FV-162A 905 FL. Citrus - Cooperatives Certified Resolution

REPRODUCE

FORM APPROVED

LOCALLY. Include form number and date on aDreoroductions.

-OMS

NO. 0581.0189

U.S. DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE
FRUIT AND VEGETABLE PROGRAMS

COOPERATIVE'S CERTIFIED RESOLUTION
At a duly convened meeting of the Board of Directors of
(Name of Cooperative)

held at

on the
day of
, 20
, at which a quorum was presented and voting throughout, the following
resolution was duly adopted and was entered in the minutes of said meeting, and is now in full force and effect:
on behalf of the Persons who are

"Be it RESOLVED, that the
(Name of Cooperative)

members of, stockholders in, or under contract with said cooperative as growers of Oranges, Grapefruit, Tangerines
and Tangelos grown in Florida, hereby ( ) APPROVES AND FAVORS or ( ) DISAPPROVES AND DISFAVORS
the continuance of the Order Regulating the Handling of Oranges, Grapefruit, Tangerines and Tangelos Grown in
Florida, is further resolved,

That
Name of Person)

(Tit/e)

of the cooperative is hereby authorized and directed to supply the information requested in said ballot, and to cast
said ballot, all in accordance with this resolution, for and on behalf of the cooperative and the persons who are
members of, stockholders in, or under contract with this cooperative."
IN WITNESS WHEREOF, I have hereunto set my hand and affIXed the seal of said cooperative this
day of
,20

(Affix Corporate Seal;
If none, so state.)
(Signature)

The followingstatements aremade in accotdance wi/h/hePrivacyActof 1974(U.S.C.552a)and/he PapetWOrlc
ReductionActof 1995. Theau/horityformquesting/his
information to be supplied on /his fann is /he Agrlcultural Mattceling Agreement Act of 1937, Sees. 1-19, 48 Stat 31, as amended, (7 U.S. C. 601-674). Furnishing /he
requested information is necessary for the administration of /he marketing order program.
According to /he PapetWOrlcReduction Act of 1995, an agency may not conduct or sponsor, and a person is not requlredto I8SpOIICItoa collection of Infonnation unless it
displays a valid OMB cootrol number. The valid OMB cootrol number for /his InformationcoIJectJonis 0581-0189. The time requiredto complete /his information
collectionis estimated toaverage 5 minutes per response, Including /hetime for reviewing Instroctions, searching existing datasources, gatheringand maintainingthe
data needed, and completing and reviewing the collection of information.

The U.S. Departmentof Agrlculture(USDA)prohibitsdiscriminationin allits programs and activitieson the basis of race, color,nationalorigin,age, disability, and
where applicable,sex, marital status, familialstatus, parentalstatus, religion,sexual orientation,genelic information,politicalbeliefs, repI1sal,or because all or
part of an Individual'sincome Is derived from any publicassistance program (Notallprohibitedbases apply to al/ programs.) Persons with disabilitieswho require
alternative means for communication of program information (Braille, laf!16print, audiotape, etc.) should cootact USDA's TARGET Center at (202) 720-2600 (voice
and TOD).
To file a complaint of discrimination, write to USDA, Director, OffICe of Civil Rights, 1400 Independence AlIMue, S. w., Washington, D.C. 20250-9410, or call (800)
795-3272 (voice) or (202) 720-6382 (TOD). USDA is an equal opportunity provider and employer.

FV-162A (OS/07)