OMB No. 0581-0264
NOMINATION FOR APPOINTMENT TO THE SOFTWOOD LUMBER BOARD
SOFTWOOD LUMBER RESEARCH, PROMOTION, CONSUMER EDUCATION AND INDUSTRY INFORMATION ORDER
(7 CFR PART 1217)
The
following statements are made in accordance with the Privacy Act of
1974 (U.S.C. 552a) and the Paperwork Reduction Act of 1995. The
authority for requesting this information to be supplied on this
form is the Commodity Promotion, Research, and Information Act of
1996, Pub. L. 104-127, 110 Stat. 1032 (7 U.S.C. 7411-7425).
Furnishing the requested information is necessary for the
administration of this program. Submission of the Tax
Identification Number is mandatory, and will be used to determine
affiliation or entity identification.
Names of Nominees and Position (Domestic Manufacturer or Importer and the REGION) for which each person is nominated. Nominees must meet eligibility requirements as described in §§ 1217.40 and 1217.41 of the Order. Nominees must also domestically ship or import the majority of their softwood lumber from the region for which they are nominated and may be asked to provide substantiating documentation to the Board. The regions are as follows: US West, US South, Northeast and Lake States; Canadian West; Canadian East; all other importing countries (please specify).
Nominee Name ________________________________________ Region_______________________
Address:
|
Name of Person or Organization submitting these nominations
Name of Organization/Person: ____________________________________ Tax ID/Importer#________________ Address: ___________________________________________________________________________________ City: _________________________ State: ________________ Zip: __________________ Phone No. ______________________ Fax No. _____________________
E-Mail: ________________________ |
Print Name and Title of Person Completing this Nomination
________________________________________________________________________________________________________ Signature Date |
Return Original Forms to: Softwood Lumber Board
Street, City, State, Zip Code
SWL-NOM (06/10)
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
0581-0264. The time required to complete this information
collection is estimated to average 15 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.
SWL-NOM (06/10)
File Type | application/msword |
File Title | Payment Due On or Before: |
Author | Margaret Irby |
Last Modified By | USDA |
File Modified | 2013-06-20 |
File Created | 2013-06-20 |