Form AMS-1 CA FMMO-Certificate of Resolution

Approved Form
OMB No. 0581-0300

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
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