CPR-2 Report of Payments to Cooperative Associations

Form Approved, OMB 0581-0032

UNITED STATES DEPARTMENT of AGRICULTURE

AGRICULTURAL MARKETING SERVICE - DAIRY PROGRAMS
MARKET ADMINISTRATOR

CPR-2
Exp. XX/XXXX

Federal Order 1

Phone:

617-737-7199

Mailing Address

Fax:

617-737-8002

89 South Street, Boston, MA 02111-2671

E-Mail:

[email protected]

PO Box 51478

Home Page: www.fmmone.com

Boston, MA 02205-1478

PAYMENTS MADE TO A COOPERATIVE ASSOCIATION
Please submit a separate form for payment to each cooperative association.
COOPERATIVE ASSOCIATION:

MONTH:

ADDRESS:

ORDER:

This report is required by the order in accordance with 7 U.S.C. 608 c 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. W& (14) (B)) or, upon conviction, in a fine of up to $5,000 per day (7 U.S.C. 608c (14) (A)).
Market Administrator Use Only

Product
Pounds

Butterfat
Pounds

Product
Pounds

Cwt.
Rate

Cwt.
Rate

Value

Date
Mailed

Amount

PRODUCER MILK - UNIFORM

TOTAL PRODUCER MILK
OTHER SOURCE RECEIPTS
GRAND TOTAL

PAYMENTS

Check
Number

First Advance
Second Advance**
Final
** If Applicable

TOTAL PAYMENTS

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

HANDLER

SIGNED
(Person Authorized to Sign for Handier)

DATE

TITLE

USDA, AMS, Dairy Programs
Market Administrator
89 South Street, Boston, MA 02111-2671
(617) 737-7199
Payments Made to a Cooperative Association

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 30 minutes per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed, and completing and
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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
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