SC-60 Producers Continuance Referendum Ballot (945, 946, 955,

REPRODUCE LOCALLY. Include form number and date on all reproductions. OMB No. 0581-0178

VOTING INSTRUCTIONS AND RULES GOVERNING PRODUCER ELIGIBILITY TO VOTE

I. VOTING PERIOD: __________________, 20___, through ____________________, 20___.

II. REPRESENTATIVE PERIOD: _______________, 20___ through _______________, 20___.

III. PRODUCTION AREA: State(s) of ________________.

IV. PERSONS ELIGIBLE TO VOTE: Any person, who is currently a _________ producer in the production area and produced such ______________ during the representative period ____________________, 20___, through ____________________, 20___, is entitled to cast one Ballot. Each separate business unit, partnership, LLC, family enterprise, corporation, association, estate, or firm is entitled to one vote.

“Producer” means any individual, partnership, LLC, corporation, association, institution, estate, or other business unit who:

• Owns and farms land resulting in ownership of the _______ produced thereon;

• Rents and farms land resulting in ownership of all or a portion of the _______ produced thereon; or

• Owns land from which, as rental for such land, ownership is obtained of a portion of the ____ produced thereon. (A lien holder, cash landlord, or person having only a financial interest in the ______ crop is not eligible to vote.)

V. HOW TO VOTE:

1. Indicate your vote by placing an “X” in the appropriate box.

2. Certify your ______ production by listing the volume in pounds that you produced, the number of acres in production, and the county or counties in which such spearmint oil was produced during the representative period __________, 20___, through _______________, 20___. If you are renting on a share-crop basis, you should show only that part of the crop represented by your share.

3. List the handlers who handled your _____, the pounds, and affiliation (co-op or independent).

4. Print or type your name, phone number, business name, and address.

5. Proxy voting is not authorized. If Ballot is cast by an officer or employee of a partnership, LLC, corporation, association or other business unit, check box to indicate your business designation, and sign to indicate authority to vote. If partnership or joint venture, list names of partners.

6. Sign below the certification. Incomplete or unsigned Ballots cannot be counted. Fold your Ballot so the Referendum Agent’s address is displayed, seal with tape and mail to:

Referendum Agent

USDA-AMS-SCP-______

_______________

_______________

For further information, please call (___) ___-____.

Ballots must be postmarked by _____________________, 20___ to be valid.

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 0581-0178. The time required to complete this information collection is estimated to average 20 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.

__________ BALLOT

UNITED STATES DEPARTMENT OF AGRICULTURE

Agricultural Marketing Service

Specialty Crops Program

___________

___________

___________

__________

TO ________ PRODUCERS:

The U.S. Department of Agriculture is conducting a referendum to determine whether ______ producers in ______________ favor continuance of Federal Marketing Order No. _____. As a consequence, an order directing that a referendum be held was published in the Federal Register on ___________________________, 20___.

A Producer Referendum Ballot is on the reverse side of this page. Also enclosed are:

1. Voting Instructions and Rules Governing Producer Eligibility to Vote;

2. News Release issued on the Referendum; and

3. Copy of the Referendum Order dated ______________________, 20___.

The voting period for the referendum is _____________________, 20___, through ___________________, 20___. Please vote promptly because Ballots postmarked later than ___________________, 20___, cannot be opened or counted. Each Ballot will be held in strict confidence.

_______________________________________

Referendum Agent

Phone: (___) ___-____

PRODUCER REFERENDUM BALLOT

Marketing Order No. ___: _________ Produced in _______

Please read the enclosed VOTING INSTRUCTIONS AND RULES GOVERNING PRODUCER ELIGIBILITY TO VOTE before completing this Ballot.

This referendum is being held to determine producer support for the Federal Marketing Order regulating the handling of _____ grown in ____. The Secretary of Agriculture (Secretary) will consider termination of this order if less than two-thirds of those voting and less than two-thirds of the volume represented in the referendum favor continuance.

A. Do you favor continuance of Marketing Order No. ___, regulating the handling of _____ grown in ________?

 YES  NO

PRODUCER ELIGIBILITY STATEMENT

B. I hereby certify that I am currently a producer of _____ within the production area and that during the representative period __________________, 20___, through __________________, 20___, I produced for market _____________________________ pounds on ___________________________ acres in __________________________________________________________________ County(ies).

C.

Name of Handler(s) who Handled your _______	Pounds	Affiliation (co-op or independent)

D. Producer’s Name _______________________________________ Telephone Number ________________________

Name of Business ________________________________________________________________________________

Mailing Address __________________________________________________________________________________

City ______________________________________ State _______________ Zip Code ________________

E. If this Ballot is cast by an officer or employee of a partnership, LLC, corporation, association or other business unit, my signature below further certifies that I am duly authorized to vote on behalf of the producing entity name on this Ballot and that I will submit evidence of such authority at the request of an Agent of the Secretary.

Partnership LLC Corporation Association Other __________________________________

_________________________________________________________ ________________________________

Signature* Title

____________________________________________________________________________________________

If Partnership or Joint Venture, list name(s).

F. I hereby certify that the information I provided on this Ballot is accurate and correct to the best of my knowledge.

_____________________________________________________________ ________________________________

Signature* Title

*Your signature certifies that you have the authority to take such action and will submit supplementary evidence of such authority at the request of an agent of the Secretary. The information provided in this Ballot is required to determine the voter eligibility and vote of spearmint oil producers. Falsification of information on this government document may result in a fine or imprisonment, or both (18 U.S.C. 1001).

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.

_____________ BALLOT

UNITED STATES DEPARTMENT OF AGRICULTURE

Agricultural Marketing Service

Specialty Crops Program

___________

___________

___________

Referendum Agent

USDA-AMS-SCP-_______

__________

__________

 FOLD HERE, TAPE AT THE TOP, AND MAIL PROMPTLY 

_________ BALLOT

SC-60 (Exp. x/xxxx) Destroy previous versions.