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U.S. DEPARTMENT OF AGRICULTURE
WA-90
Farm Service Agency
(05-29-13)
United States Warehouse Act
Form Approved - OMB No. 0560-0120
1. FOR FSA USE ONLY
A. License Number
CORPORATE SIGNATURE RESOLUTION
OR LIMITED LIABILITY COMPANY
SIGNATURE RESOLUTION
B. Initials
2. Check One:
Corporate Signature Resolution
Limited Liability Company Signature Resolution
The purpose of this form is to declare those who may execute documents on behalf of a corporation and or a limited liability company. If a corporation, this
declaration may not conflict with the Articles of Incorporation or the Bylaws. If a limited liability company, this declaration may not conflict with the Articles of
Organization or Operating Agreement.
Be it resolved that: (follow printed instructions exactly)
( a)
Corporation
I or We ( b)
(List only individual proper names here. Do not check boxes unless there are officer positions in ( f).)
( c)
and (means BOTH sign)
( d)
or (means EITHER sign)
( e)
and or (means ANY sign)
The ( f)
(List here only officers of the corporation authorized to sign. Do not check boxes unless there are proper names listed in ( a).)
( g) Limited
Liability Company
I or We ( h)
(List only individual proper names or titles)
is (are) hereby empowered to execute all bonds, supplemental bond agreements and other papers or documents required under the United States Warehouse Act
on behalf of the corporation or limited liability company, such power is to remain in effect until the Administrator of the United States Warehouse Act is given
notice in writing to the contrary by an official of the corporation or limited liability company.
Be it further resolved that:
the acts of any officer of the corporation or limited liability company in executing all previous applications, bonds and supplemental bond agreements under the
Act on behalf of the corporation or limited liability company are hereby ratified and approved.
Be it resolved that:
the purpose of this corporation or limited liability company shall include but not be limited to conducting a public warehouse for storage in accordance with the
applicable regulations and licensing agreements and the Act for agricultural products for interstate and/or foreign commerce.
Be it resolved that:
the principal place of business of the corporation or limited liability company is and shall be located at ( i)
,
(County)
.
( j)
(City and State)
3. CERTIFICATE OF BOARD RESOLUTION (CORPORATION)
, at a (b)
regular or (c)
special meeting of the board of directors of
I certify that on (a)
(Date) (MM -DD-YYYY)
(d)
(Name of Corporation)
held at (or by), (e)
(Location of Meeting or Nature of Meeting i.e. teleconference)
at which a quorum was present, that on motion made, seconded and carried, the above resolution was adopted; that this resolution has been spread on the minutes
of the board of directors; and that it has been made part of the permanent record.
Executed this (f)
.
day of (g)
(Day)
(Month and Year)
3H. Signature of Secretary
3I. Date (MM-DD-YYYY)
4. LIMITED LIABIITY COMPANY CERTIFICATION OF RESOLUTION
I (a)
of
, the (b)
(Name)
(Title)
( c)
( Legal Name of Limited Liability Company)
Certify that on (d)
the individual(s) listed above are to be authorized to sign United States Warehouse Act documents.
(Date (MM-DD-YYYY))
WA-90 (05-29-13)
NOTE:
Page 2
The following statement is made in accordance with the Privacy Act of 1974 (5 U.S.C. 552a - as amended). The authority for requesting the
information identified on this form is 7 CFR Part 735, 7 CFR Part 1423, 7 CFR Part 1427, the United States Warehouse Act (Pub. L. 106-472),
and the Commodity Credit Corporation Charter Act (15 U.S.C. 714 et seq.). The information will be used by the board of directors of a
corporation to designate individual(s) and/or officer(s) empowered to execute documents on behalf of the corporation or by a limited liability
company to certify individuals to be authorized to sign United State Warehouse Act documents. The information collected on this form may be
disclosed to other Federal, State, Local government agencies, Tribal agencies, and nongovernmental entities that have been authorized
access to the information by statute or regulation and/or as described in applicable Routine Uses identified in the System of Records Notice
for USDA/FSA-2, Farm Rec ords File (Automated) and USDA/FSA-3, Consultants File. Providing the requested information is voluntary.
However, failure to furnish the requested information will result in a determination of ineligibility to obtain new licensing or retain existing
licensing under the United States Warehouse Act.
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 an OMB control number. The valid OMB control number of this information collection is 0560-0120.
The time required to complete this information collection is estimated to average 15 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.
The provisions of appropriate criminal and civil fraud, privacy, and other statutes may be applicable to the information provided. RETURN
THIS COMPLETED FORM TO THE KANSAS CITY COMMODITY OFFICE, WAREHOUSE LICENSE AND EXAMINATION DIVISION,
STOP 9148, P.O. BOX 419205, KANSAS CITY, MO 64141-6205, OR BY FAX 816-926-1774.
The U.S. Department of Agriculture (USDA) prohibits discrimination against its customers, employees, and applicants for employment on the bases of
race, color, national origin, age, disability, sex, gender identity, religion, reprisal, and where applicable, political beliefs, marital status, familial or parental
status, sexual orientation, or all or part of an individual’s income is derived from any public assistance program, or protec ted genetic information in
employment or in any program or activity conducted or funded by the Department. (Not all prohibited bases will apply to all programs and/or
employment activities.) Persons with disabilities, who wish to file a program complaint, write to the address below or if you require alternative means of
communication for program information (e.g., Braille, large print, audiotape, etc.) please contact USDA’s TARGET Center at (202) 720-2600 (voice and
TDD). Individuals who are deaf, hard of hearing, or have speech disabilities and wish to file either an EEO or program complaint, please contact USDA
through the Federal Relay Service at (800) 877-8339 or (800) 845-6136 (in Spanish).
If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, found online at
http://www.ascr.usda.gov/complaint_filing_cust.html , or at any USDA office, or call (866) 632-9992 to request the form. You may also write a letter
containing all of the information requested in the form. Send your completed complaint form or letter by mail to U.S. Department of Agriculture, Director,
Office of Adjudication, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, by fax (202) 690-7442 or email at
[email protected]. USDA is an equal opportunity provider and employer.
File Type | application/pdf |
File Modified | 2014-12-11 |
File Created | 2003-10-07 |