, staff, and contractors, except that committee managers may consultwith the
Department of Agricultureemployees during the pendencyof informalrulemakingactions.
If marketing order committee or subcommittee members or committee employeesare sued individuallyor jointly for errors in judgement, mistakesor other acts
either of omission or commission(except for acts of dishonesty, willfulmisconduct,or gross negligence) in the conduct of their duties under the marketing
agreement or order, they may be authorized legal defense by the Departmentof Justice (DOJ). Alternatively,legal defense may be providedthrough private
counsel, if recommended by the Department of Agriculture(USDA)and approved by DOJ. USDAand OOJenjoy an excellentworkingrelationshipwith respect
to providinglegal representation for committee members and employees, either by DOJor through authorized private counsel. USDAIs committedto a
comprehensive legal defense policyfor all committee members and employees acting withinthe scope of their authorized committee duties and responsibilities.
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 2 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. Depamnent 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) 79532?2 (voice) or (202) 720-6382 (TDD). USDA is an equal opponunity provider and employer.

FV-177 (05/04)