No Form number (984) CA Walnut Bd. Ballot (Producer Members & Alternate

OMB No. 0581-0178

VOTING DEADLINE

________________, 20___

CALIFORNIA WALNUT BOARD

101 Parkshore Drive, Suite 250

Folsom, CA 95630

Tel: (916) 932-7070 Fax: (916) 932-7071

BALLOT

PRODUCER MEMBERS AND ALTERNATES

DISTRICT NO. 1 consists of the counties of the State of California that lie north of a line drawn on the southern boundaries of San Mateo, Alameda, San Joaquin, Calaveras, and Alpine counties. DISTRICT NO.2 consists of all other counties in the State of California south of the boundary line set forth in the definition of District No. 1.

VOTING INSTRUCTIONS: In accordance with the provisions of sections 984.35(_)(_), 984.35(_)(_), and 984.35(_)(_) of Marketing Order No. 984, as amended, I hereby vote for the following members and alternates as representatives of producers of the California Walnut Board (Board) for the two-year term beginning September 1, _____________________, 20___.

For the district positions, you may vote for ___ member(s) and ___ alternate(s) from your district. Indicate your vote by placing an “X” in the box opposite the name of the member(s) and alternate(s) of your choice, according to your district. Write-in lines are provided if you wish to nominate qualified walnut producers from your district who are not shown on this Ballot. Please type or print clearly your candidate’s name and address in the space provided.

Producers who grow walnuts in more than one district must select one district in which they wish to vote. Your Ballot will be invalidated if you vote for more than ___ person(s) for each position or if you vote in more than one district.

BY DISTRICT ONLY

Member (Producer)	District 1	District 2	Alternate (Producer)	District 1	District 2
Write-In Candidate for District 1:			Write-In Candidate for District 1:
Write-In Candidate for District 2:			Write-In Candidate for District 2:

For the statewide positions, you may vote for one member and one alternate regardless of your district. Indicate your vote by placing an “X” in the box opposite the name of the member and alternate of your choice. Write-in lines are provided if you wish to nominate qualified walnut producers from either District 1 or District 2 who are not shown on this Ballot.

For the statewide at-large position, your Ballot will be invalidated if you vote for more than one person for each position.

STATE OF CALIFORNIA AT-LARGE POSITION

Member (Producer)	Vote	Alternate (Producer)	Vote
Write In:		Write In:

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.

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 5 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.

CERTIFICATION OF ELIGIBILITY

I hereby certify that I am currently a qualified walnut producer in District 1  or District 2  and have voted in only one district.

______________________________________________________ ________________________________________

Legal Name of Voting Entity Tax ID No.

________________________________________________________________________________________________________

Address (incl. City, State, and Zip Code)

______________________________________________________ ________________________________________

Authorized Signature Phone No.

Please indicate the following about the producer (legal entity) for which you are voting:

□ Individual □Trust □Partnership □Corporation □Estate If a partnership, list partner(s) ________________________________________________________________________________________________________

BACKGROUND INFORMATION

In the event one handler does not handle 35% or more of the crop:

§ 984.35(a)(3) Two grower members from District 1;

§ 984.35(a)(4) Two grower members from District 2;

§ 984.35(a)(5) One grower member nominated at large from the production area.

In the event one handler handles 35% or more of the crop:

§ 984.35(b)(4) One member to represent growers from District 1 who market their walnuts through handlers that do not handle 35% or more of the crop;

§ 984.35(b)(5) One member to represent growers from District 2 who market their walnuts through handlers that do not handle 35% or more of the crop; and

§ 984.35(b)(6) One member to represent growers who market their walnuts through handlers that do not handle 35% or more of the crop shall be nominated at large from the production area.

Grower Districts:

§ 984.35(c) Grower Districts:

(1) District 1. District 1 encompasses the counties in the State of California that lie north of a line drawn on the south boundaries of San Mateo, Alameda, San Joaquin, Calaveras, and Alpine Counties.

(2) District 2. District 2 shall consist of all other walnut producing counties in the State of California south of the boundary line set forth in paragraph (c)(1) of this section.

At-large Member Position:

§ 984.437(a) With regard to Board grower member positions specified in §984.35(a)(5) or (b)(6), any ten or more such growers who marketed an aggregate of 500 or more tons of walnuts through handlers who did not handle 35% or more of the crop during the marketing year preceding the year in which Board nominations are held, may petition the Board to include on the nomination ballot the name of an eligible candidate for this position, and the name of an eligible candidate to serve as his or her alternate. The names of the eligible candidates proposed pursuant to this paragraph shall be included on the ballot together with the names of any incumbents who are willing to continue serving on the Board.

District 1 and 2 Member Positions:

§ 984.437(b) Any ten or more growers eligible to serve in the grower member positions specified in §§ 984.35(a)(3) and (4), or §984.35(b)(4) and (5), and who marketed an aggregate of 500 or more tons of walnuts through handlers who did not handle 35% or more of the crop during the marketing year preceding the year in which Board nominations are held, may petition the Board to include on the nomination ballot for a district the name of an eligible candidate for the applicable position, and the name of an eligible candidate to serve as his or her alternate. The names of the eligible candidates proposed pursuant to this paragraph shall be included on the ballot together with the names of any incumbents who are willing to continue serving on the Board.

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex, gender identity (including gender expression), sexual orientation, disability, age, marital status, family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all programs). Remedies and complaint filing deadlines vary by program or incident.

Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.) should contact the responsible Agency or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.

To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at http://www.ascr.usda.gov/complaint_filing_cust.html and at any USDA office or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: (1) mail: U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue, SW Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email: [email protected]. USDA is an equal opportunity provider, employer, and lender.

(Rev. 1/2017) Destroy previous editions.