Form FV-240A Pistachio Amendment Ballot

REPRODUCE LOCALLY. Include form number and date on all reproductions. OMB No. 0581-0215

United States Department of Agriculture

Agricultural Marketing Service

Fruit and Vegetable Programs

California Marketing Field Office

2202 Monterey Street, Suite 102-B

Fresno, CA 93721

PISTACHIO

BALLOT

__________

TO PISTACHIO PRODUCERS:

The U.S. Department of Agriculture is submitting, for producer consideration, proposed amendments to Marketing Order No. 983 (Order), regulating the handling of pistachios grown in California, Arizona, and New Mexico. The proposed amendments will not be made effective unless they are favored by at least two-thirds of the eligible producers voting in this Referendum or by producers representing at least two-thirds of the volume of pistachios voted in the Referendum. If approved, the proposed amendments would:

(SUMMARY OF AMENDMENTS TO BE PROVIDED HERE)

A Producer Referendum Ballot is on the reverse side of this page. Also enclosed are:

1. Voting Instructions and Rules Governing Producer Eligibility to Vote;

2. The news release announcing the referendum; and

3. A copy of the Referendum Order dated (_______, 20___).

The voting period for the referendum is (_______, 20___) through (_______, 20___). Please vote promptly because ballots postmarked later than (_______, 20___) cannot be opened or counted. Each ballot will be held in strict confidence.

___________________, Referendum Agent

Phone: (559) 487-5901

PRODUCER REFERENDUM BALLOT

Marketing Order No. 983

Pistachios Grown in California, Arizona and New Mexico

Please read the enclosed VOTING INSTRUCTIONS AND RULES GOVERNING PRODUCER ELIGIBILITY TO VOTE before completing this ballot.

1. This referendum is for amendment of the marketing order. Indicate your vote by placing an ‘X’ in the appropriate box.

YES 	NO 	1) Do you favor amending the order to ______?
YES 	NO 	2) Do you favor amending the order to ______?
YES  YES 	NO  NO 	3) a. Do you favor amending the order to ______? b. Do you favor amending the order to ______?
YES 	NO 	4) Do you favor amending the order to ______?
YES 	NO 	5) Do you favor amending the order to ______?
YES 	NO 	6) Do you favor amending the order to ______?
YES 	NO 	7) Do you favor amending the order to ______?
YES 	NO 	8) Do you favor amending the order to ______?
YES 	NO 	9) Do you favor amending the order to ______?
YES 	NO 	10) Do you favor amending the order to ______?

VOTER CERTIFICATION ELIGIBILITY STATEMENT

2. I hereby certify that I am an eligible producer of pistachios and that during the representative period (______, 20___), through (______, 20___), I produced:

______________________ on _____________ in _________________________ in ____________________

Pounds (assessable weight) Acres County/Counties State/States

(SIGNATURE REQUIRED BELOW – SECTION D)

C. Producer’s Name ________________________________ Phone Number __________________

Name of Business __________________________________________________________________

Mailing Address ___________________________________________________________________

City _______________________________ State ________________________ Zip _____________

D. If this ballot is cast by an officer or employee of a partnership, corporation, association or other business unit, my signature below further certifies that I am duly authorized to vote on behalf of the producing entity name on this ballot and that I will submit evidence of such authority at the request of an Agent of the Secretary.

Partnership LLC Corporation Association Other ____________________

___________________________________ __________________________________

Signature* Title

_________________________________________________________________________________

If Partnership or Joint Venture, list name(s).

E. I hereby certify that the information I provided on this ballot is accurate and correct to the best of my knowledge.

___________________________________ _______________________________________

Signature* Title

*Your signature certifies that you have the authority to take such action and will submit supplementary evidence of such authority at the request of an agent of the Secretary of Agriculture. The information provided in this ballot is required to determine voter eligibility and vote of California, Arizona and New Mexico producers.

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0581-0215. The time required to complete this information collection is estimated to average 20 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.

PLACE STAMP

HERE

POST OFFICE

WILL NOT

DELIVER

WITHOUT

POSTAGE

PISTACHIO BALLOT

UNITED STATES DEPARTMENT OF AGRICULTURE

Agricultural Marketing Service

Fruit and Vegetable Programs

Marketing Field Office

2202 Monterey Street, Suite 102-B

Fresno, CA 93721

Referendum Agent

USDA-AMS-F&V-MFO

2202 MONTEREY STREET, SUITE 102-B

FRESNO, CA 93721

FOLD HERE, TAPE AT THE TOP, AND MAIL PROMPTLY 

PISTACHIO BALLOT

VOTING INSTRUCTIONS AND RULES

GOVERNING PRODUCER ELIGIBILITY TO VOTE

1. VOTING PERIOD: (_______, 20___) through (_______, 20___).

2. REPRESENTATIVE PERIOD: (_______, 20___) through (_______, 20___).

III. PRODUCTION AREA: The States of California, Arizona and New Mexico.

IV. PERSONS ELIGIBLE TO VOTE: Any person who currently produces pistachios in any or all of the States of California, Arizona, or New Mexico, and produced such pistachios during the representative period (_______, 20___) through (_______, 20___), is entitled to cast one ballot. Each separate business unit, partnership, family enterprise, corporation, association, estate, or firm is entitled to one vote.

“Producer” means any individual, partnership, corporation, association, or other business unit who:

• Owns and farms land producing pistachios for market;

• is a renter or tenant of a farm producing pistachios for market; or

• is a landlord who received from a renter or tenant a portion of the production as rent for the land on which pistachios were produced for market. (A landlord who rents for cash, a lien-holder or a person having only a financial interest in the crop is NOT eligible to vote.)

V. HOW TO VOTE:

1. Indicate your vote by placing an ‘X’ in the appropriate box.

2. Certify your pistachio production by listing the pounds of pistachios produced for market by you (or by the producer for whom this Ballot is cast) during the period (_______, 20___) through (_______, 20___).

3. Print or type your name, phone number, business name, and address.

4. Proxy voting is not authorized. If ballot is cast by an officer or employee of a partnership, corporation, or other business unit, check box to indicate your business designation, and sign to indicate authority to vote. If partnership or joint venture, list names of partners.

5. Sign below the certification. Incomplete or unsigned ballots cannot be counted. Fold your ballot so the Referendum Agent’s address is displayed, seal with tape and mail to Referendum Agent, USDA-AMS-F&V-MFO, 2202 MONTEREY ST, SUITE 102-B, FRESNO, CA 93721. For further information, please call (______________________) or (______________________) at (_ _ _ - _ _ _ - _ _ _ _).

Ballots must be postmarked by (______, 20___).

FV-240A (Rev. 08/10. Destroy previous editions.) Page 2 of 6