SC-245 Producer Member Nomination Form

OMB No. 0581-0215

ADMINISTRATIVE COMMITTEE FOR PISTACHIOS FEDERAL MARKETING ORDER 983

Producer Member Nomination Form

Instructions

You may nominate yourself or another eligible producer for the district in which you produce pistachios. Nominees are needed for terms that expire on June 30, 20XX in Districts 1, 2, and X. Use one form per nomination (for additional forms make copies of this one or download at www.acpistachios.org).

1. Check the district in which you produce pistachios (choose one if you produce in multiple districts). The person nominated must be a producer, authorized officer or employee of a producer in this district.

2. Print the name and contact information of the person you are nominating.

3. Print your name and contact information.

4. Sign this form to certify that you, or your employer, currently produce pistachios in the District checked.

5. Return this form by email, fax, or mail by March XX, 20XX: Administrative Committee for Pistachios

4938 E. Yale Ave., Suite 102

Fresno, CA 93706

Phone: (559) 255-6480; Fax: (559) 255-6485; Email: [email protected]

Nomination

I nominate the following person for a member/alternate member position in District 1, 2, X:

Name of Nominee (Please print clearly):		Name of Business Operation:
Mailing Address, City, State and Zip:
Telephone Number:	Fax Number:	Email Address:

Certification

I certify that I, or my employer, currently produce pistachios in the District selected above and that I am authorized to submit this nomination.

Your Name (Please print clearly):	Name of Your Business Operation:
Mailing Address, City, State and Zip:
Telephone Number:	Email Address:
Signature: 	Date:

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 0581-0215. 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.

ADMINISTRATIVE COMMITTEE FOR PISTACHIOS FEDERAL MARKETING ORDER 983

Background Information

MARKETING ORDER 983

Marketing Order 983 (Order), regulating the handling of pistachios grown in California, Arizona and New Mexico became effective on November 3, 2009. The Administrative Committee for Pistachios (Committee) consists of 9 producer members, 2 handler members, 1 public member and their alternates. Of the 9 producer members, 4 are producer members and their respective alternates from District 1, 3 are producer members and their respective alternates from District 2, 1 is a producer member and his/her respective alternate from District 3, and 1 is a producer member and his/her respective alternate from District 4. The Order provides authority for pistachio producers in each of the four districts to submit the names of candidates for nomination for membership on the Committee. If you are interested in nominating yourself or another producer to serve on the Committee for Districts 1, 2, 3, or 4, please read the following information and submit the completed nomination form.

Producer member districts:

District 1: California counties Imperial, Kern, Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Luis Obispo, Santa Barbara, Tulare, and Ventura

District 2: California counties Fresno, Kings, Madera, and Merced District 3: California counties not in District 1 or 2

District 4: the states Arizona and New Mexico

20XX ELECTION: seeking nominations for the two year term July 1, 20xx – June 20, 20xx in Districts 1, 2, and X.

The Order specifies that a two-year term of office shall be staggered for elected producer members and their alternates. Every year the Committee solicits nominations for membership on the 12-member committee for the seats that expire June 30^th. Nominees will be notified and asked to return a Qualification and Acceptance form to verify eligibility and willingness to serve as a producer member or alternate producer member. Each producer member and alternate producer member on the Committee shall be, at the time of selection and during the term of office, a pistachio producer, or an officer or an employee of a producer. Members and alternate members are limited to eight consecutive years of service (may serve again after twelve or more months out of office). Names of eligible nominees will be placed on district ballots and sent to producers to vote for candidates of their choice.

NOMINATION ELIGIBILITY

Complete a nomination form to nominate yourself or another eligible producer to run for a position on the Committee. Nominees must produce pistachios in the district being nominated for. If you produce pistachios in more than one district, you may nominate a candidate from only one district of your choice. Only producers, including duly authorized officers or employees of producers, may participate in the nomination of candidates for producer members and their alternates. If you are both a producer and a handler of pistachios, you may participate in both producer and handler nominations.

AFFILIATION

The Order prescribes that not more than two members and not more than two alternate members shall be persons employed by, or affiliated with producers or handlers that are affiliated with the same handler and/or producer. Affiliation is defined as: normally appears as "affiliate of", or "affiliated with", and means a person such as a producer or handler who is: a producer or handler that directly, or indirectly through one or more intermediaries, owns or controls, or is controlled by, or is under common control with the producer or handler specified; or a producer or handler that directly, or indirectly through one or more intermediaries, is connected in a proprietary capacity, or shares the ownership or control of the specified producer or handler with one or more other producers or handlers. As used in this part, the term “control” (including the terms “controlling”, “controlled by”, and “under the common control with”) means the possession, direct or indirect, of the power to direct or cause the direction of the management and policies of a handler or a producer, whether through voting securities, membership in a cooperative, by contract or otherwise.

The following statements are made in accordance with the Privacy Act of 1974 (U.S.C. 552a) and the Paperwork Reduction Act of 1995, as amended. The authority for requesting the information to be supplied on this form is the Agricultural Marketing Agreement Act of 1937, Secs. 1-19, 48 Stat. 31, as amended, (7 U.S.C. 601-674). Furnishing the requested information is necessary for the administration of the marketing order program. Submission of the Tax Identification Number (TIN) is mandatory, and will be used to validate ballots and determine affiliation or entity identity. Please note that ballots will not become invalid if a TIN is not disclosed. The making of any false statements or representations in any matter within the jurisdiction of any agency of the United States, knowing it to be false, is a violation of title 18, section 1001 of the United States Code, which provides for fine or imprisonment, or both.

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, SW, Washington, D.C. 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.

SC-245 (Rev. 01/2017)