Registration & Consent Agreement Form printable pdf download

REGISTRATION & CONSENT AGREEMENT

…#3103

Eastern Missouri Commission Company

PO Box 87

Bowling Green, MO 63334

573-324-2295… Fax 573-324-2459 … *Email:

Buyer's Name: ______________________________________________________SS# or TIN: ____________________

Street Address: ____________________________________________________________________________________

City: ________________________________ State: ___________ Zip: ________ Drivers License:_________________

Phone #: _______________________ Cell #____________________________Fax #: ___________________________

Estimated Amount of Purchase $__________________ Email: ______________________________________________

_____ I have a Packers & Stockyards bond in the amount of ($___________) Name: _____________________________________

Name as appears on bond.

_____ I do NOT have a Packers & Stockyards bond

Name of Buyer's bank: _______________________________________________Account #: _____________________

City: _______________________________________________________ State: ________________ Zip: ___________

Phone #: _____________________________________ Contact person: ______________________________________

Is account jointly owned? No:___ Yes: ___ Name of joint owner:___________________________________________

If account with current bank less than one year, my previous bank was:

Name of previous bank: ______________________________________________Account #______________________

City: _______________________________________________________ State: ________________ Zip: ___________

Phone #: ______________________________________Contact person: ______________________________________

_____

I will be buying livestock for my own account.

_____

I will be buying livestock for the account of some other individual/business.

If buying for someone else…information about the individual/business that I will be buying for:

Name: __________________________________________________________________

Address: _________________________________________________________________

City: __________________________________ State: ____________ Zip: ____________

Contact person: _______________________________ Phone #: ____________________

I understand and agree that I will be financially responsible for the livestock that I buy at this Market, whether for myself or as

agent for someone else. Except for sales where livestock are to be delivered at a later date, accounts must be paid at the time of purchase

and persons subject to the Packers & Stockyards Act must pay by no later than the close of the next business day following the day of

purchase (7 USC 228b). Sales are on a cash basis. In transactions where livestock are to be delivered at a later date, payment shall be in

accordance with the contract. If purchases are not paid as specified, I will pay interest at the rate of _____ percent per annum (six percent if

left blank) or highest rate allowed by law, whichever is lower, until paid in full. If the Market takes legal action to collect my account and

prevails, the Market shall be entitled to reasonable attorney’s fees and court costs.

I UNDERSTAND AND AGREE THAT THERE ARE NO IMPLIED WARRANTIES OF MERCHANTABILITY

OR FITNESS FOR A PARTICULAR PURPOSE ON LIVESTOCK SOLD AT OR THROUGH THIS MARKET.

I hereby grant the Market a security interest in all livestock that I purchase at the Market, as well as all proceeds therefrom, until

the Market has received final payment, and authorize the Market to authenticate and file any and all documents that are needed to perfect

and give notice of the Market’s interest in such livestock.

I hereby authorize Market or its agent Livestock Marketing Association to contact the above-named bank(s) for information concerning

my financial responsibility and authorize the above-named bank(s) to release to Market or Livestock Marketing Association information

necessary to determine my financial responsibility and/or ability to pay for livestock purchased at/through the Market. This authorization shall

remain in effect until I notify the Market in writing that it has been cancelled. A copy of this authorization shall be as valid as the original.

Signature of Buyer: ________________________________________ Date: ___________________________________

LBT Fax 816-891-7108

Registration & Consent Agreement Form

Related Articles

Related forms

Related Categories