AVO-OPB Avocados Producer Ballot

OMB No. 0581-0093
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HASS AVOCADO BOARD
BOARD OF DIRECTORS ELECTION 20xx
OFFICIAL PRODUCER BALLOT
PLEASE FOLLOW THESE FOUR STEPS:
1.
2.
3.
4.

Determine your voting eligibility
Sign your ballot (required)
Check the appropriate voting boxes
Return ballot by Month xx, 20xx

DEADLINE TO RETURN YOUR BALLOT IS Month xx, 20xx
See reverse side for further information 

VOTER ELIGIBILITY, CERTIFICATION AND VOTING INSTRUCTIONS
STEP 1: In order to be eligible to vote, you must currently meet the definition of a Hass avocado producer: Under the
Hass Avocado Promotion, Research and Information Order, 7 CFR Part 1219, a PRODUCER is defined as: Any person who is
engaged in the business of producing Hass avocados in the United States for commercial use, who owns, or shares the ownership and
risk of loss, of such Hass avocados. All Board members and alternates shall be domiciled in the U.S.

If you DO NOT meet the criteria, check the box to the right, print and sign your name, and return your
ballot without completing it.
Name:______________________________ Signature:____________________________ Date:______________
Print

STEP 2: If you are an eligible Hass producer, complete the certification and voting sections below.
I hereby certify that I am a Hass avocado producer.

______________________________

___________________

Your avocado legal or business entity name

Signature

______________________
Date

UNSIGNED BALLOTS ARE INVALID AND WILL NOT BE COUNTED
STEP 3: Vote for no more than xx (x) producer nominees (including write-ins) by placing a check (√ ) in the left column
next to your preference. If you vote for more than X producer nominees, your ballot will be disqualified. If you wish to
vote for a producer whose name is not on the ballot, you may write the name of the person on the write-in line and
check the appropriate space. Candidate statements are included in this election package.

Vote √

PRODUCER NOMINEES

Vote √

PRODUCER NOMINEES

Write-in optional
Write-in optional
Write-in optional

AVO-OPB (Rev. 02/17) Destroy previous editions.

OMB No. 0581-0093

STEP 4: Mail this ballot to (audit firm) in the return envelope provided no later than Month xx, 20xx.
AUDIT FIRM NAME
ADDRESS
CITY, STATE, ZIP

ADDITIONAL VOTING INSTRUCTIONS
The XX producer member and xx producer alternate member seats will be open for the November 1, 20xx to
October 31, 20xx (3-year) term.
Voters who are eligible as both a producer and an importer must declare in writing prior to each election
whether they will be voting as a producer or an importer. Please complete the form included in your packet
and fax to HAB at xxx-xxx-xxxx.
Please cast your ballot for the nominees, OR WRITE IN THE PRODUCER NAME(S) OF YOUR CHOICE. If
you choose to write in a candidate name, you must include their full name and contact information. Each Hass
avocado producer is entitled to submit one ballot. If more than one ballot is submitted by the same producer,
that producer’s ballot will not be counted. An unsigned ballot or incomplete Certification Statement will
disqualify the ballot.
Signed ballots must be returned to (audit firm) in the enclosed, prepaid, self-addressed envelope. Ballots must
be received no later than close of business on Month xx, 20xx. Ballots received after that date will not be
counted.
If you have any questions regarding the ballot, please contact HAB at xxx-xxx-xxxx.
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 0581-0093. 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.
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.

AVO-OPB (Rev. 02/17) Destroy previous editions.

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IMPORTANT NOTICE
Voters who are eligible as both a producer and an
importer must declare in writing prior to each election
whether they will be voting as a producer or an
importer.
If you represent both Producer and Importer, please
complete the following and fax to HAB at xxx-xxx-xxxx.

I will be voting as: (check one)
 PRODUCER
 IMPORTER

Name: ____________________________________

Signature: _________________________________
If proper protocol is not followed, your vote could be disqualified.

AVO-OPB (Rev. 02/17) Destroy previous editions.