OMB CONTROL NO. 0580-0015
U.S. Department of AgricultureGrain Inspection, Packers and Stockyards AdministrationPackers and Stockyards Program |
Rider for General Use with Bond Required Under the Packers and Stockyards Act, 1921, as Amended and Supplemented |
Know all that (1) ______________________________________________________________
(Name of Current Principal)
_____________________________of (2)___________________________________________,
(City, State)
as Principal, and (3)_____________________________________________________________
(Name of Surety)
as Surety, issued bond number (4)_______________________, dated (5)__________________,
in favor of (6)_________________________________________________________________,
(Name of Trustee)
as Trustee.
In consideration of the premium charged for the above-described bond, Principal and Surety agree to amend the bond as follows:
Complete the applicable clause(s) set out below: |
|
7. Increase in Bond |
The bond identified above is increased FROM: $ TO: $ |
8. Decrease in Bond |
The bond identified above is decreased FROM: $ TO: $ |
9. Change in Name of Principal |
The name and address of the Principal, as given on the bond identified above, are changed
FROM ________________________________________________________________ (Name and Address) ______________________________________________________________________
TO___________________________________________________________________ (Name and Address) ______________________________________________________________________
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10. Change in Name of Trustee |
The name and address of the Trustee, as given on the bond identified above, are changed
FROM ________________________________________________________________ (Name and Address) ______________________________________________________________________
TO___________________________________________________________________ (Name and Address) ______________________________________________________________________
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11. Add Clearing Services
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The bond identified above is amended to add Condition 3, Clearing Services.
Yes No |
12. Delete Clearing Services
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The bond identified above is amended to delete Condition 3, Clearing Services.
Yes No |
13. Add Clearee to Clause 3 |
The name(s) of: _________________________________________________________ (Name and Address) ______________________________________________________________________
______________________________________________________________________
______________________________________________________________________ is (are) hereby added as clearee(s) to the bond identified above. |
14. Delete Clearee from Clause 3 |
The name(s) of: _________________________________________________________ (Name and Address) ______________________________________________________________________
______________________________________________________________________
______________________________________________________________________ is (are) hereby deleted as clearee(s) from the bond identified above. |
PROVIDED, however, that the identified bond above shall be subject to all its agreements, limitations, and conditions except as herein expressly modified, and further that this bond and all riders attached thereto, including this rider, shall not be cumulative, and when loss shall occur under this bond during a period of time within which the penalty of the bond shall vary, the aggregate liability of Surety shall in no event exceed the largest penalty of this bond in force during the period of time within which such loss shall occur under this bond.
15. This rider shall become effective as of the _____________ day of ____________________, 20____.
16. Signed and dated this _____________ day of ____________________, 20____.
17. (Name of Principal)
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(Signing on Behalf of Principal)
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18. (Name of Surety)
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(Signing on Behalf of Surety)
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19. (Name of Trustee)
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(Signing on Behalf of Trustee) |
20. Optional Additional Notes from Surety (for example special State requirements)
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According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information is 0580-0015. The time required to complete this collection is estimated to average 30 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection.
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part of an individual’s income is derived from any public assistance program. (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact USDA’s TARGET Center at (202) 720-2600 (voice and TDD). To file a complaint of discrimination, write to USDA, Director, Office of Civil Rights, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.
File Type | application/msword |
File Title | OMB CONTROL NO |
Author | IRM |
Last Modified By | cmgrasso |
File Modified | 2008-10-09 |
File Created | 2007-07-25 |