F/H Form F(3) Hazelnuts Ballot (Handler, Position 4)

OMB No. 0581-0178

HAZELNUT MARKETING BOARD

21595-A Dolores Way NE

Aurora, OR 97002-9738

Tel: (503) 678-6823

Fax: (503) 678-6825

HANDLER BALLOT

POSITION 4

The entity, __________________________________, operated as a handler during the 20___ - 20___ marketing year and is entitled to nominate a member and an alternate member to fill handler position four on the Hazelnut Marketing Board. This Ballot will be weighted based on the tonnage handled during the 20___ - 20___ marketing years. All handlers who do not qualify as the largest, second largest or third largest in the industry are eligible to make nominations for appointment to these positions. We hereby nominate:

Member: _____________________________________________________________________________

Alternate Member: _____________________________________________________________________

_____________________________________________

Handler Signature

_____________________________________________

Date

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F/H Form F(3) (Rev. 01/2014) Destroy previous editions.