Please print the form, fill it out, sign it and drop it off on your next visit to the Common Market.
Please Read the Following Information about Your Equity Share in the Common Market
When you purchase an Equity Share of the Frederick County Consumers Cooperative you become an actual owner of The Common Market.
Following Maryland law, there may be only one owner of record for each equity share, though other members of the Owner of Record's actual household may use the Owner's card. The Owner of Record must be 18 years of age or older. An equity share entitles the Owner of Record to one vote in how your co-op is governed. Owners vote for the Board of Directors who represent and protect the Owners' interest.
Changes to the bylaws are also approved by Owner consent through voting.
Equity Shares are non-transferable.
The Common Market Equity Share Form
This information is for Common Market use only
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| Owner # ______________ |
| Date Card is Issued: _________________________________ | Cashiers Initials _____________ |
| Name of Owner of Record (print) ____________________________________________________________ |
| Address _________________________________________________________________________________________________ |
| City ______________________________ | State _______________________ | Zip ___________________ |
| Phone Number ______________________ | E-Mail __________________________________________ |
| Senior Owner (60 or older) _________ |
| -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Owner of Record Signature ____________________________________________________________ |
| Date _____________________ |
| -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Payment Options: Please check one option. |
| | 1. Paid in Full | $200 | | |
|
| Deposit | Quarterly Payment | # of Payments |
| | 2. Six (6) Payment Plan | $50 | $25 | 6 X $25 |
| | 3. Ten (10) Payment Plan | $50 | $15 | 10 X $15 |
|
White- Store Copy Yellow- Owner copy
|
| Staff use only |
| Payment made today: $200 _______________ | $50 ________________ | Other ______________ |
|
| Payment type |
| Cash _____ | Check _____ | Charge _____ | Debit _____ |
|
| Congratulations - You're an Owner of The Common Market Co-op |
| 5728 Buckeystown Pike + Frederick, Maryland 21704 + 301.663.3416 + www.commonmarket.coop |
