FV-136 Producer Referendum Ballot (Hazelnuts)

HAZELNUT 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

TO HAZELNUT PRODUCERS:
Marketing Order No. 982, regulating the handling of Hazelnuts grown in Oregon and Washington, requires
the Secretary of Agriculture to conduct a referendum approximately once every 10 years to ascertain whether
producers favor continuance. 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
ballots postmarked later than
strict confidence.
, Referendum Agent
Phone: (503) 326-2724

through
. Please vote promptly because
, cannot be opened or counted. Each ballot will be held in

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

OMB No. 0581-0178

PRODUCER REFERENDUM BALLOT
Marketing Order No. 982: Hazelnuts Grown in Oregon and Washington
Please read the enclosed VOTING INSlRUCTIONS AND RULES GOVERNING PRODUCER EllGIBIL/IT
TO VOlE before completing this bal/ot.
This referendum is being held to determine producer support for the federal 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 than two-thirds of the volume
represented in the referendum favor continuance.

A.

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

DYES

DNO

PRODUCER ELIGIBILITY STATEMENT
B.

I hereby certify that I am currently a producer of hazelnuts within the production area and that during

the representativeperiod

, through

on
Tons

, I producedfor the ftesh market:

In
Acres

County(ies)

c.
Name of Packing House(s) that
Handled your Hazelnuts

Tons

Affiliation
(co-op or independent)

D.

Phone Number

Producer's Name
Name of Business
Mailing Address
City

E.

State

Zip

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.

D Partnership D LLC D Corporation D Association D Other
Signature*

Title

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

F.

I hereby certify that the information I provided on this baUot 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 infonnation provided in this ballot is required to detennine voter eligibility and vote of hazelnut
producers. Falsification of infonnation 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 ns.c. 1001).
According to the PaperwotX Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a
collection of infonnation unless it displays a valid OMB control number. The valid OMB control number for this information collection is 05810178. 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 (Bmille, 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.

FV-136

(12/06)

HAZELNUT BALLOT
UNITED STATES DEPARTMENT OF AGRICULTURE
Agricultural Marketing Service
Fruit and Vegetable Programs
Northwest Marketing Field Office
1220 SW 3RD AVE STE 385
POR1LAND OR 97204-2807

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

HAZELNUT BALLOT

VOTING INSTRUCTIONSANDRULES GOVERNINGPRODUCER ELIGffiILITY TO VOTE
L

VOTING PERIOD:

through

II.

REPRESENTATIVE PERIOD:

III.

PRODUCTION AREA:

IV.

PERSONS ELIGffiLE TO VOTE: Any person who is currently a hazelnut producer in the
production area and produced such hazelnuts 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.

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 trom 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. Certify your hazelnut production by listing the volume in tons that you produced, the number of
acres in production, and the county or counties in which such hazelnuts 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 hazelnuts, the tonnage, and affiliation (co-op
or independent).
D. Print or type your name, phone number, business name, and address.
E. Proxy voting is not authorized. Ifballot 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

.