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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 Referendum 

period during which producers may vote for or against the proposed amendments to the marketing order 

regulating the handling of tomatoes grown in Florida. For an amendment to the marketing order to pass, it 

must be supported by at least two-thirds of the growers voting 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 

August 1, 20___ through July 31, 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. 
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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 August

1, ____ through July 31, ____? _________ lbs.

F. What is the number of acres of Florida Tomatoes you harvested during the period of August 1, ____ through July 31, 

_____? _______________ acres.

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

Name: __________________________________ Name: ________________________________________

Address: ________________________________ Address: ______________________________________

________________________________ ______________________________________

PART III - REFERENDUM QUESTION

“YES” VOTE MEANS YOU FAVOR THE CHANGE; “NO” VOTE MEANS YOU OPPOSE THE CHANGE.

TOMATOES GROWN IN FLORIDA MARKETING ORDER AMENDMENTS: YES NO

1.

2.

3.

4.

5.

6.

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 D 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
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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.