FV-156 Producer Referendum Ballot (Vidalia Onions)

REPRODUCE LOCALLY. Include form number and date on all reproductions. OMB No. 0581-0178

U.S. DEPARTMENT OF AGRICULTURE

AGRICULTURAL MARKETING SERVICE

FRUIT AND VEGETABLE PROGRAM

OFFICIAL PRODUCER BALLOT

Marketing Order No. 955: Vidalia Onions Grown In Georgia

This Ballot will be held in strict confidence. Be sure Parts II, III, and IV of your Ballot are completed. Unsigned Ballots, or Ballots that cannot be validated because Parts II, III, or IV are incomplete, will not be counted.

PART I - REFERENDUM INSTRUCTIONS

1. REFERENDUM PERIOD: __________, 20___ through __________, 20___ is the Referendum period during which producers may vote on this marketing order. For this marketing order to continue, it must be supported by at least two-thirds of the producers voting or at least two-thirds of the volume of Vidalia onion production represented by those voting in the Referendum.

B. ELIGIBILITY REQUIREMENTS: Any person who produced Vidalia onions for market during the period of January 1, 20___ through December 31, 20___, and who is now a producer, is eligible to vote. Such persons may vote on the continuance of the marketing order using the attached Ballot.

1. A producer (or grower) is defined as: (a) any person who produces Vidalia onions in the designated production area; (b) a renter or tenant of acreage producing Vidalia onions for market; or (c) a landlord who received from a renter or tenant Vidalia onions as rent for the land on which such Vidalia onions were grown. A cash landlord, lienholder, or person having only a financial interest in the crop is not an eligible voter.

2. A business unit, partnership, family enterprise, corporation, association, estate, or firm may vote. Each such entity is entitled to one vote.

3. Proxy voting is not authorized.

C. INSTRUCTIONS FOR VOTING: Provide the voter information requested in Part II. In Part III, mark the block for or against the marketing order. Certify your vote by signing the appropriate section of Part IV. If you do not complete Parts II, III, and IV, your Ballot cannot be validated, and your vote will not be counted. Remove the pages containing Parts II, III, and IV, and return them in the envelope provided.

BALLOTS POSTMARKED AFTER ____________________, 20___

WILL NOT BE COUNTED IN THE REFERENDUM.

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 0581-0178. The time required to complete this information collection is estimated to average 20 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.

PART II - VOTER INFORMATION

This information will be held in strict confidence.

A. Your name: ___________________________________________________________________________

B. What is the specific location of your Vidalia onion acreage represented in this Ballot?

_____________________________________________________________________________________

Address, City, State, and Zip code

C. Do you reside on the above property which produces the Vidalia onions? □ Yes □ No

If no, please provide your residential address and telephone number: _______________________________

_____________________________________________________________________________________

Address, City, State, and Zip code

____________________________________

Telephone

D. If you are not voting as an individual producer, please check the appropriate box indicating your voting status and write the name and address of the business unit you represent.

□ Partnership □ Corporation □ Other (Specify) __________________________________________

Business Name: ________________________________________________________________________

Business Address: ______________________________________________________________________

E. What is the number of 40 pound bags of Vidalia onions, or equivalent, you produced for market during the period of January 1, ____ through December 31, ____? _________ bags.

F. What is the number of acres of Vidalia onions you harvested during the period of January 1, ____ through December 31, _____? _______________ acres.

G. Which packinghouse(s) handled your Vidalia onions during the representative period?

Name: __________________________________ Name: _____________________________________

Address: ________________________________ Address: ___________________________________

________________________________________ __________________________________________

PART III - REFERENDUM QUESTION

Do you favor continuance of Marketing Order No. 955, regulating the handling of Vidalia onions grown in Georgia? □ YES □ NO

PART IV - VOTER CERTIFICATION

All information provided in this Ballot will be subject to on-site verification by officials of the Office of Inspector General, U.S. Department of Agriculture. The information on this Ballot is required to determine voter eligibility and vote of Vidalia onion producers. Falsification of information on this government document may result in a fine, imprisonment, or both (18 U.S.C. 1001).

A. Your signature, if signing as an individual.

I am the producer named in Part II of this Ballot, and I certify that I am not a cash landlord, lienholder, or person having only a financial interest in the crop, and that the information provided on this Ballot and any attachment hereto is accurate and correct to the best of my knowledge.

______________________________________________________ _______________________

Signature Date

B. If signing as the representative of a producing entity other than an individual, designate your title and sign below.

I am the representative named in Part II D of this Ballot: A partner casting the Ballot for a partnership; or an officer or employee casting the Ballot for a cooperative association, corporation, school, institution, or similar business unit; or the administrator, executor, or trustee casting the Ballot for a producing estate; and, by signing this Ballot, I agree to provide evidence thereof at the request of an authorized agent of the Secretary of Agriculture.

___________________________________________________________ _____________________

Signature and title Date

FV-156 (Rev. 01/2014. Destroy previous editions.)