LS-379 Referendum Ballot

FORM APPROVED – OMB 0581-0093
UNITED STATES DEPARTMENT OF AGRICULTURE AGRICULTURAL MARKETING SERVICE REFERENDUM ON THE SORGHUM PROMOTION AND RESEACH ORDER BALLOT	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 0581-0093. The time required to complete this information collection is estimated to average 6 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. Department 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 from 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, 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). USDA is an equal opportunity provider and employer.
NOTE: INSTRCUTIONS TO VOTERS (Please read carefully)
1. If voting as an individual, you must vote in the county Farm Service Agency (FSA) Office in the county in which you reside, or the county FSA Office serving the county in which you reside.
2. If voting on behalf of an entity (partnership, corporation, estate, etc.) you must vote in the county FSA office in which it is located, or the county FSA office serving the county in which it is located.
3. On the envelope marked "SORGHUM REFERENDUM," complete the required Registration information and sign the Certification Statement.
4. Mark the "Ballot" below.
5. Fold in half and insert into the envelope marked "SORGHUM BALLOT" and seal.
6. Insert the "SORGHUM BALLOT" envelope into the envelope marked "SORGHUM REFERENDUM," seal, and deposit into the "Ballot Box."
Do you support continuation of the Sorghum Promotion and Research Order?		YES	NO
NOTE: Insert this ballot into the envelope marked "Sorghum Ballot," seal, and place into the envelope marked "Sorghum Referendum."
LS-379