DAIRY MEMBERSHIP APPLICATION

APPLICANT INFORMATION

Name:

Company Name Phone:

Current address:
City: State: ZIP Code:

Email: Website:

ADDITIONAL CONTACT NAMES:

Name

Name

ASSESSMENT INFORMATION
Assessment is valued as one dollar ($1.00) per head of fresh and dry animals.

Example: 1,000 fresh animals plus 150 dry animals = $1150.00 per annual assessment
Payments can be made on an Annual, Semi-annual, Quarterly or a Monthly schedule; Please circle the
payment plan you desire. An invoice will be sent to the address provided above.
ANNUAL

SEMI-ANNUAL

QUARTERLY

MONTHLY
*Requirements of the Federal Internal Revenue Service (IRS) require that MPI inform members that the
portion of association expenses related to direct lobbying efforts are not deductible under federal tax law.
MPI has set that percentage at 12%.

Signature: Date:

Mail to: Milk Producers of Idaho

821 W State Street
Boise Idaho 83702
208-850-8897