The Edward R. Madigan USA Export Excellence Award Applic

APPLICATION INSTRUCTIONS FOR
THE EDWARD R. MADIGAN UNITED STATES AGRICULTURAL EXPORT EXCELLENCE AWARD
No Madigan Award will be considered unless a completed application form has been received.
By submitting this application, the applicant authorizes Federal Departments, Agencies, and Commissions to provide the
U.S. Department of Agriculture with information pertaining to the applicant for the purposes of determining the
Applicant’s eligibility and fitness to receive the award for which it is applying.
The Edward R. Madigan United States Agricultural Export was established by Congress in the Federal Improvement and Reform
(FAIR) Act of 1996. The award commemorates Edward R. Madigan who, as a congressman from Illinois and later as Secretary of
Agriculture, played a major role in reshaping U.S. agricultural policy to enable farmers and ranchers to respond more effectively to
market signals and pursue export opportunities.
I. PURPOSE
The Madigan Award is designed to help increase U.S. agricultural exports by:
• Identifying efforts of U.S. entities to develop and expand markets through new products and services and innovative marketing
techniques;
• recognizing achievements of those who have demonstrated or supported entrepreneurial efforts to expand and create new
markets for, or increase the value or volume of, agricultural exports; and
• Disseminating information on successful methods for developing and expanding markets for U.S. agricultural exports.
II. CATEGORIES
Entities may apply or be nominated for the Madigan Award in one of three categories:
• Development of new products or services for agricultural export markets;
• Development of new agricultural export markets; or
• Creative marketing of products or services in these markets
III. QUALIFICATION CRITERIA
To qualify for the Madigan Award, an entity must have:
• exhibited significant entrepreneurial effort to create new markets for, or to increase exports of, U.S. agricultural products; or
• Provided significant assistance to others in creating new markets for, or increasing exports of, U.S. agricultural products.
In addition, entities must:
• not have received another award in the same category for 5 years; and
• Meet other requirements that the Secretary of Agriculture deems appropriate.
IV. HOW TO APPLY
To be considered for the Madigan Award, an entity must apply to the board in writing or be nominated for it by the governor of a State.
All applications and nominations should be sent to: Coordinator, Edward R. Madigan United States Agricultural Export Excellence
Award, U.S. Department of Agriculture, Foreign Agricultural Service, Office of Trade Programs, STOP 1020, 1400 Independence
Avenue., S.W., Washington, DC 20250-1020. Questions about the application can be e-mailed to Dale.Miller@fas.usda.gov.
CONFIDENTIALITY
The U.S. Department of Agriculture will preserve the confidentiality of information about entities that falls under the categories of trade
secrets, proprietary information, and privileged commercial or financial material.
VI. ELIGIBILITY
The eligibility of an entity to receive the Madigan Award will be based on a background check to disclose such factors as that entity’s
financial status, debarment or suspension from Government programs, and violations of Federal laws and regulations. In addition,
entities must:
•
not have received another award in the same category for 5 years; and,
•
Meet other requirements that the Secretary of Agriculture deems appropriate.
VII. AWARDS FOR ENTREPRENEURIAL EFFORT

Applications and nominations of entities that have exhibited significant entrepreneurial effort to create new markets for or to increase
exports of, U.S. agricultural products can include one or more of the following:
• statistical evidence of a substantial increase (by value or volume) in exports over the past 3 years
• information showing that exports constitute a significant share of the entity's total product sales or significantly exceed the
industry average
• opening of a market previously closed to U.S. companies
• expansion of a market previously limited by difficult competitive conditions
• introduction of a new product or service to U.S. agricultural export trade
• key exporting difficulties that have been overcome
• details on foreign competition
• information about the entity's product(s) or service(s)
• the entity's market research and strategic planning
• the entity's international marketing program
• opening or expansion of a sales office to serve a foreign market
• information on organizations (financial institutions, freight forwarders, etc.) used in the entity's export operations
• a description of the development or expansion of the entity's distributor network and/or joint ventures
• Participation in trade missions and shows.
VIII. AWARDS FOR ASSISTANCE IN ENTREPRENEURIAL EFFORT
Applications and nominations of entities that have provided significant assistance to others in creating new markets for, or increasing
exports of, U.S. agricultural products can include one or more of the following:
• a detailed description of service(s) provided to exporters
• information on innovative solutions to trade problems
• a description of promotional program(s)
• Statistical evidence of the effectiveness of the service(s) or program(s).
IX. BOARD OF EVALUATORS
The Secretary of Agriculture appoints a board of at least five individuals from the private sector, chosen for their knowledge and
experience in exporting U.S. agricultural products, to evaluate applications and nominations for the Madigan Award. The board reports
its recommendations for award recipients to the Secretary of Agriculture.
X. RECIPIENT
On the basis of recommendations received from the board of evaluators, the President of the United States or the Secretary of
Agriculture presents the award to entities that significantly contribute to the advancement of U.S. agricultural exports.
To help fulfill the purpose of the Madigan Award, recipients are expected to provide general information on export techniques they have
found successful to interested parties. Entities may publicize their receipt of the Madigan Award in advertisements and other materials.
XI. PREPARATION OF APPLICATION FORM
Item 1. AWARD BEING APPLIED FOR: Select only one.
Item 2. ORGANIZATION INFORMATION: Name of the organization as you would wish it to appear on the Madigan Award Plaque.
Item 3. SIGNATURE: The application should be signed by a responsible official (officer of organization or individual).
Item 4. TYPE OF ORGANIZATION: Indicate if the firm is a manufacturer, service exporter, agricultural producer or service
organization such as an export management company, freight forwarder, financial or educational institution, chamber of commerce,
state agency. If a subsidiary or division of another organization, explain under JUSTIFICATION FOR AWARD why sub-unit should
receive the Award rather than the parent organization.
Item 5. EMPLOYEES: Indicate the number of U.S. employees currently working for the organization and how many of this number are
employed directly due to export activities, either production for export markets or management of international sales and marketing. If a
trade association, chamber of commerce, trade club or similar organization, include total membership of the association.
Item 6. MAJOR PRODUCTS EXPORTED: To identify your product or services NAICS category please accesses the following web
site: http://www.census.gov/epcd/www/naics.html.
Item 7. STATE OFFICIAL RECOMMENDING AWARD: The signature of a State official is required.
Item 8. EXPORT STATISTICS: Please list export figures for each of the four (4) past years, plus latest quarterly data. Data should
include shipments to Canada and Mexico, but NOT to Puerto Rico, Virgin Islands, Alaska and Hawaii. If you wish this information

treated as BUSINESS CONFIDENTIAL, please so indicate by checking the box below. Except to the extent required by law, no
information or data for which the applicant has requested BUSINESS CONFIDENTIAL treatment will be disclosed to persons not
involved in processing this application without the applicant’s prior written consent. Statistics should be given on the basis of actual
export data, not estimated future projections.
Item 9. KEY EXPORTING CHALLENGES: Self-explanatory.
Item 10. JUSTIFICATION: In a clear and concise manner, the applicant should: outline the organization’s entrepreneurial efforts or
assistance in entrepreneurial effort, which forms the basis for the Award application (See VII. AWARDS FOR ENTREPRENEURIAL
EFFORT and VIII. AWARDS FOR ASSISTANCE IN ENTREPRENEURIAL EFFORT). Applicant should also indicate how the
organization met the challenges indicated in Item 9: KEY EXPORTING CHALLENGES.

According to the Paperwork 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 number for this information collection is 0551-0031. 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 & maintaining data needed for completing & 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, sex,
religion, age, disability, political beliefs, sexual orientation, and marital or family status. (Not all prohibited bases apply to all programs.) Persons with
disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact USDA’s TARGET
Center at (202) 720-2600 (voice and TDD).
To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, Room 326-W, Whitten Building, 14th and Independence Avenue, SW,
Washington DC 20250-9410 or call (202) 720-5964 (voice and TDD). USDA is an equal opportunity provider and employer

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March 2012, OMB 0551-0031

APPLICATION FOR THE EDWARD R. MADIGAN UNITED STATES AGRICULTURAL EXPORT EXCELLENCE AWARD
No Madigan Award will be considered unless a completed application form has been received.
By submitting this application, the applicant authorizes Federal Departments, Agencies, and Commissions to provide the U.S.
Department of Agriculture with information pertaining to the applicant for the purposes of determining the applicant’s eligibility
and fitness to receive the award for which it is applying.
Final Selection will be made by the Secretary of Agriculture.
1. AWARD BEING APPLIED FOR (Choose one):

4. TYPE OF ORGANIZATION:

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SUBSIDIARY OR DIVISION OF:

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Entrepreneurial – New Products or Services
Entrepreneurial – Development of New Markets
Entrepreneurial – Creative Marketing
Entrepreneurial Assistance - New Products and Services
Entrepreneurial Assistance-Development of New
Markets
Entrepreneurial Assistance – Creative Marketing

(If applicable explain under justification for Award why sub-unit
should receive the Award rather than the parent organization.)
5. EMPLOYEES:

2. ORGANIZATION INFORMATION:

Total number of employees…………… ___________

Organization Name:

Number of employees whose jobs……. ___________
are attributed to exporting

Street Address:

City, State, Zip:

Total membership …..………………… ___________
(Applicable to trade associations, chambers of commerce,
trade clubs, et cetera)

Telephone:

6. MAJOR PRODUCTS EXPORTED:

Street Address:

Fax:
Company Web Site:
Tax ID Number:
NAICS category (ies):

Name of Organization’s President:
Identify company ownership:
If the company has two or more owners, please mark a “1” and “2” (or
“3”, etc.) in the boxes to indicate the race/ethnicity of each owner.
Please check all categories of race/ethnicity that apply to each owner.

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
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American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Other Islander
White

3. SIGNATURE:
I have reviewed the information provided in this application and, to the
best of my knowledge, all the information provided is true and correct.
I understand that the Madigan Board of Evaluators will review this
application.

Signature of Responsible Official

Date

Signature of Corporate Secretary
or Other Responsible Official (if applicable)

Date

7. STATE OFFICIAL RECOMMENDING AWARD:

Signature of State Official

Title

Date

8. EXPORT STATISTICS:
Please list export figures for each of the four (4) past years, plus latest quarterly data. Data should include shipments to Canada
and Mexico, but NOT to Puerto Rico, Virgin Islands, Alaska and Hawaii. If you wish this information treated as BUSINESS
CONFIDENTIAL, please so indicate by checking the box below. Except to the extent required by law, no information or data for
which the applicant has requested BUSINESS CONFIDENTIAL treatment will be disclosed to persons not involved in processing
this application without the applicant’s prior written consent.


BUSINESS CONFIDENTIAL
YEAR

TOTAL SALES

EXPORT SALES

PERCENTAGE OF
EXPORTS TO TOTAL
SALES

INCOME FROM
LICENSING
AGREEMENTS

9. KEY EXPORTING CHALLENGES: Check key exporting problems met: (Include in “Justification” section below discussion on
how you overcame these problems)
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Development obtaining foreign distribution

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Specifications

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Packaging

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Delivery

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Credit terms

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Pricing

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Tariff barriers

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Dealer restrictions

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Non-tariff barriers

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Corporate organization

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Import quotas

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Product design

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Foreign Production
Selecting export channels of distribution

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Spare parts and servicing

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Adverse competitive conditions

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Market research

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Foreign language requirements

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Other (specify)

10. JUSTIFICATION FOR AWARD: (Use additional paper, if necessary. Please attach to nomination form. See Instructions for
guidance with writing justification.)

Comment [p1]:

XI. PREPARATION OF APPLICATION ADDENDUM

CUT AND PASTE OR PHOTOCOPY THE TEXT BELOW (IRS WAIVER) ONTO COMPANY LETTERHEAD OR
ORGANIZATION LETTERHEAD
In connection with the above-named company's (or organization's) application to the Department of Commerce for
the President's Madigan" Award, I am signing this waiver to permit the Internal Revenue Service (IRS) to release
otherwise confidential tax information about the company (or organization) to appropriate officials of the Department
of Commerce. This waiver is made pursuant to 26 U.S.C. 6103and is limited to the following:
1. Whether this company (or organization) has failed to file a Federal income tax return for any of the last three
years for which filing of a return might have been required. (If the filing date, without regard to extensions, and
normal processing period for the most recent year's return has not yet elapsed on the date IRS receives this
waiver, and the IRS records do not indicate a return for the most recent year, the "last three years" will mean
the three years preceding the year for which returns are currently being filed and processed.)
2. Whether there is any tax, penalty or interest liability for which the IRS gave notice of the amount due and
requested payment that has been outstanding for more than 180 days and has not yet been paid.
3. Whether this company (or organization) has been or is under investigation by the IRS for possible criminal
offenses.
4. Whether this company (or organization) has been assessed any civil penalty for fraud during the current or last
three calendar years.
In the event of an adverse response to any of the above (negative to subparagraph 1 or affirmative to
subparagraph(s) 2, 3, or 4), I hereby authorize the Internal Revenue Service to provide to the Department of
Commerce, upon request, additional tax information pertaining to such adverse response.
To assist the Internal Revenue Service in locating the Federal tax information, I am voluntarily providing the following
information regarding the company (or organization):
Name of Company______________________________________________________________________
Employer Identification Number (EIN): ______________________________________________________
Address: _____________________________________________________________________________
Returns required to be filed: ______________________________________________________________
_____________________________________________________________________________________
If consolidated corporate income tax returns were filed for any of the years covered by No. 1 above, complete the
following:
Name of parent company: ________________________________________________________________
EIN of Parent Company__________________________________________________________________
Year(s): _______________________________________________________________________________
If an income tax return for any of the last three years was not filed, please explain why (e.g., a non-profit organization):
_________________________________________________________________________
If signing as a corporate officer, partner, tax matters partner/person, I certify that I have the authority to execute this
form on behalf of the taxpayer.
(Signature)______________________________
(Title)__________________________________
(Date)__________________________________
REQUIRED BY THE TAX REFORM ACT OF 1976