FV-52 CO. Potatoes Confidential Background Statement

OMB NO. 0581-0178
u.s. DEPARTMENT OF AGRICULTURE
AGRICULTIJRAL MARKETING SERVICE
FRUIT AND VEGETABLE PROGRAMS

COLORADO POTATO ADMINISTRATIVE COMMITTEE

CONFIDENTIAL BACKGROUND STATEMENT
(COMMITTEE MEMBER)
MARKETING ORDER NO. 948

PosmON

DISTRICT

Name

COMMITTEE YEAR
Telephone Nwnber

Business Address

(If you are a handler, also show your finn's name and in what capacity you serve in such finn.)

Years growing (if grower member)
Potato acreage (if grower member)
Years handling (if handler member)
Approximate cwt. handled (if handler member)
Membership in industry organizations

Marketing order committee members, in their official capacities, are prohibited trom 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 trom 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 &om 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, stafI;
and contractors, except that committee managers may consult with the Depamnent of Agriculture (USDA) employees during the pendency of informal rulemaking actions.
Ifmarketing 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 Depamnent of Justice (001). Alternatively, legal defense may be provided through private counsel, ifrecommended by 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 oftheir
authorized committee duties and responsibilities.

I am willing to serve on the Colorado Potato Administrative Committee.

(Signature)

(Date)

The above Information is required to detennine 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 5 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. Depamnent 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 ftom 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, audio tape, 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, SW, Washington. DC 20250-9410 or call (800) 795-3272 (voice) or (202) 7206382 (TDD). USDA is an equal opportunity provider and employer.
FV-52 (07/07)