SAMPLE Acceptance Letter/Statement

Sorghum Agreement to Serve.pdf

National Research, Promotion, and Consumer Information Programs

SAMPLE Acceptance Letter/Statement

OMB: 0581-0093

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Form Approved O.M.B. 0581-0093

NOMINEE’S AGREEMENT TO SERVE

If appointed, I agree to serve on the Sorghum Promotion, Research, and
Information Board (Board), and to disclose to the Secretary of Agriculture any
relationship with any sorghum promotion entity or any organization that has a
contractual relationship with the Board.

___________________
Date

_______________________
Signature

Note: 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 0581-0093. There is no time estimated to complete this information collection because it requires only a signature.
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. 202509410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.


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