FV-176 CA. Almonds (Producer Nominee Questionnaire)

OMB No. 0581-0178

REPRODUCE LOCALLY. hlclude fonn number and date on all reproductions.
UNITED STATES DEPARTMENT OF AGRICULTORE
AGRICULTURAL MARKETING SERVICE
FRUIT AND VEGETABLE PROGRAMS

CONFIDENTIAL ALMOND BOARD OF CALIFORNIA
PRODUCER NOMINEE QUESTIONNAIRE
The Secretary of Agriculture needs the following information for consideration in connection with your nomination to serve on the Abnond
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.

MailingAddress

(Street)

3.

TelephoneNumber(includearea code)

4.

Numberof acresof almondsyou farm

5.

Numberofyearsyou bavebeena producerof almonds

6.

Did youproducealmondsduring the currentcropyear?

(City)

(State)

(Zip)

(Yes) or (No)

7.

List the handler(s) that currently handle your crop. If more than one handler, list percentages handled by each.

8.

List other deciduousfruit and nut crops and acreagein whichyou havean ownershipinterest:

I am willing to serve on the Abnond Board of California if selected by the Secretary of Agriculture.
(Signature)

(Date)

Marketing order conullittee members, in their official capacities, are prohibited &om taking auy action specifically designed to influence legislation, iucluding any attempt to
influence public opinion concerning legislation. Coumuttee members may not cOI1Ullunicatewith any official of a State or Federal legislative body for the purpose of attempting to
influence legislation. Comn1ittee members are also prohibited &001 attempting to influence State or Federal government actions or policies or those offoreign govenunents, except
as specifically authorized under the marketing order or expressly approved by the Secretary.
Conmuttee members are specifically precluded &om authorizing the expenditure of marketing order funds for the purpose of attempting to influence legislation or government
actions. These same prolubitions apply to committee managers, sta1l; and contractors, except that conUluttee managers may consult with the Department of Agriculture employees
during the pendency of infornlal rnlemaking actions.
If marketing order cOlllmittee or subcomnuttee members or committee employees are sued individually or jointly for errors in judgement, n1istakes or other acls either of omission
or conunission (except for acts of dishonesty, willful misconduct, or gross negligence) in the conduct of their duties under the marketing agreement or order, they may be authorized
legal defense by the Department of Justice (D01). Alternatively, legal defense may be provided through private counsel, if recommended by the Department of Agriculture
(USDA) and approved by DOJ. USDA and DOJ enjoy an excellent working relationship with respect to providing legal representation for comn1ittee members and employees,
either by DOJ or through authorized private counsel. USDA is conumtted to 4 comprehensive legal defense policy for all colIDmttee members and employees acting within the
scope of their authorized colIDluttee duties and responsibilities.
A:ccording to ~e 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
?Ispl~ys a vahd OMB control number. The valid OMB control number for this information collection is 0581-0178. The time required to complete this information collection
IS esbrnated to average 2 n1inutes per response, including the time for reviewing instructions, searching existing data sources, gatllering and maintaining the data needed and
completing and reviewing the collection of information.
'

The U.S. Department of Agriculture (USDA) prohibits discrin1ination in all its programs and activities on tile 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 witll 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 (TOO). USDA is an equal opportunity provider and employer.
FV-176
(05/04)