SC-128B 927-Processed Pear Cooperative Association Certificate o

REPRODUCE LOCALLY. Include form number and date on all reproductions. OMB No. 0581-0189

CERTIFICATE OF RESOLUTION

(Cooperative Association)

Marketing Order No. 927: Pears Grown in Oregon and Washington

At a duly convened meeting of the Board of Directors of _______________________________________

Name of Cooperative Association

held at _________________________ on the _____ of _______________, 20___, the following

resolution was adopted:

RESOLVED, that we authorize _______________________________________________ who is

Authorized agent’s name

____________________________________ of the Cooperative Association, to cast the attached

Title

Cooperative Association Referendum Ballot for the membership of the aforesaid organization.

CERTIFICATION

I, __________________________________, Secretary of _____________________________________ do hereby certify this is a true and correct copy of a resolution adopted at the above-named meeting as said resolution appears in the minutes thereof.

IN WITNESS WHEREOF, I have hereunto set my hand and the seal of said Corporation this _____ day of ________________________, 20___.

_______________________________________

Corporate Seal: Signature

if none, so state

_______________________________________

Address of Firm

_______________________________________

City, State, and Zip Code

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0581-0189. The time required to complete this information collection is estimated to average 5 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: (1) mail: U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue, SW Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email: [email protected]. USDA is an equal opportunity provider, employer, and lender.

SC-128B (Exp. X/XXXX) Destroy previous editions.