FV-57 Spearmint Oil (Producer Member/Alternate Member) Backgro

OMB No. 0581-0178

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

U.S. DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE
FRUIT AND VEGETABLE PROGRAMS

SPEARMINT OIL ADMINISTRATIVE COMMITTEE
100 N Fruitland, STE B
Kenniwick, WA 99336

CONFIDENTIAL
BACKGROUND STATEMENT
(PRODUCER MEMBER)

MARKETING ORDER NO. 985

COMMITTEE YEAR

POSITION

DISTRICT
Name

Telephone

Business Mailing Address (include city, county, State, and ZIP)

Years growing
Speannint acreage
Membership in industry organizations

Marketing order committee members, in their official capacities, are prohibited from taking any action specifically designed to influence legislation, including any
attempt to influence public opinion conceming legislation. Committee members may not communicate with any official of a State or Federal legislative body for the
purpose of attempting to influence legislation. Committee members are also prohibited from attempting to influence State or Federal government actions or policies or
those of foreign governments, except as specifically authorized under the marketing order or expressly approved by the Secretary. Committee members are specifically
precluded from authorizing the expenditure of marketing order funds for the purpose of attempting to influence legislation or government actions. These same
prohibitions apply to committee managers, staff, and contractors, except that committee managers may consult with the Department of Agriculture (USDA) employees
during the pendency of informal rulemaking actions.
If marketing order committee or subcommittee members or committee employees are sued individually or jointly for errors in judgement, mistakes or other acts, either
of omission or commission (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 lustice (001). Alternatively, legal defense may be provided through private counsel, if recommended
by USDA and approved by 001. USDA and 001 enjoy an excellent working relationship with respect to providing legal representation for committee members and
employees, either by DOlor through authorized private counsel. USDA is committed to a comprehensive legal defense policy for all committee members and
employees acting within the scope of their authorized committee duties and responsibilities.

I am willing to serve on the Speannint Oil Administrative Committee.

(Date)

(Signature)

The above information is required to determine the eligibility and willingness of the nominee to serve on the committee.
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. 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 belieft. 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 meansfor communication of program information (Braille. large

print. audiotape. etc.) should contact USDA 's TARGET Center at (202) 720-2600 (voice and TDD). TolUe a complaint of discrimination. write to USDA. Director. Office of Civil Rights. 1400
Independence

Avenue. S. w.. Washington.

FV-57 (12/06)

D.C. 20250-9410.

or call (800) 795-3272 (voice) or (202) 720-6382 (TDD).

USDA is an equal opportunity

provider and employer.