CPR-2 Report of Payments to Cooperative Associations

Return to: Federal Milk Order No. 1—Northeast Marketing Area
333 North Fairfax Street
Mailing Address: P.O. Box 25828
Alexandria, VA 22313-5828
Tel: (703) 549-7000 —Fax (703) 549-7003
Email: [email protected] Website: www.fmmone.com

CPR-2
Form Approved, OMB No. 0581-0032
This report is required by the Order in
accordance with 7 U.S.C. 608c and d.
Failure to report can result in the
assessment of a civil penalty of up to
$1,000 per day (7 U.S.C. 608c (14)(B))
or, upon conviction, in a fine of up to
$5,000 per day (7 U.S.C. 608c (14)(A)).

REPORT OF PAYMENTS TO COOPERATIVE ASSOCIATIONS
Name of Cooperative Association:
Address:
Rate

Pounds
Producer Milk

$

Amount
$

Butterfat
Protein
Other Solids
Value of Milk $
Other Charges: (Identify)

Pounds
$

$

Adjustments: (Identify)

Total Amount Due $
RECONCILIATION OF BILLING AND PAYMENTS
Date

Check No.

Rate

Pounds

Partial Payment

$

Amount
$

Other:

Final Payment
Total Amount Paid $
I declare under the penalties provided by law, that this report (including schedules and statements), has been examined by me and to the best of
my knowledge and belief is true, correct, and complete. I also certify that I am authorized to sign this report.

Handler:

Authorized
Signature:
Title:

Delivery
Month:

Date:

SUBMIT A SEPARATE REPORT FOR EACH COOPERATIVE TO THE MARKET ADMINISTRATOR AT THE ABOVE ADDRESS ON OR BEFORE THE 21ST OF THE MONTH
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 0581-0032. The time required to complete this information collection is estimated to average 1.0 hour 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 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, DC 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.