DA-19 Dairy Nomination of Milk Producers or Importers to Serve

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

U.S. DEPARTMENT OF AGRICULTURE AGRICULTURAL MARKETING SERVICE

DAIRY PROGRAMS

NOMINATION OF MILK PRODUCERS OR IMPORTERS TO SERVE ON THE NATIONAL DAIRY PROMOTION AND RESEARCH BOARD

(Under the Dairy Production Stabilization Act of 1983 and the Dairy Promotion and Research Order (7 CFR 1150.101 et seq.))

The Dairy Promotion and Research Order (Order) provides that producer and farm organizations, and importer and importer organizations may nominate milk producers or dairy product importers to serve on the National Dairy Promotion and Research Board. Each producer and importer organization may submit to the Secretary nomination(s) for each appointment to be made as defined in §1150.131 and §1150.133 of the Order in which the organization represents producers or importers. The nominee must be a milk producer located in the region such person is to represent, or a dairy product importer as defined in §1150.121 of the Order.

Attach a separate sheet if additional space is needed. Please submit a separate form for each nominee.

If any nominee(s) is named as a result of a caucus of organizations representing milk producers in the same region or importers, identify the nominee(s) and list for each the

names and addresses of the organizations participating in the caucus.

NOMINEE(S) NAMES AND MAILING ADDRESSES OF ORGANIZATIONS

NAME AND MAILING ADDRESS OF ORGANIZATION SUBMITTING THIS NOMINATION FORM

RETURN ORIGINAL TO: USDA, AMS, DAIRY PROGRAMS

PROMOTION AND RESEARCH BRANCH

Street

City, State, and Zip

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DA-19 (Expiration Date xx/xx/20xx) See reverse for burden/non-discrimination statement