FV-259 929-Cranberries Qualification Statement Public Member/Al

Generic OMB Fruit Crops, Marketing Order Administration Branch

FV-259 Cranberry Background Statement Public (07-10) (2)

Generic Fruit Crops (Mandatory)

OMB: 0581-0189

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OMB No. 0581-0189

UNITED STATES DEPARTMENT OF AGRICULTURE

AGRICULTURAL MARKETING SERVICE

FRUIT AND VEGETABLE PROGRAMS


QUALIFICATION STATEMENT

(CONFIDENTIAL)


Cranberry Marketing Committee – Public Member And Alternate


The following information will be used by the Secretary of Agriculture in selecting a Public Member representative to serve on the Cranberry Marketing Committee. The Cranberry Marketing Committee administers Federal Marketing Order No. 929, which regulates the handling of cranberries grown in Massachusetts, Rhode Island, Connecticut, New Jersey, Wisconsin, Michigan, Minnesota, Oregon, Washington, and Long Island in the State of New York.


Name:

Mailing Address:

Town/City: _____________________________________ State: _____ Zip Code: __________

Telephone: (H) ________________________________ (W) ________________________________

Fax: ______________________________________ E-mail: ______________________________


Educational Background:


Occupation: (Employer's Name & Address):


Briefly state your qualifications and why you are interested in serving as the public alternate member on the Committee.


Briefly state your past and current work (service) with public groups. Please indicate offices held, etc.


Please list dates and give a brief summary of any other experience you believe would be pertinent. If a student, please state your major and minor course of study.


Please list the organizations to which you belong or are affiliated:


Do you or members of your immediate family have financial interest in or close association with the production, processing, financing, or marketing of agricultural commodities? Yes No:


NOTE: The public member and alternate public member are not salaried positions. However, authorized travel expenses, while on Committee related business, are reimbursable.


I hereby certify that I am qualified to serve on the Cranberry Marketing Committee. If selected by the Secretary, United States Department of Agriculture, I will carry-out the duties of this position as defined in the Cranberry Marketing Order to the best of my ability.




Signature: __________________________________________ Date: ___________________________





























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 0581-0189. The time required to complete this information collection is estimated to average 5 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 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.

FV-259 (Rev. 7/10. Destroy previous editions.)

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleThe following information is requested by the Secretary for use in selecting Public Member representatives of the Cranberry Mark
AuthorDavid N. Farrimond
File Modified0000-00-00
File Created2021-01-30

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