BLU-NAF Blueberry-Nominee Application

Form Approved OMB No. 0581-0093

U.S. HIGHBUSH BLUEBERRY COUNCIL

BLUEBERRY PROMOTION RESEARCH AND INFORMATION ORDER

STATE/REGION NOMINEE APPLICATION

The national cultivated blueberry promotion, research and information order, the U.S. Highbush Blueberry Council (USHBC), is seeking highbush (cultivated) blueberry producers to serve as state/region USHBC members.

To be listed as a nominee on the final ballot, you must complete this application and return it to the U.S. Highbush Blueberry Council (USHBC) office no later than by close of business on Date, Month XX, 20XX. (See Nominee Application Instruction Sheet included with this application for details concerning eligibility, terms of office, etc.)

Nominees for the following USHBC state/region positions are requested:

Top Six Production States (20XX to 20XX)

1. XXXXX 4. XXXXXX

2. XXXXX 5. XXXXXX

3. XXXXX 6. XXXXXX

Please add my name to the ballot as a nominee for USHBC member/alternate for the state/region of:

CHECK ONE ONLY. APPLICATIONS WITH MORE THAN ONE STATE/REGION MARKED WILL BE REJECTED

[ ] STATE/REGION

[ ] STATE/REGION

[ ] STATE/REGION

PRINT

Nominee Name: ________________________________________________

Street: _________________________________________________________

City: ______________________________________ State: __________ Zip: _______________

Phone: ________________________________ Fax: ______________________________

Email: _____________________________________________

I hereby certify that I have produced 2,000 pounds or more of cultivated blueberries in the state indicated above during the period of xx/xx/xx to xx/xx/xx.

Signature: ______________________________________________ Date: ________________________

(Application Continues on Back of This Page)

BLU-NAF (rev.03/17) Destroy previous edition.

Nominee Qualification Statement:

Please type or print your reasons for applying for this USHBC state position, your background and experience. Note that the information you provide will be reprinted and distributed with the final ballot and will be used by voters in determining their selection. By providing this information you hereby consent to having it published with the final ballot.

(Use additional page if necessary)

To be listed on the final state ballot you must return this completed application to the U.S. Highbush Blueberry Council (USHBC) no later than by the close of business on Date, Month XX, 20XX. Incomplete or inaccurate applications, or any application received after 5pm Pacific time that day will not be accepted. Applications can be sent to the USHBC via fax to (XXX) XXX-XXXX, e-mail to xxxxxx, or mail to:

USHBC State Nominees

c/o U.S. Highbush Blueberry Council

Street

City, State Zip

USHBC Diversity Outreach Policy

The USHBC has adopted a diversity outreach plan to attempt to achieve a diverse representation on the Council. USHBC programs are open to all individuals without regard to race, color, national origin, sex, religion, age, disability, political beliefs, sexual orientation, genetic information, parental status, and marital or family status. It is USHBC policy that membership on the Council and its committees reflect the diversity of individuals served by its programs. To accomplish this objective, the USHBC will strive to attain representation of growers and other industry participants from diverse backgrounds on the Council and USHBC committees. To this end, the USHBC strongly encourages women, minorities and persons with disabilities to seek nominations to the USHBC and to participate in Council and USHBC committee activities.

If you have any questions concerning this nomination procedure, or the final balloting process, please contact the USHBC office 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 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.

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.

BLU-NAF (rev.03/17) Destroy previous edition.

Reproduce Locally. Include form number and date on all reproductions Form Approved – OMB No. 0581-0093

U.S. HIGHBUSH BLUEBERRY COUNCIL

BLUEBERRY PROMOTION, RESEARCH and INFORMATION ORDER

COUNCIL MEMBER NOMINEE APPLICATION INSTRUCTIONS

The national cultivated blueberry promotion, research and information order, the U.S. Highbush Blueberry Council (USHBC), is seeking highbush (cultivated) blueberry producers to serve as state members and alternates. To be listed as a nominee on the final ballot, you must complete the enclosed application and return it to the U.S. Highbush Blueberry Council office.

Nomination Period

Nominations for state/region member positions on the USHBC will be accepted from Month XX to Month XX, 20XX. Completed applications must be received by the USHBC no later than close of business on Date, Month XX, 20XX.

Nominee Eligibility

Each person (as defined below) who produced 2,000 pounds or more of cultivated blueberries during the period of January 1, 20XX through December 31, 20XX is eligible to be nominated to the USHBC.

1. A person means any individual, group of individuals, partnership, corporation, association, cooperative, or any other legal entity.

1. Partnership includes, but is not limited to: (a) a husband and wife who have title to, or leasehold interest in, a blueberry farm as tenants in common, joint tenants, tenants by the entirety, or, under community property laws, as community property, and (b) joint ventures wherein one or more parties to the agreement, informal or otherwise, contributed land and others contributed capital, labor, management, or other services, or any variation of such contributions by two or more parties.

2. Eligible producer means any person who produced 2,000 pounds or more of blueberries (cultivated) in the United States during the representative period who: (a) Owns, or shares the ownership and risk of loss of, the crop; (b) Rents blueberry production facilities and equipment resulting in the ownership of all or a portion of the blueberries produced; (c) Owns blueberry production facilities and equipment but does not manage them and, as compensation, obtains the ownership of a portion of the blueberries produced; or (d) is a party in a landlord-tenant relationship or a divided ownership arrangement involving totally independent entities cooperating only to produce blueberries who share the risk of loss and receive a share of the blueberries produced. No other acquisition of legal title to blueberries shall be deemed to result in persons becoming eligible producers.

3. Blueberries means only cultivated blueberries grown in the United State of genus

Vaccinium Corymbosum and Ashei, including the northern highbush, southern highbush, and rabbit eye varieties and excluding the lowbush (native) blueberry Vaccinium Angustifolium.

Nominee Positions

Producer nominees are now requested for X USHBC state/region member positions from the top six highbush blueberry production states. Those receiving the most votes for each producer seat will be recommended as council members. Those receiving the second most votes for each position will be recommended as the alternate for that position. The names of those who receive the third and fourth most votes will also be sent on to the U.S. Secretary of Agriculture for consideration. Nominees for the following state USHBC member positions are requested:

BLU-NAF (rev.03/17) Destroy previous edition.

State Representatives

• XXXXX

• XXXXX

• XXXXX

• XXXXX

• XXXXX

• XXXXX

Terms of Office

USHBC state/region members and alternates will serve for a term of three years starting January 1, 20XX and will be able to serve a maximum of two consecutive terms. A USHBC member may serve as an alternate during the years the member is ineligible for a member position.

How to be Placed on the Final Ballot as a USHBC Nominee

To be listed on the final USHBC state ballot you must complete all information required in the Nominee Application Form included in this packet. (Note: Application Form is also available on the USHBC website @ www.XXXX.org.) Once complete, the application is to be sent on to the U.S. Highbush Blueberry Council office to arrive no later than the close of business on Date, Month XX, 20XX.

Incomplete applications, or any application received after 5 pm Pacific Time on Month XX, 20XX, will not be accepted. Applications can be faxed to the USHBC at (xxx) xxx-xxxx or sent via e-mail to xxxxxxx, or mail to:

USHBC State/Region Nominee

U.S. Highbush Blueberry Council

Street

City, State Zip

Names of nominees will then be placed on the final state ballots to be mailed to growers on Month XX, 20XX. Voting will take place over a five-week period from Month XX to Month XX, 20XX.

If you have any questions concerning this USHBC state member nomination procedure, or the final balloting process, please contact the USHBC office at (xxx) xxx-xxxx.

BLU-NAF (rev.03/17) Destroy previous edition.