REPRODUCE LOCALLY. Include form number and date on all reproductions. OMB No. 0581-0178
Marketing Order No. 956: Walla Walla Sweet Onions
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 cooperative
Title
association referendum Ballot for the membership of the aforesaid organization.
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 association 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 a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0581-0178. 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- 114B (Exp. x/xxxx) Destroy previous editions.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | REPRODUCE LOCALLY |
Author | Barry Broadbent |
File Modified | 0000-00-00 |
File Created | 2024-07-28 |