PSD- 2100 Bond Rider Gen'l. Use with Surety Bond

OMB CONTROL NO. 0581-0308

U.S. Department of Agriculture
Agricultural Marketing Service
Fair Trade Practices Program
Packers and Stockyards Division

RIDER FOR GENERAL USE WITH SURETY BOND
Required Under the Packers and Stockyards Act, 1921,
as Amended and Supplemented

Know all that (1)______________________________________________________________________________
(Name of Current Principal)

of (2)____________________________________________________________________________, as Principal,
(City, State)

and (3)_____________________________________________________________________________________
(Name of Surety)

as Surety, issued bond number (4)

, dated (5)
(Original effective date of bond)

,

in favor of (6)___________________________________________________________________, as Trustee.
(Name of 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 sum
The surety bond identified above is increased
of Bond
FROM: $
TO: $
8. Decrease in sum
The surety bond identified above is decreased
of Bond
FROM: $
TO: $
9. Change in Name
The name, address, phone no. and email of the Principal, as given on the surety
of Principal
bond identified above, are changed
FROM: ________________________________________________________________

(Name, Address,
Phone, and Email)

(Name and Address)

________________________________________________________________
TO:

________________________________________________________________
(Name and Address)

________________________________________________________________
10. Change in
Name of
Trustee

(Name, Address,
Phone, and Email)

The name, address, phone no. and email of the Trustee, as given on the surety bond
identified above, are changed
FROM: ______________________________________________________________
______________________________________________________________

TO:

_______________________________________________________________
_______________________________________________________________

11. Amend
Condition
Clauses of
Surety Bond

12. Add Condition
Clause 3 to bond

Form PSD 2100

The condition clause of the surety bond identified above is amended

FROM: ________________________________________________________________
TO:

________________________________________________________________
Add condition 3, Clearing Services to the above-named surety bond.
If checked go to line 14 of this form.

Expires XX/XX/XXXX

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13. Delete
Conditional Clause
3 from bond
14. Add Clearee to
Clause 3

(Name(s),
Addresses(s),
Phone(s)) and
Email
15. Delete
Clearee
from
Clause 3
(Name(s),
Addresses(s),
Phone(s)) and
Email

Delete condition 3, Clearing Services from the above named bond.
If checked go to line 15 of this form.
The name(s), address(s), and phone(s) of:
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

is (are) hereby added as clearee(s) to the surety bond identified above.
The name(s), address(s), and phone(s) of:
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

is (are) hereby deleted as clearee(s) from the surety 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.
16. This rider shall become effective as of the __________________ day of _____________________, 20_____.
17. Signed and dated this _____________ day of ____________________, 20____.
18.

(Name of Principal)

(Signing on Behalf of Principal)

19.

(Name of Surety)

(Signing on Behalf of Surety)

20.

(Name of Trustee)

(Signing on Behalf of Trustee)

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 is
0581-0308 The time required to complete this collection is estimated to average 1.5 hours 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 law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is
prohibited from discriminating on the basis of race, color, national origin, sex, age, disability, and reprisal or retaliation for prior civil
rights activity. (Not all prohibited bases apply to all programs.) 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 State or local Agency that administers the program 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 is also available in languages
other than English.
To file a complaint alleging discrimination, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at
http://www.ascr.usda.gov/complaint_filing_cust.html, or at any USDA office or write a letter addressed to USDA and provided 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: (a) mail: U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights,
1400 Independence Avenue, SW, Washington, D.C. 20250-9410; (b) fax: (202) 690-7442; or (c) email: [email protected].
Form PSD 2100

Expires XX/XX/XXXX

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Instructions to Complete
Rider for General Use with Surety Bond
Form PSD 2100
A rider amending a surety bond requires complete and correct information to be submitted to the
Packers and Stockyards Division (PSD) on form PSD 2100.
If any information is missing or incorrect, the PSD will return the surety bond rider form to the
principal or surety for completion or correction. If a trustee has been named to the surety bond,
the regional office will obtain the trustee’s signature, and will ensure the trustee retains an
original copy of the surety rider for their files.
Operating without proper registration and bond may subject the principal to severe civil penalties
as authorized by law for each violation, and additional penalties for each day the violation
continues (7 U.S.C § 203).
Submit the completed form to the PSD regional office that covers your area. The Areas covered
by each regional office are listed below the regional office's address.
Regional Offices of the Packers and Stockyards Division
Agricultural Marketing Service, Fair Trade Practices Program
Eastern Regional Office
Midwestern Regional Office
Western Regional Office
75 Ted Turner Drive SW, Ste 230 210 Walnut Street, Room 317
3950 Lewiston St., Suite 200
Atlanta, GA 30303-3308
Des Moines, IA 50309-2110
Aurora, CO 80011-1556
Telephone: (404) 562-5840
Telephone: (515) 323-2579
Telephone: (303) 375-4240
FAX: (404) 562-5848
FAX: (515) 323-2590
FAX: (303) 371-4609
E-mail:
E-mail:
E-mail:
[email protected]
[email protected] [email protected]
States Covered
States Covered
States Covered
AL, AR, CT, DC, DE, FL, GA,
IA, IL, IN, KY, MB, MI, MN,
AB, AK, AZ, BC, CA, CO, HI,
LA, MA, MD, ME, MS, NC,
MO, ND, NE, OH, ON, SD, WI ID, KS, MT, NM, NV, OK, OR,
NH, NJ, NL, NY, PA, PR, QC,
SK, TX, UT, WA, WY
RI, SC, TN, VA, VT, WV

If you have any questions about the form or completing the form, please contact the PSD
Regional Office that covers your area, as listed above.
The Surety must complete line 1 through 17, and sign line 19.
The Principal must sign line 18.
If a trustee is named to the surety bond, the trustee must sign line 20 which the appropriate PSD
will obtain.

Form PSD 2100

Expires XX/XX/XXXX

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Line
No.
1
2
3
4
5
6
7
8
9

10

11
12
13
14
15
16

Subject

Instruction

Current Principal

Enter name of the principal. The name must match that
listed on the original bond, or the most current as changed
by a previous rider.
City and State of Principal Enter the city and state where principal operates.
Surety
Enter the name of the surety company writing the bond.
Bond Number
Enter the original bond number (do not list rider numbers).
Bond Date
Enter the original effective date of the bond. This item
must ALWAYS reference the original date the bond was
issued, NOT the date of the most current rider.
In Favor of
If a trustee is named on the original bond or added with a
previous rider, enter the name of the trustee. If no trustee
is named, leave this line blank, or enter N/A or None listed.
Increase in Bond
Enter the amount of the bond before the increase in the
FROM section, and the amount of the bond after the
increase In the TO section.
Decrease in Bond
Enter the amount of the bond before the decrease in the
FROM section, and the amount of the bond after the
decrease in the TO section.
Change in Name of
Enter the full name, address, and phone no. of the principal
Principal
in the FROM section as it is stated on the original bond or
previous rider, and the principal’s amended name, address,
and phone no. in the TO section.
Change in Name of
Enter the full name, address, and phone of the former
Trustee
(previous) trustee in the FROM section, and the full name,
address, and phone of the successor (new) trustee in the
TO section.
Amend Condition Clause Enter the condition clause stated on the original bond in the
of bond
FROM section, and the condition clause the bond is
changed to in the TO section.
Add Condition Clause 3 to Check the box to indicate if the rider adds clearing services
surety bond
to the bond (Condition Clause 3 on form PSD 2000).
Delete Condition Clause 3 Check the box to indicate if the rider deletes clearing
from surety bond
services from the bond (Condition Clause 3 on form PSD
2000).
Add Clearee to Condition Enter the full name, address, and phone of each clearee
Clause 3 from surety
being added to the surety bond.
bond
Delete Clearee from
Enter the full name, address, and phone of each clearee
Condition Clause 3 from
being deleted from the surety bond.
surety bond
Rider Effective Date
Enter the effective date of the rider.

Form PSD 2100

Expires XX/XX/XXXX

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Line
No.
17
18

Subject

Instruction

Signed and Dated

Enter the date that the rider was signed, sealed, and dated
by the surety.

Principal Signature

The principal, or someone authorized to sign for the
principal (i.e. partner, owner, or officer), must sign the
surety bond.
•
•
•

19

Surety Signature

If an individual operation, the principal must sign
the surety bond.
If a partnership operation, one of the partners must
sign the surety bond.
If a corporation, Limited Liability Corporation,
Limited Liability Partnership, or association, an
owner, officer or duly authorized agent of the firm
must sign the surety bond.

Enter the name of the surety. The rider MUST be signed
by the Attorney-in-Fact for the surety.
A Power of Attorney must be attached to the bond rider.
The date of the Power of Attorney must be equal to or
prior to the effective date of the bond rider. The person
listed as the Attorney-in-Fact signing the surety bond rider
for the surety company must be listed on the Power of
Attorney.

20

Trustee Signature

If a trustee is named on the surety bond rider, PSD will
obtain the trustee’s signature, where indicated on the form.

NOTE: Electronic signatures are considered valid.

Form PSD 2100

Expires XX/XX/XXXX

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