REPRODUCE LOCALLY. Include form number and date on all reproductions. OMB No. 0581-0178
U.S. DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE
SPECIALTY CROPS PROGRAM
OFFICIAL PRODUCER BALLOT
Marketing Order No. 955: Vidalia Onions Grown In Georgia
This Ballot will be held in strict confidence. Be sure Parts II, III, and IV of your Ballot are completed. Unsigned Ballots, or Ballots that cannot be validated because Parts II, III, or IV are incomplete, will not be counted.
PART I - REFERENDUM INSTRUCTIONS
REFERENDUM PERIOD: __________, 20___ through __________, 20___ is the Referendum period during which producers may vote on this marketing order. For this marketing order to continue, it must be supported by at least two-thirds of the producers voting or at least two-thirds of the volume of Vidalia onion production represented by those voting in the Referendum.
B. ELIGIBILITY REQUIREMENTS: Any person who produced Vidalia onions for market during the period of January 1, 20___ through December 31, 20___, and who is now a producer, is eligible to vote. Such persons may vote on the continuance of the marketing order using the attached Ballot.
1. A producer (or grower) is defined as: (a) any person who produces Vidalia onions in the designated production area; (b) a renter or tenant of acreage producing Vidalia onions for market; or (c) a landlord who received from a renter or tenant Vidalia onions as rent for the land on which such Vidalia onions were grown. A cash landlord, lienholder, or person having only a financial interest in the crop is not an eligible voter.
2. A business unit, partnership, family enterprise, corporation, association, estate, or firm may vote. Each such entity is entitled to one vote.
3. Proxy voting is not authorized.
C. INSTRUCTIONS FOR VOTING: Provide the voter information requested in Part II. In Part III, mark the block for or against the marketing order. Certify your vote by signing the appropriate section of Part IV. If you do not complete Parts II, III, and IV, your Ballot cannot be validated, and your vote will not be counted. Remove the pages containing Parts II, III, and IV, and return them in the envelope provided.
BALLOTS POSTMARKED AFTER ____________________, 20___
WILL NOT BE COUNTED IN THE REFERENDUM.
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 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.
PART II - VOTER INFORMATION
This information will be held in strict confidence.
A. Your name: ___________________________________________________________________________
B. What is the specific location of your Vidalia onion acreage represented in this Ballot?
_____________________________________________________________________________________
Address, City, State, and Zip code
C. Do you reside on the above property which produces the Vidalia onions? □ Yes □ No
If no, please provide your residential address and telephone number: _______________________________
_____________________________________________________________________________________
Address, City, State, and Zip code
____________________________________
Telephone
D. If you are not voting as an individual producer, please check the appropriate box indicating your voting status and write the name and address of the business unit you represent.
□ Partnership □ Corporation □ Other (Specify) __________________________________________
Business Name: ________________________________________________________________________
Business Address: ______________________________________________________________________
E. What is the number of 40 pound bags of Vidalia onions, or equivalent, you produced for market during the period of January 1, ____ through December 31, ____? _________ bags.
F. What is the number of acres of Vidalia onions you harvested during the period of January 1, ____ through December 31, _____? _______________ acres.
G. Which packinghouse(s) handled your Vidalia onions during the representative period?
Name: __________________________________ Name: _____________________________________
Address: ________________________________ Address: ___________________________________
________________________________________ __________________________________________
PART III - REFERENDUM QUESTION
Do you favor continuance of Marketing Order No. 955, regulating the handling of Vidalia onions grown in Georgia? □ YES □ NO
PART IV - VOTER CERTIFICATION
All information provided in this Ballot will be subject to on-site verification by officials of the Office of Inspector General, U.S. Department of Agriculture. The information on this Ballot is required to determine voter eligibility and vote of Vidalia onion producers. Falsification of information on this government document may result in a fine, imprisonment, or both (18 U.S.C. 1001).
A. Your signature, if signing as an individual.
I am the producer named in Part II of this Ballot, and I certify that I am not a cash landlord, lienholder, or person having only a financial interest in the crop, and that the information provided on this Ballot and any attachment hereto is accurate and correct to the best of my knowledge.
______________________________________________________ _______________________
Signature Date
B. If signing as the representative of a producing entity other than an individual, designate your title and sign below.
I am the representative named in Part II D of this Ballot: A partner casting the Ballot for a partnership; or an officer or employee casting the Ballot for a cooperative association, corporation, school, institution, or similar business unit; or the administrator, executor, or trustee casting the Ballot for a producing estate; and, by signing this Ballot, I agree to provide evidence thereof at the request of an authorized agent of the Secretary of Agriculture.
___________________________________________________________ _____________________
Signature and title Date
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.
SC-156 (Rev. 01/2017) Destroy previous editions.
File Type | application/msword |
File Title | REPRODUCE LOCALLY |
Author | TTicheno |
Last Modified By | Pish, Marylin - AMS |
File Modified | 2017-02-01 |
File Created | 2017-02-01 |