SC-1 (966) FL. Tomatoes Producer Referendum

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

U.S. DEPARTMENT OF AGRICULTURE

AGRICULTURAL MARKETING SERVICE

SPECIALTY CROPS PROGRAM

OFFICIAL PRODUCER BALLOT

Marketing Order No. 966: Tomatoes Grown In Florida

This Ballot will be held in strict confidence. Be sure Parts II, III, and IV of your Ballot are completed. Unsigned Ballots, or Ballots that cannot be validated because Parts II, III, or IV are incomplete, will not be counted.

PART I - REFERENDUM INSTRUCTIONS

A. REFERENDUM PERIOD: ______________, 20___ through ______________, 20___ is the period during which producers may vote in the continuance of the marketing order regulating the handling of tomatoes grown in Florida. For the referendum to pass, it must be supported by at least two-thirds of the growers voting and/ or at least two-thirds of the volume of tomato production in Florida represented by those voting in the referendum.

B. ELIGIBILITY REQUIREMENTS: Any person who produced tomatoes for market during the period of _________, 20___ through ________, 20___ and who is now a producer, is eligible to vote. Such persons may vote on the items (1) through (6) using the attached ballot.

1. A producer is defined as: (a) any person who produces tomatoes in the designated production area; (b) a renter or tenant of acreage producing tomatoes for market; or (c) a landlord who received from a renter or tenant tomatoes as rent for the land on which such tomatoes were grown. A cash landlord, lienholder, or person having only a financial interest in the crop is not an eligible voter.

2. A business unit, partnership, family enterprise, corporation, association, estate, or firm may vote. Each such entity is entitled to one vote.

3. If you believe you are eligible to submit more than one ballot, additional ballots may be obtained by contacting the Southeast Marketing Field Office at (863) 324-3375.

4. Proxy voting is not authorized.

C. INSTRUCTIONS FOR VOTING: Provide the voter information requested in Part II. In Part III, mark in the block of your choice for each referendum question. Please note that each issue includes a reference to the affected section of the order as it appears in the attached order. Certify your vote by signing the appropriate section of Part IV. If you do not complete Parts II, III, and IV, your Ballot cannot be validated, and your vote will not be counted. Remove the pages containing Parts II, III, and IV, and return them in the envelope provided.

BALLOTS POSTMARKED AFTER ____________________, 20___

WILL NOT BE COUNTED IN THE REFERENDUM.

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.

PART II - VOTER INFORMATION

This information will be held in strict confidence.

A. Your name: ___________________________________________________________________________________

B. What is the specific location of your tomato acreage represented in this Ballot?

_____________________________________________________________________________________________

C. Do you reside on the above property which produces the tomatoes? □ Yes □ No

If no, please provide your residential address and telephone number: ______________________________________

______________________________________________________________________________________________

D. If you are not voting as an individual producer, please check the appropriate box indicating your voting status and write the name and address of the business unit you represent.

□ Partnership □ Corporation □ Other (Specify) _______________________________________________

Business Name: ________________________________________________________________________________

Business Address: ______________________________________________________________________________

E. What is the number of cartons (25 lbs.) tomatoes, or equivalent, you produced for market during the period of _________ through ________? _________ lbs.

F. What is the number of acres of Florida Tomatoes you harvested during the period of _________ through __________? _______________ acres.

G. Which packinghouse(s) handled your Florida Tomatoes during the representative period?

Name: __________________________________ Name: ________________________________________

Address: ________________________________ Address: ______________________________________

________________________________________ _______________________________________________

PART III - REFERENDUM QUESTION

This referendum is for continuance of Marketing Order number 966 (Order), as amended, regulating the handling of tomatoes grown in Florida. The Secretary of Agriculture (Secretary) will consider termination of the Order if less than two thirds of those voting and less than two thirds of the volume represented in the referendum favor continuance. Indicate your vote by placing an “X” in the appropriate box.

 I FAVOR continuance of the Order  I DO NOT FAVOR continuance of the Order

PART IV - VOTER CERTIFICATION

All information provided in this Ballot will be subject to on-site verification by officials of the Office of Inspector General, U.S. Department of Agriculture. The information on this Ballot is required to determine the voter eligibility and vote of Florida Tomato producers. Falsification of information on this government document may result in a fine, imprisonment, or both (18 U.S.C. 1001).

A. Your signature, if signing as an individual.

I am the producer named in Part II of this Ballot, and I certify that I am not a cash landlord, lienholder, or person having only a financial interest in the crop, and that the information provided on this Ballot and any attachment hereto is accurate and correct to the best of my knowledge.

______________________________________________________ ________________________________

Signature Date

B. If signing as the representative of a producing entity other than an individual, designate your title and sign below.

I am the representative named in Part II of this Ballot: A partner casting the Ballot for a partnership; or an officer or employee casting the Ballot for a cooperative association, corporation, school, institution, or similar business unit; or the administrator, executor, or trustee casting the Ballot for a producing estate; and, by signing this Ballot, I agree to provide evidence thereof at the request of an authorized agent of the Secretary of Agriculture.

___________________________________________________________ ________________________________

Signature and title Date

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: program.intake@usda.gov. USDA is an equal opportunity provider, employer, and lender.

SC-01 (Rev. XX/2017) Destroy previous editions.