LS-26 Nomination of Cattle Producers

REPRODUCE LOCALLY. Include form number and date on all reproductions.

FORM APPROVED. - OMB NO. 0581-0093

U.S. DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE

NOMINATION OF CATTLE PRODUCERS FOR APPOINTMENT TO CATTLEMEN'S BEEF PROMOTION AND RESEARCH BOARD
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. 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.
Information is collected to obtain names of nominees for appointment as members of the Board. Response is voluntary.
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, gender, religion, age, disability, sexual orientation,
marital or family status, political beliefs, parental status, or protected genetic information. (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, Room 326-W, Whitten Building, 14th and Independence Avenue, SW, Washington, DC 20250-9410 or call
202-720-5964 (voice and TDD). USDA is an equal opportunity provider and employer.

Pursuant to the Beef Promotion and Research Act of 1985, the following names of cattle producers are submitted as nominees
to the Cattlemen's Beef Promotion and Research Board as representatives of the indicated state.
2.

NAME(S) OF NOMINEE(S)
(List name(s) for each allotted position on the Board)

3.

1. STATE

CERTIFICATION NO. OF ORGANIZATION/ASSOCIATION REPRESENTED
(List only if different from organ./assoc. submitting this nomination)

IF MORE SPACE IS NEEDED, USE ADDITIONAL FORMS.
4. WHEN NOMINATIONS ARE THE RESULT OF A CAUCUS, LIST THE CERTIFICATION NUMBERS OF ORGANIZATIONS OR ASSOCIATIONS PARTICIPATING IN THE
CAUCUS.
A.

E.

I.

B.

F.

J.

C.

G.

K.

D.

H.

L.

5. IDENTIFICATION OF PERSON AND ORGANIZATION/ASSOCIATION SUBMITTING THESE NOMINATIONS
A. NAME AND ADDRESS OF ORGANIZATION/ASSOCIATION

B. CERTIFICATION NO.

C. NAME AND TITLE (Type or print)

D. SIGNATURE

RETURN ORIGINAL FORMS TO:

Marketing Programs Branch
Livestock and Seed Program, AMS
U.S. Department of Agriculture, Room 2638-S
1400 Independence Avenue, SW, MAIL STOP 0251
Washington, DC 20250-0251

LS-26 (07-03) (Destroy previous edition dated 03-02.)

DATE