No Form number Vidalia Onion Election Ballot

OMB No. 0581-0178

GROWER BALLOT

Marketing Order No. 955 - Vidalia Onions Grown in Georgia

20___ ELECTION

Ballot No. ________________

These elections are for nominees to fill (4) seats and (4) alternate seats on the Vidalia Onion Committee. Please indicate your votes by placing an “X” on the line next to the names of your selected candidates. You may vote for up to eight individuals (including any write-ins). Ballots with more than eight votes will be voided. All candidates listed below are eligible to serve.

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WRITE IN CANDIDATES MAY BE LISTED BELOW

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According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for the information collection is 0581-0178. The time required to complete this information collection is estimated to average 5 minutes, including the time for reviewing instructions, searching existing data sources, gathering 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.

Rev. 01/2014. Destroy previous editions.