FV-72 Dates Producer Referendum Ballot

REPRODUCE LOCALLY. Include form number and date on all reproductions. OMB No. 0581-0178

TO DATE PRODUCERS:

The U.S. Department of Agriculture is submitting, for producer consideration, proposed amendments to Marketing Order No. 987 (order), regulating the handling of dates grown in Riverside County, California. 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 dates voted in the Referendum. If approved, the proposed amendments would:

• Amend__________________________________________________

• Amend__________________________________________________

• Amend__________________________________________________

• Amend__________________________________________________

• Amend__________________________________________________

• Amend__________________________________________________

• Amend__________________________________________________

• Amend__________________________________________________

Voting Instructions and Rules Governing Producer Eligibility to Vote is on the reverse side of

this page. Also enclosed are:

1. A Producer Referendum Ballot;

2. The news release announcing the Referendum; and

3. A copy of the Referendum Order dated _______________________

The voting period for the Referendum is ____________ through _____________. Please vote promptly because ballots postmarked later than _____________ cannot be opened or counted. Each ballot will be held in strict confidence.

________________, Referendum Agent

________________, Referendum Agent

Phone: (559) 487-5901

DON’T FORGET TO CAST YOUR VOTE AND SIGN YOUR BALLOT

PRODUCER REFERENDUM BALLOT

Marketing Order No. 987

Dates Grown in Riverside County, California

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
YES 	NO 	2) Do you favor amending the order
YES 	NO 	3) Do you favor amending the order
YES 	NO 	4) Do you favor amending the order
YES 	NO 	5) Do you favor amending the order
YES 	NO 	6) Do you favor amending the order
YES 	NO 	7) Do you favor amending the order

Signature and Certification is required on reverse of ballot

U.S. DEPARTMENT OF AGRICULTURE

AGRICULTURAL MARKETING SERVICE

PRODUCER REFERENDUM BALLOT

MARKETING ORDER NO. 987

On proposed amendment of Marketing Order No. 987, as amended, for domestic dates produced or packed in Riverside County, California.

This ballot will be held confidential. Please read the enclosed rules of eligibility and voting instructions before completing this ballot. Your ballot envelope MUST be postmarked by ________ and received by this office no later than __________, in order to be counted in the referendum.

I HEREBY CERTIFY that I am, or the producer’s name I have inserted in item 3 below is, now an eligible producer of Deglet Noor, Zahidi, Khadrawy or Halawy dates, and that during the period of October 1, _____, through September 30, ____. Produced the following quantity of dates for market:_____________________pounds (Field run)

NOTE: If you are farming on a share crop basis, report only that part of the tonnage representing your share.

1. NAME(S) OF ANY PARTNER(s) 2. PARTNER(S) MAILING ADDRESS

3. PRODUCER’S SIGNATURE (or name, if item 5 is applicable) 4. MAILING ADDRESS

5. If this ballot is cast by an officer or employee of a corporate producer such as a corporation, institution,

or school, or by an administrator, executor, or trustee of a producing estate. PLEASE INDICATE YOUR TITLE OR CAPACITY*

I HEREBY CERTIFY to the Secretary of Agriculture that I have authority to cast this ballot for the producer named above in item 4 and that I will submit evidence of such authority at the request of an Agent of the Secretary.

SIGNATURE (From all voters)

TITLE OR CAPACITY (Stipulating your authority to vote)*

*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 Riverside County, California 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 0581-0178. 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.

VOTING INSTRUCTIONS AND RULES

GOVERNING PRODUCER ELIGIBILITY TO VOTE

1. VOTING PERIOD: _________ through __________.

2. REPRESENTATIVE PERIOD: October 1, ______ through September 30, ______.

III. PRODUCTION AREA: Riverside County, California.

IV. PERSONS ELIGIBLE TO VOTE: Any person who currently produces dates in Riverside County, California, and produced such dates during the representative period October 1, _____ through September 30, ______, 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 dates for market;

• is a renter or tenant of a farm producing dates 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 dates 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 date production by listing the pounds of dates produced for market by you (or by the producer for whom this ballot is cast) during the period October 1, _____ through September 30, ______.

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 certifying your authority to vote. If partnership or joint venture, list names of partners.

5. Sign below the certification. Incomplete or unsigned ballots cannot be counted. Return your completed ballot to the USDA in the postage paid envelope provided. For further information, please call __________or __________ at 559-487-5901.

Ballots must be postmarked by ____________.

FV-72 (Rev. 1/12. Destroy previous editions.)