2027 Heritage Cooperative Board of Directors Nomination Form

2027 BOARD OF DIRECTORS NOMINATION

DIRECTOR CANDIDATE REQUIREMENTS

The candidate must meet all of the following requirements:

Be a Member or an owner of a Member entity in good standing (be a Producer of agricultural products, own 1 share of Common stock, and be an active patron accepted into membership by the Board).
Have a good credit history at Heritage Cooperative.
Not have a significant financial interest in a product or service that competes with a product or service offered by Heritage Cooperative.
Have the ability and desire to attend all Board meetings unless excused.
Be a resident of a region where a director’s term is expiring or vacant.

Applicant's Name

First NameLast Name

Member is

Title/Office

County of Residence

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Format: (000) 000-0000.

Email

example@example.com

Agricultural products Member produces (field crops, vegetables, fruit, dairy, livestock, etc.)

Do you have any other significant business interest or career in addition to your farming operation?

Please describe additional interests.

What percentage of your agronomy inputs are purchased from Heritage Cooperative?

What percentage of your feed and livestock inputs are purchased from Heritage Cooperative?

What percentage of your energy inputs are purchased from Heritage Cooperative?

What percentage of your harvested grain is delivered to Heritage Cooperative?

Which Heritage Cooperative branches do you patronize?

Memberships in community or agricultural organizations:

Why do you have an interest in serving Heritage Cooperative as a Board Member?

Please describe your farm operation

CERTIFICATION AND ACKNOWLEDGEMENT

By signing below: (i) I certify the information provided on this Application is true to the best of my knowledge. (ii) I acknowledge receipt of copies of the Articles, Bylaws, and Board policies affecting my status as a Member or as an owner of a Member entity. If approved as a candidate for election, I agree to comply with all provisions of the Amended and Restated Articles of Incorporation (“Articles”), the Amended and Restated Bylaws (“Bylaws”), and the policies and conditions of Membership adopted by the Board of Directors as currently in effect or as amended in the future.

Signature