FV-90 So. Texas onions Background Questionnaire/Nominee Questi

FORM APPROVED

-OMB NO. 0581-0178

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

CONFIDENTIAL BACKGROUND STATEMENT
(Onions Grown in South Texas)

I.

NAME (Please print)

2.

BUSINESS ADDRESS (City, County, State, and ZIp)

3.

TELEPHONE NUMBER (Include area code)

E-MAIL ADDRESS

FAX NUMBER (Include area code)

4b. LAST SEASON'S CROP

48. YEARS GROWING TIDS COMMODITY (ifproducer)

Total Production

Acres

4d. APPROXIMATE QUANTITY HANDLED UNDER TIDS PROGRAM

4c.

YEARS HANDLING TIDS COMMODITY (if hondler)

4e.

FIRM NAME AND YOUR POSITION

5.

HAVE SERVED PREVIOUSLY AS (Mark "X" in appropriate box):

6.

MEMBERSIDP IN INDUSTRY ORGANIZATIONS

7.

OFFICES HELD OR ANY OTHER PARTICULAR ACTIVITY IN PAST FEW YEARS CONNECTED WITH INDUSTRY PROGRAMS

o

COMMITTEE MEMBER

0

ALTERNATE MEMBER

COMMENTS

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 concerning legislation. Committee members may not comnnmlcate with any official of a State or Federal legislative body for the purpose of attempllng 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 employees during the
,endenc of Informal rul
. actions.
H marketing order committee or subcommittee members or committee employees are sued individually or Jointly for errors in Judgement, mIQakes or other acts either of C>IIIImonor
commission (except for acts of dishonesty, wlliful 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 (DOJ). 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 committee members and employees, either by DOJ or
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.

CERTIFICATION STATEMENT: I cenify I meet the eligibility requirements of the Order and I am willing to serve on the conmnttee.

(Signature)

(Date)

Accorond to a collection of intarnotion
unI
it 5 minutes per
r""POOSe, including the time for reviewing instructions. searching e>dsting data sources, gathering and maintaining the dala needed. and completing and reviewing the collection of
intormation.
The U.S. Department of Agriculture (USDA)prohibits clscrimination In all its programs and activities on the basis of race. color, national origin, OQ9, clsabilitv, and where applicable,
&eX,marital status, familial status, parental stalus, religion. sexual orientation. genetic Infarnotion, political bellets, reprisal, or because all or part of an Individual's Income Is derived from any
public assistance program (Nol all prohibited bases apply to all programs.)
Persons with clsabllities who require alternotlve means for convnunlcalion
of program intormation (Braille. large
print. audiofape,
etc.) should contact USDA's TARGErCenter aI (202) 72()..2600 (voice and TDD). 10 file a complaint of discrimination. write to USDA. Director. Office of Civil Rights, 1400
Independence
Avenue, S,W., WlO1IhIngton. D.C, 20250-9410, or call (800) 795-3272 (voice) or (202) 72()"6382 (foo). USDAIs an equal oppoffi.wlity provider and employer.

FV-90 (12/06)