AVO-OIB Avocados Importer Ballot

OMB No. 0581-0093
(Logo)

HASS AVOCADO BOARD
BOARD OF DIRECTORS ELECTION 20XX
OFFICIAL IMPORTER BALLOT
PLEASE FOLLOW THESE FOUR STEPS:
1.
2.
3.
4.

Determine your voting eligibility
Sign your ballot (required)
Check the appropriate voting boxes
Return ballot by Month xx, 20xx

DEADLINE TO RETURN YOUR BALLOT IS Month xx, 20xx
See reverse side for further information 

VOTER ELIGIBILITY, CERTIFICATION AND VOTING INSTRUCTIONS
STEP 1: In order to be eligible to vote, you must currently meet the definition of a Hass avocado importer: Under
the Hass Avocado Promotion, Research and Information Order, 7 CFR Part 1219, an IMPORTER is defined as: Any person
who imports Hass avocados into the United States. The term includes a person who holds title to Hass avocados
produced outside of the United States immediately upon release by Customs, as well as any person who acts on
behalf of others, as an agent, broker, or consignee, to secure the release of Hass avocados from Customs and
the introduction of the released Hass avocados into the current of commerce and who is listed in the import
records of Customs as the importer of record for such Hass avocados. Board members and alternates shall be
domiciled in the United States.
If you do not meet the criteria, check the box to the right, print and sign your name, and return your
ballot without completing it.
Name:___________________________ Signature:__________________________________ Date:_____________
(Print)

STEP 2: If you are an eligible Hass importer, complete the certification and voting sections below.
I certify that I am an importer of Hass avocados in the United States.

_____________________________
Your legal or avocado business entity name

___________________
Signature

______________________
Date

UNSIGNED BALLOTS ARE INVALID AND WILL NOT BE COUNTED
STEP 3: Vote for no more than xx importer nominees (including write-ins) by placing a check (√ ) in the left column
next to your preference. If you vote for more than xx importer nominees, your ballot will be disqualified. If you wish to
vote for an importer whose name is not on the ballot, you may write the name of the person on the write-in line and
check the appropriate space. Candidate statements are included in this election package.

Vote √

IMPORTER NOMINEES

Vote √

IMPORTER NOMINEES

Write-in optional
Write-in optional
Write-in optional

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OMB No. 0581-0093
STEP 4: Mail this ballot to (audit firm) in the return envelope provided no later than Month xx, 20xx.
AUDIT FIRM NAME
ADDRESS
City, State, Zip

ADDITIONAL VOTING INSTRUCTIONS
The XX importer member and xx importer alternate member seats will be open for the November 1, 20xx to
October 31, 20xx (3-year) term.
Voters who are eligible as both a producer and an importer must declare in writing prior to each election
whether they will be voting as a producer or an importer. Please complete the form included in your packet
and fax to HAB at (xxx) xxx-xxxx.
Please cast your ballot for the nominees, OR WRITE IN THE IMPORTER NAME(S) OF YOUR CHOICE. If
you choose to write in a candidate name, you must include their full name and contact information. Each
Hass avocado importer is entitled to submit one ballot. If more than one ballot is submitted by the same
importer, that importer’s ballot will not be counted. An unsigned ballot or incomplete Certification Statement
will disqualify the ballot.
Signed ballots must be returned to (audit firm) in the enclosed, prepaid, self-addressed envelope. Ballots
must be received no later than close of business on Month xx, 20xx. Ballots received after that date will not
be counted.
If you have any questions regarding the ballot, please contact HAB at (xxx) xxx-xxxx.
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 0581-0093. The time required to complete this information collection is estimated to average 15 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.
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.

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OMB No. 0581-0093

IMPORTANT NOTICE
Voters who are eligible as both a producer and an
importer must declare in writing prior to each election
whether they will be voting as a producer or an
importer.
If you represent both Producer and Importer, please
complete the following and fax to HAB at xxx-xxx-xxxx.

I will be voting as: (check one)
 PRODUCER
 IMPORTER

Name: ____________________________________

Signature: _________________________________
If proper protocol is not followed, your vote could be disqualified.

AVO-OIB (Rev. 02/17) Destroy previous editions.