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OMB No. 0581-0032
CERTIFICATE OF RESOLUTION
To be submitted in conjunction with the Cooperative Association Ballot
At a duly convened meeting of the Board of Directors of the
_______________________________
Name of Cooperative
held at ____________________________________ on ________________ , at
City and State
Date
which time a quorum was present, the following resolutions were adopted:
RESOLVED that ____________________________________________
Name of Cooperative
(approves_______ ) or (disapproves_______) the issuance by the Secretary of Agriculture
of the proposed order to regulate the handling of milk in the following marketing area:
________________________________________________________________________
Marketing Area
IT IS FURTHER RESOLVED that ___________________________________
Print Name of Person Signing Ballot
be authorized to cast a ballot on behalf of the association.
I, _______________________________, Secretary of
Print Your Name Here
_______________________________
Name of Cooperative
hereby certify that this is a true and correct copy of the resolution adopted at the
aforesaid meeting and is the same as that appearing in the minutes thereof.
Date Signed
Secretary's Signature -- Do Not Print
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 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.
In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies,
offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color,
national origin, religion, sex, gender identity (including gender expression), sexual orientation, disability, age, marital status, family/parental status,
income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity
conducted or funded by USDA (not all bases apply to all programs). Remedies and complaint filing deadlines vary by program or incident. Persons with
disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.)
should contact the responsible Agency or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay
Service at (800) 877-8339. Additionally, program information may be made available in languages other than English. To file a program discrimination
complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at http://www.ascr.usda.gov/complaint_filing_cust.html
and at any USDA office or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the
complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: mail: U.S. Department of Agriculture Office of the Assistant
Secretary for Civil Rights 1400 Independence Avenue, SW Washington, D.C. 20250-9410; fax: (202) 690-7442; or email:[email protected].
USDA is an equal opportunity provider, employer, and lender.
File Type | application/pdf |
Author | Elliott, KarlaP - AMS |
File Modified | 2018-08-17 |
File Created | 2017-07-10 |