COC-150 (932) CA Olives - Producer Nominee Questionnaire

OMB No. 0581-0178

CALIFORNIA OLIVE COMMITTEE

PRODUCER NOMINEE QUESTIONNAIRE

Information concerning producer nominees to be used by the Secretary of Agriculture in selecting producer members and alternate producer members of the California Olive Committee (COC) pursuant to the Marketing Agreement and Order Regulating the Handling of Olives Grown in California.

CONFIDENTIAL

Name:_________________________________________________ Date of Birth:_____________________

Address:___________________________________________________ EIN:____________________________

City, State:_______________________________ Zip Code:___________ Phone:______________________

Fax:______________________ Email:__________________________________________________________

Number of years you have been a producer of olives for market as packaged olives: ________

Major varieties of olives you now farm, approximate acreage, and counties of production for each:

Variety		Approx. Acreage		County		Variety		Approx. Acreage		County

Approximate tonnage of olives for market as packaged olives produced by you during the 20___ season: _________ Tons, Natural Condition Weight.

Are you a member of a cooperative marketing association handling olives? ________________

If so, give name and any position held: ____________________________________________________________

Are you connected as an employee, officer, director, or other capacity with any independent organization handling olives? _________ If so, list name and indicate nature of connection: ____________________________________

____________________________________________________________________________________________

Are you a member of any other organization furthering the interest of olives producers? _________

If so, list such organizations and any positions held: __________________________________________________

____________________________________________________________________________________________

I will serve as a producer member or alternate producer member of the California Olive Committee.

__________________________ ______________________________________________

Date Signature

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 OMB 0581-0178. The time required to complete this information collection is estimated to average 6 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.

PRODUCER NOMINEE QUESTIONNAIRE

Marketing order committee members, in their official capacities, are prohibited from taking any action specifically designed to influence legislation, including any attempt to influence public opinion concerning legislation. Committee members may not communicate with any official of a State or Federal legislative body for the purpose of attempting to influence legislation. Committee members are also prohibited from attempting to influence State or Federal government actions or policies or those of foreign governments, except as specifically authorized under the marketing order or expressly approved by the Secretary of Agriculture.

Committee members are specifically precluded from authorizing the expenditure of marketing order funds for the purpose of attempting to influence legislation or government actions. These same prohibitions apply to committee managers, staff, and contractors except that committee managers may consult with U.S. Department of Agriculture (USDA) employees during the pendency of informal rulemaking actions.

If marketing order committee or subcommittee members or committee employees are sued individually or jointly for errors in judgment, mistakes, or other acts either of omission or commission (except for acts of dishonesty, willful misconduct, or gross negligence) in the conduct of their duties under the marketing agreement or order, they may be authorized legal defense by the Department of Justice (DOJ). Alternatively, legal defense may be provided through private counsel, if recommended by USDA and approved by DOJ. USDA and DOJ enjoy an excellent working relationship with respect to providing legal representation for committee members and employees, either by DOJ or through authorized private counsel. USDA is committed to a comprehensive legal defense policy for all committee members and employees acting within the scope of their authorized committee duties and responsibilities.

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.

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.

COC-150 (Rev. 01/2017) Destroy previous editions.