Form LS-87 Nomination of Sheep Industry Board

REPRODUCE LOCALLY.

FORM APPROVED OMB NO. 0581-0263
U.S. DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE

NOMINATIONS TO THE NATIONAL SHEEP INDUSTRY IMPROVEMENT CENTER BOARD
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 0581-0263. The time required to complete this information
collection is estimated to average 30 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.

Pursuant to the Commodity Promotion, Research, and Information Act of 1996, the following names of
sheep or goat producers are submitted as nominees to the National Sheep Industry Improvement Center
Board from the indicated State.

STATE/UNIT

NAMES(S) OF NOMINEE(S)
(List name(s) for each allotted position on the Board)

IF MORE SPACE IS NEEDED, USE ADDITIONAL FORMS.
A COMPLETED BACKGROUND INFORMATION SHEET SIGNED BY EACH NOMINEE MUST BE ATTACHED.

3. IDENTIFICATION OF PERSON AND ORGANIZATION/ASSOCIATION SUBMITTING THESE NOMINATIONS
A. NAME AND ADDRESS OF ORGANIZATION/ASSOCIATION

C. NAME AND TITLE (PRINT OR TYPE)

D. EMAIL ADDRESS ([email protected])

B. FACSIMILE NO. AND AREA CODE

RETURN FORMS TO:

LP-87 (Expires 09-30-22)

E. SIGNATURE

Research and Promotion Division
Livestock and Poultry Program, AMS
U.S. Department of Agriculture, Room 2610-S
1400 Independence Avenue, SW., STOP 0251
Washington, D.C. 20250-0251
FAX: (202) 720-1125

DATE

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