OMB NO. 0581-0093 |
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UNITED STATES DEPARTMENT OF AGRICULTURE AGRICULTURAL MARKETING SERVICE REFERENDUM ON THE SORGHUM PROMOTION AND RESEACH ORDER BALLOT |
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 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.
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NOTE: INSTRCUTIONS TO VOTERS (Please read carefully) |
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1. If voting as an individual, you must vote in the county Farm Service Agency (FSA) Office in the county in which you reside, or the county FSA Office serving the county in which you reside. |
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2. If voting on behalf of an entity (partnership, corporation, estate, etc.) you must vote in the county FSA office in which it is located, or the county FSA office serving the county in which it is located. |
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3. On the envelope marked "SORGHUM REFERENDUM," complete the required Registration information and sign the Certification Statement. |
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4. Mark the "Ballot" below. |
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5. Fold in half and insert into the envelope marked "SORGHUM BALLOT" and seal. |
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6. Insert the "SORGHUM BALLOT" envelope into the envelope marked "SORGHUM REFERENDUM," seal, and deposit into the "Ballot Box." |
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Do you support continuation of the Sorghum Promotion and Research Order? |
YES |
NO |
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NOTE: Insert this ballot into the envelope marked "Sorghum Ballot," seal, and place into the envelope marked "Sorghum Referendum."
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LP-379 (Expiration Date XX/XX/XXXX) |
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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.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | LS-379 |
Author | Leigh Ann Gallion |
File Modified | 0000-00-00 |
File Created | 2021-01-13 |