FV-133 ID./E. Oregon Potatoes Confidential Background Statement

OMB No. 0581-0178

REPRODUCE LOCALLY. Include fonn number and date on all TeDroductions.

U.S. DEPARTMENT OF AGRICULTURE
AGRICULTURALMARKETING SERVICE
FRUIT AND VEGETABLE PROGRAMS

IDAHO - EASTERN OREGON POTATO COMMITTEE
P. o. Box 2192
Idaho Falls,ill 83403

CONFIDENTIAL BACKGROUND STATEMENT
(COMMITTEE MEMBER)
MARKETING ORDER NO. 945
POSITION

DISTRICT
Name

COMMITTEE YEAR
Telephone (

Address (Business)

(If you are a handler, also show your firm's name and in what capacity you serve in such firm.)

Years growing (if grower member)
Potato acreage (if grower member)

Years handling (if handler member)
Approximate cars handled (if handler member)
Membership in industry organizations

Marketing order committee members, in their official capacities, are prohibited from taking any action specifically designed to influence legislation, including any attempt to
influence public opinion concerning legislation. Committee members may not communicate with any official of a State or Federal legislative body for the purpose of
attempting to influence legislation. Committee members are also prohibited from attempting to influence State or Federal government actions or policies or those offoreign
governments, except as specifically authorized under the marlceting order or expressly approved by the Secretary. Committee members are specifically precluded from
authorizing the expenditure of marlceting order funds for the purpose of attempting to influence legislation or government actions. These same prohibitions apply to committee
managers, staf( and contractors, except that conunittee managers may consuh with the Department of Agriculture (USDA) employees during the pendency ofinfonnal
rulemaking actions.
If marketing order committee or subcommittee members or committee employees are sued individually or jointly for errors in judgement, mistakes or other acts, either of
omission or commission (except for acts of dishonesty, willful misconduct, or gross negligence) in the conduct of their duties under the marlceting agreement or order, they
may be authorized legal defense by the Department of Justice (DOl). Alternatively, legal defense may be provided through private counsel, if recommended by USDA and
approved by DOJ. USDA and DOJ enjoy an excellent working relationship with respect to providing legal representation for committee members and employees, either by
DOJ or through authorized private counsel. USDA is committed to a comprehensive legal defense policy for all committee members and employees acting within the scope of
their authorized committee duties and responsibilities.

I am willing to serve on the Idaho

(Signature)

-Eastern

Oregon Potato Committee.

(Date)

The above infonnation is required to detennine the eligibility and willingness ofthe nominee to serve on the conunittee.
According to the Paperwork Reduction Act of i995, 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 5 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.
The u.s. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, disability, and where
applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part of an
individual's income is derived from any public assistance program (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for
communication of program information (Brail/e, large print, audiotape, etc.) should contact USDA's TARGET Center at (202) 720-2600 (voice and TDD). To file a complaint of
discrimination, write to USDA, Director, Office of Civil Rights, 1400 independence Avenue, S.w., Washington, D.C. 20250-9410, or call (800) 795-3272 (voice) or (202) 7206382 (TDD). USDA is an equal opportunity provider and employer.
FV-133 (07/07)