FV-15 924-Fresh Prunes Confidential Background Questionnaire/S

REPRODUCE LOCALLY. Include form number and date on all reproductions.
WASHINGTON-OREGON FRESH PRUNE
MARKETING COMMITTEE
P.O. Box 2386
Yakima, WA 98907

OMB No. 0581-0189

U.S. DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE
FRUIT AND VEGETABLE PROGRAMS

CONFIDENTIAL BACKGROUND STATEMENT
(COMMITTEE MEMBER)
MARKETING ORDER NO. 924
DISTRICT

POSITION

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.)
E-mail address
Years growing (if grower member)
Fresh prune acreage (if grower member)
Years handling (if handler member)
Approximate tons 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 of foreign governments, except as specifically authorized under
the marketing order or expressly approved by the Secretary. Committee members are specifically precluded from authorizing the expenditure of
marketing order funds for the purpose of attempting to influence legislation or government actions. These same prohibitions apply to Committee
managers, staff, and contractors, except that Committee managers may consult with the Department of Agriculture (“USDA”) employees during
the pendency of informal 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 marketing agreement or order, they may be authorized legal defense by the Department of Justice (“DOJ”). 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 Washington-Oregon Fresh Prune Marketing Committee.
Signature

Date

The above information is required to determine the eligibility and willingness of the nominee to serve on the Committee.
NOTE: 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 05810189. 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 (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 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) 720-6382 (TDD). USDA is an equal opportunity provider and employer.

FV-15 (Rev. 7/10. Destroy previous editions.)