OMB Control No. 0580-0015
U.S. Department of Agriculture Grain Inspection, Packers and Stockyards Administration Packers and Stockyards Program |
Rider for General Use with Trust Fund Agreement or Trust Agreement (Bond Equivalents) Required Under Packers and Stockyards Act, 1921, As Amended and Supplemented |
To be attached to and to form a part of Trust Fund Agreement No. (1) . or Trust Agreement No. (2) in the amount of (3) $ , dated (4) ,
naming (5) .
,
as Principal, (6) ,
as Trustee; and if a Trust Fund Agreement, (7) ,
as Depository.
The subject Agreement is amended as follows:
8. Increase in sum of The sum of the Trust Fund Agreement identified above is increased.
Trust Fund Agreement FROM $ .
TO $ ,
Not For Use with Trust Agreement
(If a Depository is named, complete the Depository Statement on the second page of this form.)
9. Decrease in sum of The sum of the agreement identified above is decreased.
Agreement FROM $ TO $ .
Not For Use with Trust Agreement
10. Change in name The name of the principal as given in the agreement identified above is changed.
of Principal FROM .
TO .
.
11. Change of Trustee The Trustee as given in the agreement identified above is changed.
FROM .
TO .
_______________________________________________________________________
The change in trusteeship and transfer of the original agreement to the new trustee is agreed to and accepted.
_____________________________________________ ____________________________________________
12(a) Former trustee’s signature 12(b) Successor trustee’s signature
13. Adding Condition The agreement identified above is amended to add Condition 3, Clearing Services.
Clause Three to
Agreement Please check YES or NO, as applicable YES NO
14. Deleting Condition The agreement identified above is amended to delete Condition 3, Clearing Services.
Clause Three to
Agreement Please check YES or NO, as applicable YES NO
15. Adding Clearee to THE NAME(S) OF .
Clause Three _______________________________________________________________________
of Agreement _______________________________________________________________________
(Name(s) and Address(s)
is (are) added as clearee(s) under the clearing services clause of agreement identified above.
16. Deleting Clearee THE NAME(S) OF .
from Clause Three _______________________________________________________________________
of Agreement _______________________________________________________________________
(Name(s) and Address(s)
is (are) deleted as clearee(s) under the clearing services clause of agreement identified above.
If This Rider Is Amending a Trust Fund Agreement, Please Complete Items 17 through 21, Otherwise Proceed to Item 22
17. Change of The Depository Is Changed
Depository FROM .
(Name(s) and Address(s)
.
TO .
(Name(s) and Address(s)
.
____________________________________________ __________________________________________
18(a) Signature of Officer of Former Depository 18(b)* Signature of Officer of Successor Depository
Depository
Statement
19.
Name of Bank or Other
Depository
20.
Account or Security(ies)
Identification and Number
Depository
acknowledges having received notice that the account and/or
security(ies) identified above are trust funds under the above trust
fund agreement, to be paid out only as directed in writing by
trustee, or by a successor trustee appointed by Packers and
Stockyards Program and properly identified as such, or by a court of
competent jurisdiction. Depository will not be responsible for any
person's disposition of such funds.
21.
Depository by (Authorized
signature)
All other conditions of this agreement remain the same.
22. This rider shall become effective as of the day of , 20 .
_______________________________________ ___________________________________
23(a) Signature of Principal 23(b) Signature of Trustee
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.
Form
P&SP-2400 August 2007 Page
File Type | application/msword |
File Title | RIDER FOR GENERAL USE WITH TRUST FUND AGREEMENT (BOND EQUIVALENT) REQUIRED UNDER PACKERS AND STOCKYARDS ACT, 1921, AS AMENDED |
Author | IRM |
Last Modified By | cmgrasso |
File Modified | 2008-10-09 |
File Created | 2007-07-25 |