FV-126A CA Walnuts Producer Referendum (Amendment)

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

CALIFORNIA WALNUT BALLOT

UNITED STATES DEPARTMENT OF AGRICULTURE

Agricultural Marketing Service

Fruit and Vegetable Program

Marketing Field Office

2202 Monterey Street, Suite 102-B

Fresno, CA 93721

CALIFORNIA

WALNUT

BALLOT

_____________________________________________________________________________________

TO CALIFORNIA WALNUT PRODUCERS:

The U.S. Department of Agriculture is submitting for producer consideration proposed amendments to Marketing Order No. 984 (Order), regulating the handling of walnuts grown in California. The proposed amendments will not be made effective unless they are favored by at least two-thirds of the eligible producers voting in this Referendum or by producers representing at least two-thirds of the volume of English walnuts voted in the Referendum. If approved, the proposed amendments would:

_____________________________________________________________________

A Producer Referendum Ballot is on the reverse side of this page. Also enclosed are:

1. Voting Instructions and Rules Governing Producer Eligibility to Vote;

2. The news release announcing the Referendum; and

3. A copy of the Referendum Order dated _______________________________________, 20___.

The voting period for the referendum is ___________________________, 20___. Please vote promptly because Ballots postmarked later than __________________, 20___, cannot be opened or counted. Each Ballot will be held in strict confidence.

____________________________________

Referendum Agent

Phone: (559) 487-5901

PRODUCER REFERENDUM BALLOT

Marketing Order No. 984: Walnuts Grown in California

Please read the enclosed VOTING INSTRUCTIONS AND RULES GOVERNING PRODUCER ELIGIBILITY TO VOTE before completing this Ballot.

1. This referendum is for amendment of the Order. Indicate your vote by placing an ‘X’ in the appropriate box.

YES 	NO 	1) Do you favor (list proposed amendment) ________________________?
YES 	NO 	2) Do you favor (list proposed amendment) ________________________?
YES 	NO 
YES 	NO 
YES 	NO 
YES 	NO 
YES 	NO 
YES 	NO 
YES 	NO 
YES 	NO 
YES 	NO 
YES 	NO 
YES 	NO 
YES 	NO 
YES 	NO 
YES 	NO 
YES 	NO 
YES 	NO 
YES 	NO 

VOTER CERTIFICATION ELIGIBILITY STATEMENT

2. I hereby certify that I am eligible producer of walnuts within the production area and that during the representative period from ______________________, 20___ to _____________________, 20___, I produced: __________________ pounds (kernelweight) on _______________________ acres, in ____________________________________________________________________ County(ies).

SIGNATURE REQUIRED BELOW – SECTION D

3. Producer’s Name _____________________________________ Phone Number _____________

Name of Business _______________________________________________________________

Mailing Address ________________________________________________________________

City _______________________________ State ________________ Zip _________

4. If this Ballot is cast by an officer or employee of a partnership, corporation, association or other business unit, my signature below further certifies that I am duly authorized to vote on behalf of the producing entity name on this Ballot and that I will submit evidence of such authority at the request of an Agent of the Secretary.

Partnership LLC Corporation Association Other ________________________

___________________________________ _______________________________________

Signature* Title

_____________________________________________________________________________________

If Partnership or Joint Venture, list name(s).

5. I hereby certify that the information I provided on this Ballot is accurate and correct to the best of my knowledge.

________________________________________ _______________________________________

Signature* Title

*Your signature certifies that you have the authority to take such action and will submit supplementary evidence of such authority at the request of an agent of the Secretary of Agriculture. The information provided in this Ballot is required to determine voter eligibility and vote of California walnut producers. Falsification of information on this government document may result in a fine, or imprisonment, or both (18 U.S.C. 1001).

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to 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.

CALIFORNIA WALNUT BALLOT

UNITED STATES DEPARTMENT OF AGRICULTURE

Agricultural Marketing Service

Fruit and Vegetable Program

Marketing Field Office

2202 Monterey Street, Suite 102-B

Fresno, CA 93721

Referendum Agent

USDA-AMS-F&V-MFO

2202 MONTEREY STREET, SUITE 102-B

FRESNO, CA 93721

_____________________________________________________________________________________

FOLD HERE, TAPE AT THE TOP, AND MAIL PROMPTLY 

CALIFORNIA

WALNUT BALLOT

VOTING INSTRUCTIONS AND RULES GOVERNING PRODUCER ELIGIBILITY TO VOTE

1. VOTING PERIOD: _______________, 20 __ through _______________, 20__

2. REPRESENTATIVE PERIOD:______________ , 20__ through _______________, 20__

3. PRODUCTION AREA: The State of California.

4. PERSONS ELIGIBLE TO VOTE: Any person who is currently a walnut producer in the State of California and produced such walnuts during the representative period _______________, 20__ through _______________, 20__, is entitled to cast one Ballot. Each separate business unit, partnership, family enterprise, corporation, association, estate, or firm is entitled to one vote.

“Producer” means any individual, partnership, corporation, association, or other business unit who:

1. Owns and farms land producing English walnuts for market;

2. Is a renter or tenant of a farm producing English walnuts for market; or

3. Is a landlord who received from a renter or tenant a portion of the production as rent for the land on which English walnuts were produced for market. (A landlord who rents for cash, a lien-holder or a person having only a financial interest in the crop is NOT eligible to vote.)

5. HOW TO VOTE:

Indicate your vote by placing an ‘X’ in the appropriate box.

Certify your walnut production by listing the pounds of English walnuts produced for market by you (or by the producer for whom this Ballot is cast) during the period __________________, 20___, through ___________________ , 20___.

Print or type your name, phone number, business name, and address.

Proxy voting is not authorized. If Ballot is cast by an officer or employee of a partnership, corporation, or other business unit, check box to indicate your business designation, and sign to indicate authority to vote. If partnership or joint venture, list names of partners.

Sign below the certification. Incomplete or unsigned Ballots cannot be counted. Fold your Ballot so the Referendum Agent’s address is displayed, seal with tape and mail to:

Referendum Agent

USDA-AMS-FV-NWMFO

2202 MONTEREY ST, SUITE 102-B

FRESNO, CA 93721.

For further information, please call ______________________ at (559) 487-5901.

Ballots must be postmarked by _______________, 20__ to be valid.

FV-126-A (Rev. 1/2014. Destroy previous editions.)