FV-283 FL. Tomotoes Background Questionnaire/Nominee Questionna

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FORM APPROVED OMB No. 0581-0178
u.s. DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE
FRUIT AND VEGETABLE PROGRAMS

MARKETING ORDER FOR TOMATOES GROWN IN FLORIDA
FLORIDATOMATOES- MARKETINGORDERNO.966
CONmDENTIALBACKGROUNDSTATEMENT
(For the Infonnation of Secretary of Agriculture)
Season POSmON: Member: _

FOR:

AIternate_ DISTRICT:2

3 4

1.

Name

2.

Address (Business)

3.

Have served previously as a member or alternate

4.

Years growing (if grower)

5.

Acres and last yearlls production (if grower)

6.

Membership in industry organizations

7.

Officeheld or anyother particular activityin past years connected with industryprograms

8.

Marketing order committee members, in their official capacities, are prohibited ITom taking any action
specifically designed to influence legislation, including any attempt to influence public opinion concerning
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 ITom 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.

Phone No. (

)

Committee members are specifically precluded ITom authorizing the expenditure of marketing order funds for
the purpose of attempting to influence legislation or government actions.
These same prohibitions apply to committee mangers, staff, and contractors, except that committee managers
may consult with the Department of Agriculture employees during the pendency of informal rulemaking
actions.
9.

If marketing order committee or subcommittee members or committee employees are sued individually or
jointly for errors in judgment, 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 Justice (DOJ).

FV-283 (07-07)

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Alternatively, legal defense may be provided through private counsel, if recommended by the Department of
Agriculture (USDA) and approved by DOl 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.
I am willing to serve on the Committee.

(Date)

(Signature)

NOTE: Accordingto the Paperwork ReductionAct of 1995, an agency may not conduct or sponsor, and a
person is not required to respond to a collectionof informationunless it displays a valid OMBcontrol
number. The validOMBcontrol number for this informationcollectionis 0581-0178. The time required to
complete this informationcollectionis estimated to average 5 minutes per response, includingthe time for
reviewing instructions, searching existing data sources, gathering and maintainingthe data needed, and
completing and reviewingthe collectionof information.
The U.S. Department of Agriculture(USDA)prohibits discriminationin all its programs and activitieson the
basis of race, color, national origin, age, disability,and where applicable, sex, marital status, familial
status, parental status, religion,sexual orientation, genetic information,politicalbeliefs, reprisal, or
because all or part of an individual'sincome is derived from any publicassistance program (Not all
prohibited bases apply to all programs.) Persons with disabilitieswho require alternative means for
communicationof 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) 795-3272 (voice) or (202) 720-6382 (TDD).
USDAis an equal opportunity provider and employer.

FV-283 (07-07)

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