APPROVED - OMB NO. 0581-0093

UNITED STATES DEPARTMENT OF AGRICULTURE

AGRICULTURAL MARKETING SERVICE

NOMINATION FOR APPOINTMENT TO THE LAMB

PROMOTION, RESEARCH, AND INFORMATION

BOARD (BOARD)

Please mark an "X" in appropriate block: Producer

Seedstock Producer

Feeder

First Handler

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 0581-0093. 

The time required to complete this information collection is estimated to average 30 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.

NOTE: Information is collected to obtain names of nominees for appointment as members of the Board. Response is

voluntary. Pursuant to the Lamb Promotion, Research, and Information Order, the following names are submitted as

nominees.

NAME(S) OF NOMINEE(S)

(List name(s) for each allotted position on the Board)

IF MORE SPACE IS NEEDED, USE ADDITIONAL FORMS. A COMPLETED ADVISORY COMMITTEE BACKGROUND INFORMATION FORM SIGNED BY

EACH NOMINEE MUST BE ATTACHED.

WHEN NOMINATIONS ARE THE RESULT OF A CAUCUS, LIST THE CERTIFICATION NUMBERS OF ORGANIZATIONS OR

ASSOCIATIONS PARTICIPATING IN THE CAUCUS.

A. E. I.

B. F. J.

C. G. K.

D. H. L.

IDENTIFICATION OF PERSON AND ORGANIZATION/ASSOCIATION SUBMITTING THESE NOMINATIONS

NAME, ADDRESS, AND EMAIL CERTIFICATION NO. NAME AND TITLE (Type or print)

TELEPHONE NO. SIGNATURE DATE

RETURN ORIGINAL OF THIS FORM AND THE ADVISORY COMMITTEE BACKGROUND INFORMATION FORM TO:

Research and Promotion Division 

Livestock and Poultry Program, AMS, USDA

1400 Independence Avenue, SW.; Room 2625-S; STOP 0251

Washington, D.C. 20250-0251 

LP-84 (Expiration Date 11/30/2024) See reverse for burden/non-discrimination statement
 

 LP-84 (Expiration Date 11/30/2024)

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.