FV-92A Official Ballot--Regulating Handling of Pears Grown in C

REPRODUCE LOCALLY. Include form number and date on all reproductions. OMB No. 0581-0189

UNITED STATES DEPARTMENT OF AGRICULTURE

AGRICULTURAL MARKETING SERVICE

FRUIT AND VEGETABLE PROGRAMS

COOPERATIVE’S OFFICIAL BALLOT

ON CONTINUATION OR TERMINATION OF MARKETING ORDER NO. 917,

REGULATING THE HANDLING OF PEARS GROWN IN CALIFORNIA

Pursuant to the resolution(s) adopted by the Board of Directors of _________________________, a cooperative association of producers, bona fide engaged in marketing fresh pears grown in California, or rendering services for, or advancing the interests of producers of said fruits, the following is submitted:

1. Those producers who, on the date this Ballot is cast, are members of, stockholders in, or under contract with said association, produced, during the 20___ season, the following quantities of fruit for fresh shipment:

	Volume-fill lugs	2-layer lugs	35 lb cartons	Flat	Other containers (lbs)
Pears

2. The total number of our pear producers is ____________. A list showing the names of our producers and the volume of fruit shipped by each is attached.

3. The resolution(s) adopted by the Board of Directors, dated __________________, 20___ pursuant to voting in the referendum is (are) attached.

4. DOES THE COOPERATIVE ASSOCIATION FAVOR CONTINUATION OR TERMINATION OF MARKETING ORDER NO. 917, AS AMENDED, REGULATING THE HANDLING OF PEARS GROWN IN CALIFORNIA? (place an “X” in the appropriate box)

 FAVOR CONTINUATION  FAVOR TERMINATION

_____________________________________ ________________________________

Name of Cooperative Association Signature of Authorized Official, and Title

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 30 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, SW, 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-92-A (Rev. 10/12. Destroy previous editions.)