No Form No. (955) Nominations to the Vidalia Onion Committee

OMB No. 0581-0178

VIDALIA ONION COMMITTEE

P.O. Box 1609, Vidalia, GA 30475

Phone: (912) 537-1918 / Fax: (912) 537-2166

NOMINATIONS TO THE VIDALIA ONION COMMITTEE

Please use this form to cast your nomination for individuals to serve on the Vidalia Onion Committee for fiscal years 20___ / 20___.

I nominate the following people to serve on the Vidalia Onion Committee.

1. __________________________________ 2.___________________________________

3. __________________________________ 4.___________________________________

5. __________________________________ 6.___________________________________

7. __________________________________ 8.___________________________________

THIS IS NOT A BALLOT!

Please submit to the Vidalia Onion Committee by ________________, 20___ at the address above.

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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.

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