FV-53 Cranberries Producer Ballott (rev.)

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

USE TAPE – DO NOT STAPLE

ag code 0237

united states department of agriculture

Agricultural Marketing Service

Fruit and Vegetable Program

Marketing Order AND AGREEMENT DIVISION

1400 INDEPENDENCE AVE., S.W.

Room 1406 - South Building

WASHINGTON, DC 20250-0237

Official Business

Penalty for Private Use $300 No Postage Stamp Necessary

Postage Has Been Prepaid By:

Referendum Agent

Southeast Marketing Field Office

799 Overlook Drive, Suite A

Winter Haven, FL 33884

BALLOT

U.S. DEPARTMENT OF AGRICULTURE AGRICULTURAL MARKETING SERVICE OFFICIAL PRODUCER BALLOT CRANBERRY MARKETING ORDER NO. 929

INSTRUCTIONS: Complete the Ballot and Certification. Fold on the dotted line with the address displayed, and return. Information you enter on this Ballot will be kept strictly confidential. In order to be counted, your Ballot must be signed and postmarked by ________________, 20___.

Please read all questions and answer those that apply to you. This Referendum is for the purpose of determining whether growers favor continuance of Marketing Order No. 929.

Do you favor continuance of Marketing Order No. 929 regulating the handling of cranberries grown in the States of Massachusetts, Rhode Island, Connecticut, New Jersey, Wisconsin, Michigan, Minnesota, Oregon, Washington, and Long Island in the State of New York?

YES, I favor continuance of Marketing Order No. 929.

NO, I do not favor continuance of Marketing Order No. 929.

CERTIFICATION STATEMENT

I hereby certify that I am a producer and produced cranberries within the defined production area during the 20___ crop year (September 1, 20___ through August 31, 20___). (If you did not harvest cranberries from your acreage during 20___ because of crop failure or non-bearing acreage, write “NONE” in the space provided for number of barrels below).

________________ from ___________________ in _____________________________

(barrels) (approx. acreage) (State)

Name		Address
Signature
		Date

NOTE: If you are renting on a share crop basis, you should report only that part of the crop represented by your share.

If you marketed any of the above cranberries through a cooperative marketing association, please list the cooperative’s name.

NOTE: If the vote is cast on behalf of a corporate, estate, or producer, my signature certifies that I have the authority to take such action. (IN SUCH CASE, SHOW NAME OF SUCH CORPORATION, ESTATE, OR PRODUCER AND YOUR TITLE BELOW).

Name of corporation, estate, or producer

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 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.

FV-53 (Rev. 9/13. Destroy previous editions.)