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OMB No. 0581-0215
BALLOT FOR ELECTION OF PRODUCER MEMBERS
AND ALTERNATE PRODUCER MEMBERS
Pistachio producers in Districts ____recently had the opportunity to nominate eligible candidates for membership on the
Administrative Committee for Pistachios (Committee) for the two-year term of office ending June 30, 20_____. Producers are
now being requested to vote for the candidates of their choice. Enclosed are voting instructions, eligibility requirements and a
ballot with the nominees listed. Please read the voting directions carefully and submit your completed and signed
ballot in the enclosed envelope. To be valid, the ballot must be signed and postmarked, faxed, or hand
delivered to the Administrative Committee for Pistachios Office in Fresno, California, by
, 20
.
INSTRUCTIONS FOR COMPLETING ONE OF THE ENCLOSED BALLOTS
1.
VOTING PERIOD: _________, 20___ through _________, 20___.
2.
Refer to the ballots for all industry positions and districts for the current nomination and election process.
3.
VOTER ELIGIBILITY: Only Producers, including duly authorized officers or employees of Producers, shall participate in
the election of Producer members and alternate Producer members of the Committee. No producer shall participate in the
election of Committee members in more than one district. If a producer commercially produces pistachios during the
current production year in more than one district, the producer must vote in the same district in which he or she participated
in the nominations process previously conducted. However, if the producer did not participate in the nominations process,
he or she may select in which district he or she wishes to vote and shall indicate it on the ballot. In certifying your
eligibility, please be mindful of the following definitions:
“Producer” means any person engaged within the production area in a proprietary capacity in the production of pistachios
for sale.
“Proprietary Capacity” means the capacity or interest of a producer or handler that, either directly or through one or more
intermediaries, is a property owner together with all the appurtenant rights of an owner including the right to vote the
interest in that capacity as an individual, a shareholder, member of a cooperative, partner, trustee or in any other capacity
with respect to any other business unit.
“Affiliation” normally appears as “affiliate of,” or “affiliated with,” and means a person such as a producer or handler who
is: a producer or handler that directly, or indirectly through one or more intermediaries, owns or controls, or is controlled
by, or is under common control with the producer or handler specified; or a producer or handler that directly, or indirectly
through one or more intermediaries, is connected in a proprietary capacity, or shares the ownership or control of the
specified producer or handler with one or more other producers or handlers. As used in this part, the term “control”
(including the terms “controlling”, “controlled by”, and “under the common control with”) means the possession, direct or
indirect, of the power to direct or cause the direction of the management and policies of a handler or a producer, whether
through voting securities, membership in a cooperative, by contract or otherwise. Also, please be mindful that not more
than two members and not more than two alternate members shall be persons employed or affiliated with producers or
handlers that are affiliated with the same handler and/or producer. Additionally, only one member and one alternate
member in any one district representing producers shall be employed by or affiliated with the same handler and/or
producer.
4.
The attached ballots list the nominees by district as well as the number of producer positions you are entitled to vote for.
Vote for the candidate(s) of your choice in the appropriate space. If you would like to vote for a producer that has not been
nominated, write in the candidate(s) name(s) of your choice in the appropriate space(s). The person receiving the highest
number of votes shall be the member nominee for that district and the person receiving the second highest number of votes
shall be the alternate member nominee. In case of a tie vote, the nominee shall be selected by a drawing.
5.
In the spaces provided, print your name, the producer’s name (if different), address and telephone number.
6.
Certify that you are eligible to cast this ballot by signing and dating the ballot.
7.
The completed ballot must be signed, and postmarked, faxed or delivered by _________20, ____ to be valid.
8.
The USDA prohibits discrimination in all its programs and activities. Please see bottom of ballot for more details. We
request that you be mindful of the USDA’s policy regarding Civil Rights and consider eligible women, minorities, and the
physically challenged for membership on the Committee.
9.
If you have any questions, please contact the Administrative Committee for Pistachios: 4938 E. Yale Avenue, Suite 102,
Fresno, CA 93727; Telephone (559) 255-6480; FAX (559) 255-6485.
FV-246 (Rev. 05/2014. Destroy previous editions.)
Instructions
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OMB No. 0581-0215
UNITED STATES DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE
FRUIT AND VEGETABLE PROGRAM
ADMINISTRATIVE COMMITTEE FOR PISTACHIOS
MARKETING ORDER 983
PRODUCER MEMBER AND ALTERNATE MEMBER BALLOT
DISTRICT 1 BALLOT
NOTE: You must be a producer in District 1 to vote on this ballot. If you are a producer
in more than one district, you may vote for candidates in only one district. Please discard
the other ballots. Duplicate ballots cannot be counted.
PRODUCER NOMINEE LIST
District 1 (Southern California) consists of Imperial, Kern, Los Angeles, Orange, Riverside, San
Bernardino, San Diego, San Luis Obispo, Santa Barbara, Tulare, and Ventura counties.
District 1 has ___ producer member positions and ___ alternate producer member positions to be
filled. Each producer is entitled to cast only one vote for each position to be filled. You may
vote for ___ candidates (one for each position). Cast your vote by checking the box next to the
candidates of your choice and/or submitting write-in candidates.
District 1 Candidates:
Candidate
Candidate
Candidate
Candidate
Candidate
Write-in Candidate
Write-in Candidate
Write-in Candidate
Write-in Candidate
SIGNATURE AND CERTIFICATION IS REQUIRED ON REVERSE OF BALLOT
FV-246 (Rev. 05/2014. Destroy previous editions.)
District 1 Ballot
REPRODUCE LOCALLY. Include form number and date on all reproductions.
OMB No. 0581-0215
CERTIFICATION STATEMENT
Please indicate the following:
Individual
Trust
Partnership*
Corporation
Tax ID:
*If partnership, list general partners
I certify that I or my employer currently produce(s) pistachios for market in District 1, and that I
have voted in only one district in this election process. If I am casting a ballot on behalf of my
employer, I certify that I have such authority to do so.
Producer Name (please print)
Title (if voting on behalf of a corporation, estate or trust)
Print Name
Signature
Phone Number
Date
Address
To be valid, the completed ballot must be signed, and postmarked, faxed, or hand delivered
to the Administrative Committee for Pistachios office in Fresno, California, by
,
20 .
ADMINISTRATIVE COMMITTEE FOR PISTACHIOS
4938 East Yale Avenue, Suite 102
Fresno, CA 93727
TEL: (559) 255-6480 FAX: (559) 255-6485
The following statements are made in accordance with the Privacy Act of 1974 (U.S.C. 552a) and the Paperwork Reduction Act of 1995, as
amended. The authority for requesting the information to be supplied on this form is the Agricultural Marketing Agreement Act of 1937, Secs. 119, 48 Stat. 31, as amended, (7 U.S.C. 601-674). Furnishing the requested information is necessary for the administration of the marketing order
program. Submission of the Tax Identification Number (TIN) is mandatory, and will be used to validate ballots and determine affiliation or entity
identity. Please note that ballots will not become invalid if a TIN is not disclosed. The making of any false statements or representations in any
matter within the jurisdiction of any agency of the United States, knowing it to be false, is a violation of title 18, section 1001 of the United States
Code, which provides for fine or imprisonment, or both.
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 05810215 The time required to complete this information collection is estimated to average 15 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-246 (Rev. 05/2014. Destroy previous editions.)
District 1 Signature Page
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 PROGRAM
ADMINISTRATIVE COMMITTEE FOR PISTACHIOS
MARKETING ORDER 983
PRODUCER MEMBER AND ALTERNATE MEMBER BALLOT
DISTRICT 2 BALLOT
NOTE: You must be a producer in District 2 to vote on this ballot. If you are a producer
in more than one district, you may vote for candidates in only one district. Please discard
the other ballots. Duplicate ballots cannot be counted.
PRODUCER NOMINEE LIST
District 2 (Central California) consists of Fresno, Kings, Madera and Merced counties of
California.
District 2 has ___ producer member positions and ___ alternate producer member positions to be
filled. Each producer is entitled to cast only one vote for each position to be filled. You may
vote for ___ candidates (one for each position). Cast your vote by checking the box next to the
candidates of your choice and/or submitting write-in candidates.
District 2 Candidates:
Candidate
Candidate
Candidate
Candidate
Candidate
Write-in Candidate
Write-in Candidate
Write-in Candidate
Write-in Candidate
SIGNATURE AND CERTIFICATION IS REQUIRED ON REVERSE OF BALLOT
FV-246 (Rev. 05/2014. Destroy previous editions.)
District 2 Ballot
REPRODUCE LOCALLY. Include form number and date on all reproductions.
OMB No. 0581-0215
CERTIFICATION STATEMENT
Please indicate the following:
Individual
Trust
Partnership*
Corporation
Tax ID:
*If partnership, list general partners
I certify that I or my employer currently produce(s) pistachios for market in District 2, and that I
have voted in only one district in this election process. If I am casting a ballot on behalf of my
employer, I certify that I have such authority to do so.
Producer Name (please print)
Title (if voting on behalf of a corporation, estate or trust)
Print Name
Signature
Phone Number
Date
Address
To be valid, the completed ballot must be signed, and postmarked, faxed, or hand delivered
to the Administrative Committee for Pistachios office in Fresno, California, by
,
20
.
ADMINISTRATIVE COMMITTEE FOR PISTACHIOS
4938 East Yale Avenue, Suite 102
Fresno, CA 93727
TEL: (559) 255-6480 FAX: (559) 255-6485
The following statements are made in accordance with the Privacy Act of 1974 (U.S.C. 552a) and the Paperwork Reduction Act of 1995, as
amended. The authority for requesting the information to be supplied on this form is the Agricultural Marketing Agreement Act of 1937, Secs. 119, 48 Stat. 31, as amended, (7 U.S.C. 601-674). Furnishing the requested information is necessary for the administration of the marketing order
program. Submission of the Tax Identification Number (TIN) is mandatory, and will be used to validate ballots and determine affiliation or entity
identity. Please note that ballots will not become invalid if a TIN is not disclosed. The making of any false statements or representations in any
matter within the jurisdiction of any agency of the United States, knowing it to be false, is a violation of title 18, section 1001 of the United States
Code, which provides for fine or imprisonment, or both.
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 05810215. The time required to complete this information collection is estimated to average 15 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-246 (Rev. 05/2014. Destroy previous editions.)
District 2 Signature Page
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 PROGRAM
ADMINISTRATIVE COMMITTEE FOR PISTACHIOS
MARKETING ORDER 983
PRODUCER MEMBER AND ALTERNATE MEMBER BALLOT
DISTRICT 3 BALLOT
NOTE: You must be a producer in District 3 to vote on this ballot. If you are a producer
in more than one district, you may vote for candidates in only one district. Please discard
the other ballots. Duplicate ballots cannot be counted.
PRODUCER NOMINEE LIST
District 3 (Northern California) consists of all counties in California where pistachios are
produced that are not included in District 1 or District 2.
District 3 has ___ producer member positions and ___ alternate producer member positions to be
filled. Each producer is entitled to cast only one vote for each position to be filled. You may
vote for ___ candidates (one for each position). Cast your vote by checking the box next to the
candidates of your choice and/or submitting write-in candidates.
District 3 Candidates:
Candidate
Candidate
Candidate
Write-in Candidate
Write-in Candidate
SIGNATURE AND CERTIFICATION IS REQUIRED ON REVERSE OF BALLOT
FV-246 (Rev. 05/2014. Destroy previous editions.)
District 3 Ballot
REPRODUCE LOCALLY. Include form number and date on all reproductions.
OMB No. 0581-0215
CERTIFICATION STATEMENT
Please indicate the following:
Individual
Trust
Partnership*
Corporation
Tax ID:
*If partnership, list general partners
I certify that I or my employer currently produce(s) pistachios for market in District 3, and that I
have voted in only one district in this election process. If I am casting a ballot on behalf of my
employer, I certify that I have such authority to do so.
Producer Name (please print)
Title (if voting on behalf of a corporation, estate or trust)
Print Name
Signature
Phone Number
Date
Address
To be valid, the completed ballot must be signed, and postmarked, faxed, or hand delivered
to the Administrative Committee for Pistachios office in Fresno, California, by
,
20 .
ADMINISTRATIVE COMMITTEE FOR PISTACHIOS
4938 East Yale Avenue, Suite 102
Fresno, CA 93727
TEL: (559) 255-6480 FAX: (559) 255-6485
The following statements are made in accordance with the Privacy Act of 1974 (U.S.C. 552a) and the Paperwork Reduction Act of 1995, as
amended. The authority for requesting the information to be supplied on this form is the Agricultural Marketing Agreement Act of 1937, Secs. 119, 48 Stat. 31, as amended, (7 U.S.C. 601-674). Furnishing the requested information is necessary for the administration of the marketing order
program. Submission of the Tax Identification Number (TIN) is mandatory, and will be used to validate ballots and determine affiliation or entity
identity. Please note that ballots will not become invalid if a TIN is not disclosed. The making of any false statements or representations in any
matter within the jurisdiction of any agency of the United States, knowing it to be false, is a violation of title 18, section 1001 of the United States
Code, which provides for fine or imprisonment, or both.
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 05810215. The time required to complete this information collection is estimated to average 15 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-246 (Rev. 05/2014. Destroy previous editions.)
District 3 Signature Page
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 PROGRAM
ADMINISTRATIVE COMMITTEE FOR PISTACHIOS
MARKETING ORDER 983
PRODUCER MEMBER AND ALTERNATE MEMBER BALLOT
DISTRICT 4 BALLOT
NOTE: You must be a producer in District 4 to vote on this ballot. If you are a producer
in more than one district, you may vote for candidates in only one district. Please discard
the other ballots. Duplicate ballots cannot be counted.
PRODUCER NOMINEE LIST
District 4 (Arizona and New Mexico) consists of the states of Arizona and New Mexico.
District 4 has ___ producer member positions and ___ alternate producer member positions to be
filled. Each producer is entitled to cast only one vote for each position to be filled. You may
vote for ___ candidates (one for each position). Cast your vote by checking the box next to the
candidates of your choice and/or submitting write-in candidates.
District 4 Candidates:
Candidate
Candidate
Candidate
Write-in Candidate
Write-in Candidate
SIGNATURE AND CERTIFICATION IS REQUIRED ON REVERSE OF BALLOT
FV-246 (Rev. 05/2014. Destroy previous editions.)
District 4 Ballot
REPRODUCE LOCALLY. Include form number and date on all reproductions.
OMB No. 0581-0215
CERTIFICATION STATEMENT
Please indicate the following:
Individual
Trust
Partnership*
Corporation
Tax ID:
*If partnership, list general partners
I certify that I or my employer currently produce(s) pistachios for market in District 4, and that I
have voted in only one district in this election process. If I am casting a ballot on behalf of my
employer, I certify that I have such authority to do so.
Producer Name (please print)
Title (if voting on behalf of a corporation, estate or trust)
Print Name
Signature
Phone Number
Date
Address
To be valid, the completed ballot must be signed, and postmarked, faxed, or hand delivered
to the Administrative Committee for Pistachios office in Fresno, California, by
,
20 .
ADMINISTRATIVE COMMITTEE FOR PISTACHIOS
4938 East Yale Avenue, Suite 102
Fresno, CA 93727
TEL: (559) 255-6480 FAX: (559) 255-6485
The following statements are made in accordance with the Privacy Act of 1974 (U.S.C. 552a) and the Paperwork Reduction Act of 1995, as
amended. The authority for requesting the information to be supplied on this form is the Agricultural Marketing Agreement Act of 1937, Secs. 119, 48 Stat. 31, as amended, (7 U.S.C. 601-674). Furnishing the requested information is necessary for the administration of the marketing order
program. Submission of the Tax Identification Number (TIN) is mandatory, and will be used to validate ballots and determine affiliation or entity
identity. Please note that ballots will not become invalid if a TIN is not disclosed. The making of any false statements or representations in any
matter within the jurisdiction of any agency of the United States, knowing it to be false, is a violation of title 18, section 1001 of the United States
Code, which provides for fine or imprisonment, or both.
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 05810215. The time required to complete this information collection is estimated to average 15 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-246 (Rev. 05/2014. Destroy previous editions.)
District 4 Signature Page
File Type | application/pdf |
Author | LWZeng |
File Modified | 2014-01-03 |
File Created | 2014-01-02 |