FV-156 Producer Referendum Ballot (Vidalia Onions)

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FORM APPROVED

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OMB NO. 01581-0178

UNlI'ED STAUS DEPAR'l'MENT 011'AGBICVLnJRB
AGRICULTURAL MARKETJNGSERVICE
FRurr AND VEGBTABLBPROGRAMS

OFFICIAL PRODUCER BALLOT
MARKETINGORDERNO. 955
VIDALIAONIONSGROWNIN GEORGIA
Tbk ballot willbe held In strict conlldence. Be sure Parts 0, m aud IV of your ballot are completed. Uuslped ballots, or
baDo8B
that C8IIDot
be validatedbecauseParts n. m and IV are IDcomplete,will not be counted.
PART I. REFERENDUM INSTRUCTIONS

A.

REFERENDUMPERIOD: Mardll,

through March 31,

, is the referendum period duriDg which

producersmayvoteon thismarketingorder.
For this marb1ing order to mntinl1f11.it must be supported by at least two-tbirds of the producers voting or at least two-Ibirds
of die volume of Vidalia Onion production represented by 1hose voting in the referendum.

B.

ELlGJBJLrrY ItEQVIREMENTS: Any person who produc:edVidalia Onions for market during the period of Jaauary 1,
through August 15,

, aod who is now a producer. is eligible to vote. Such persons may vote on the

cont1mul_ of 1beMarhting Order using die attached ballot.
1.

A producer (or grower) is defined as: (a) any personwho producesVidalia Onioosin tho designatedproduction area
(

); (b) a renter or tenant of

acreageproduciogVidalia Ooioas for market; or (c) a landlord who received from a renter or teDaDtVidalia Onions
as rent for the land on which such Vidalia Onions ~eIe grown. A cash landlord. lienholder, or person having only
a finaDcialinterest in the crop is DOtan eligible voter..

C.

2.'.

A businessunit. partnership, family enterprise. corporation. association. estate, or firm may vote. Each such entity
is entitled to ODevote.

3.

Proxy voting is DOtauthorized.

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INSTRUCTIONS FOR VOTING: Provide the voter information requested in Part n. In Part m, mark the block for or
against the Marketing Order. Certify your vote by signingthe appropriate section of Part IV. If you do not complete Parts
n. m. and IV. your ballot cannot be validated. and your vote will not-be counted.

Remove the pages COfltJIinif1g
Parts U. m. and IV. and return in the envelope provided.

FV-156 (06104)

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FORM

PARI' U

APPROveO

- OMBNO.0581-0178

-VOTER INFORMATION

'Ibis information wi11be held in strict confidence.

A.

Your name

B.

What is the specific location of your Vidalia Onion acreage represented in this ballot?

(Please print clearly)

(Highway or street address. if applicable, and county)

(City. State, and ZIP Code)

C.

Do you reside on the above property which produces the Vidalia Onioos? (
your ~
address aDdtelephooe number:

) Yes

(

) No If DO,pleaseprovide

(Street and No. or R.F.D. No.. City. State. and ZIP Code)
(Telephone number (Area Code»
D.

If you are DOtvoting as an individualproducer. please check the appropriate box indicatingyour voting status and write the
name and address

(

of the business

) Partnership

(

~

you represent.

) Corporation

(

) Other (Specify)

(Name and address .of business UDit)

E.

What is the number of SOpound bags of Vidalia Onions. or equivalent. you produced for market during the period
.?

through
F.

What is the number of acres of Vidalia Onioos you harvested during the period.

through

.

.?

G.

bags.

acres.

WhichpacJdnghouse(s)
handledyourVidaliaOnioDS
duringthere~ve

period?

(Name and address of packinghouse(s»

FV-156

(06104)

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FORM APfIIK)VED

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OMB NO. 0581.0178

PART m. RBI'ERBNDUMQUFsnONS
-YES8 vote meaas JOIII1'8in favor of die Marketina Order for V1da1ia00i0DI GIown in 0ecqiL
-NO. vocemeaDI you are not in &vOl"of die MarbdDa Older for VidaUa0IIi0DaGrown in Geoqia.
Do JOG

tile MarbdD& on.

far VId8IIa 0aI0a8 GrowIIID Gecqlat

(

) YES

(

) NO

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PART IV VOTBII.uYI:unCATION
All informadoG provided in dda ballot wUl be subject to oo-site verifk:aIioG by ofticWa of die Office of IDspec10r Geoenl.
Departmeat of ApicultuIe.

U.S.

Tbe iDtormaIioD OIl1bJs baDot II required to det.ermiD8 voter eUgibili1y aud vole of Vidalia OnIon producen. paJaitkalioD of
iDformation oalhla govemmeat documeDt may result in a fiDe of DOtmore tban $10,000 or JmprisoDmeDt for DOtmore dum tive (5)

years. or both (18 U.S.C. 1001).

A.

.

Your sipature, if sipliDa81an iDdividual.
I am d8 producer Damed in Put D of tbIa ballot. aDd I certify tbat I am DOta cash IaDd1cmI.1J~lPder,
cmIy a fiDIDcia1inIeJeIt in d8 Crop, aDd tbat die informatioD provided on tbIa baiIot ad any II"-~
aDd comet to die beat of mylalow1edl8.

(Date)

(SfsDIIum)

B.

If siaDiD881 die repIe8eIIWiveof a producing

or penon haviDa
hereto II accaraI8

eJdityotber Iban an iDdividual,desipaJe your title aDdsip below.

I am die rep1eleldative aamed in Part D D of tbia ballot: A partner castiq die ba1Iotfor a partDenhip; or an officer or
eDIp10yeecutiDa die ballot for a coopo1ative888OCiadaa,cxnporatioD.scboOl,iIII1itPdoa.or similar busiDeu uait; 01'die
Sldmmtmator. eucmur. or trustee casdq die ballot for a pIOduciDaestate;
by lipiDs dda ballot. I a;ree to pJOVid8

.'

evideace dteleof lit die IeCpJestof an audIOIb:ed apat of die Secretary of Agricu1tme.

(Sipature

aDd title)

iIALLoTS PoS'I'MARUD AlI'TER
COUNTEDIN THE REJ'ERENDUM.

(Date)
..

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. WILL Nm BB

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 unlus It displays a valid OMB control number. The valid OMB control number for this information
coUection Is 0581-0178. The time required to compkte this information collection is estimated to average 20 minutes per response,
Including tJuItimefor reviewing Instructions, searching IDCisting
data sources, gathering and maintaining the data needed. and
compkting 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 applicabk. sex, marital status,familial status. parental status. religion, sexual orientation,
genetic information, political beliB/i. reprisal. or becouse aUor pari of an individual's income is dertvedfrom any public assistance
program (Not aUprohibited bases apply to aUprograms.) Persons with disabilities who require alternative meansfor communication
of program Information (Brallk. large print. audiotape. etc.) should contact USDA's TARGEI' Center at (202) 720-2600 (voice and
TDD). Tojiz. a complaint of discrimination. write to USDA. Director, Office of Civil Rights, 1400 Independence Avenue, S.w..
WashingtOll,Q.C. 20250-9410, or caU (800) 795-J272 (voIce) or (202) 720-6J82 (IDD). USDA Is an equal opportunity provider and
employer.

FV-158 (06/04) (DestrOY previous editions)

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