F/H Form F(2) Hazelnut Ballot (Growers)

HAZELNUT MARKETING BOARD
21595-A Delores Way N.E.
Aurora, OR 97002-9738

(fold line)

-------------------------------------------------------------F/H Fonn F(2)

BALLOT
(To be submitted ONLY by eligible growers)
Please write in the name of one grower from your district who you would like to have represent growers from
your district on the Hazelnut Marketing Board. This election is for a two year term beginning July 1,

DISTRICT NO.

CANDIDATE NAME
This ballot must be postmarked not later than April 30,
hazelnuts during the past season in the district noted above.

Print Name

Address

. I hereby

certify that I produced

County in which
orchard is located
City

Signature

State

Zip

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 awmge 3 minutes per response, Including the time for reviewing Instroctions, 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 aUIts programs and acfMtIes 011the basis of race, color, national origin, age, disability, and where applicable, sex, marttaJ status, famlltal 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 ass/stance progrem (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of
program Information (Braille, tarpe print, audiotape, etc.) should contact USDA's TARGET Center at (202) 720-2600 (voice and TOO). To flle a complaint of
discrimination, write to USDA, Director, Offlce of Civil Rights, 1400 Independence Avenue, S. w., Washington, D. C. 20250-9410, or call (800) 795-3272 (voice)
or (202) 720-6382 (TDD). USDA Is an equal opportunity provider and employer.

IMPORTANT
The following growers have been nominated to serve on the Hazelnut marketing Board from the districts noted. The person
receiving the highest number voters in a district will be the member and the person receiving the second highest number of
votes will become the alternate member. Growers may vote foe only one candidate and are eligible to vote only for a
candidate in a district in which they produce hazelnuts. Any eligible grower can be elected to the Board. A grower need not
be nominated and his/her name does not need to appear below for himlher to be eligible to serve. Write-in candidates are
permissible. The Board encourages qualified women, minorities, and physically challenged candidates to participate and
seek membership.

NOMINEES
DISTRICT NO.1 (State of Washington, Clackamas, and Multnomah Counties)
1.
2.
DISTRICT NO.2 (Marion and Polk Counties)
1.
2.
DISTRICT NO.3 Linn, Lane, and Benton Counties)
1.
2.
DISTRICT NO.4 (Yamhill County)
1.
2.

DISTRICTNO.5 (Washingtonandall otherCounties)
1.
2.
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HAZELNUT MARKETING BOARD
21595-A Delores Way N.E.
Aurora, OR 97002-9738