FV-50A Cooperative Assoc. Referendum Ballot (CO Potatoes)

REPRODUCE LOCALLY. Include form number and date on all reproductions

OMB 0581-0178

COOPERATIVE ASSOCIATION REFERENDUM BALLOT
Marketing Order No. 948: Irish Potatoes Grown in Colorado
Please read the attached VOTING INSTRUCTIONS AND RULES GOVERNING PRODUCER ELIGIBILITY
TO VOTE before completing this ballot. This referendum is being held to determine producer support for the
federal marketing order regulating the handling of potatoes grown in Colorado. 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 the Marketing Order No. 948, regulating the handling of potatoes grown
in Colorado?

… YES

… NO

COOPERATIVE ASSOCIATION ELIGIBILITY STATEMENT
B.

Contact Name _________________________________

Phone Number _____________________

Name of Cooperative Association _____________________________________________________
Mailing Address ___________________________________________________________________
City _______________________________ State ________________________ Zip _____________
What is the total hundredweight of potatoes produced for fresh market 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 ballot is required to determine voter eligibility and vote of potato 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 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 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) 7202600 (voice and TDD). To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, 1400 Independence Avenue, SW, Washington, DC
20250-9410 or call (800) 795-3272 (voice) or (202) 720-5964 (TDD). USDA is an equal opportunity provider and employer.
FV-50A (12/06)

VOTING INSTRUCTIONS AND RULES GOVERNING PRODUCER ELGIBILTY TO VOTE
I.

VOTING PERIOD: __________ through __________

II.

REPRESENTATIVE PERIOD: __________ through __________

III.

PRODUCTION AREA: State of Colorado

IV.

PERSONS ELIGIBLE TO VOTE: Any cooperative association engaged in the handling of potatoes grown
in the production area for the fresh market during the representative period. Section 608c(12) 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 Capper-Volstead 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.
“Producer” means any individual, partnership, LLC, corporation, association, institution, estate, or other
business unit who:
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V.

Owns and farms land resulting in ownership of the potatoes produced thereon;
Rents and farms land resulting in ownership of all or a portion of the potatoes produced thereon; or
Owns land from which, as rental for such land, ownership is obtained of a portion of the potatoes produced
thereon. (A lien holder, cash landlord, or person having only a financial interest in the potato 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 Colorado potato 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 potatoes for fresh 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 potatoes produced for fresh market during the representative period in hundredweight.
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.

Ballots must be postmarked by __________.