Exhibit 10.iii.(p)

                       EXECUTIVE SEVERANCE AGREEMENT


This  Executive  Severance  Agreement  (the  "Agreement)  is  dated  as  of
__________________, 1999 between __________________ (the  "Executive")  and
IMC Global Inc., a Delaware corporation (the "Company").

WHEREAS,  the  Company desires to retain the Executive as its  Senior  Vice
President,  Environment,  Health and Safety and the  Executive  desires  to
continue in such position; and

WHEREAS,  the  Company  and  the Executive desire  to  provide  appropriate
assurances for the Executive to continue to perform the Executive's  duties
and responsibilities thereby promoting the stability of the Company.

NOW,  THEREFORE, in consideration of the agreements and covenants contained
herein,  the  sufficiency of which is acknowledged, the Executive  and  the
Company hereby agree as follows:

1.    Definitions.   Each term defined herein shall be  given  its  defined
meaning  wherever  used  in  this Agreement  unless  the  context  requires
otherwise.

(a)  "Base Salary" means the Executive's annualized base salary as adjusted
from time to time.

(b)   "Cause"   means  the  Executive  (i)  grossly  neglects  her  duties,
(ii)  engages  in misconduct; (iii) breaches a material provision  of  this
Agreement,  including, but not limited to, Section 4; (iv) willfully  fails
to cooperate fully with the Company in effecting a smooth transition of the
Executive's  duties  and  responsibilities to  such  person(s)  as  may  be
designated  by  the  Company.  Gross neglect means the willful  failure  to
perform  the  essential functions of the Executive's  job  or  the  willful
failure  to  carry out the Company's reasonable directions with respect  to
material  duties after the Executive is notified in writing by the  Company
that  the  Executive  is  failing to perform these essential  functions  or
failing to carry out the reasonable directions of the Company.  Such notice
shall specify the functions or directions that the Executive is failing  to
perform  and  what steps need to be taken to cure and shall set  forth  the
reasonable time frame, which shall be at a minimum 45 days, within which to
cure.   "Misconduct"  means embezzlement or misappropriation  of  corporate
funds,  or  other  acts  of  fraud, dishonesty, or self-dealing;  provided,
however, that the Executive shall be given notice and an opportunity within
the  next 45 days to explain her position and actions to the Company, which
shall  then  make  a  final  decision; any  significant  violation  of  any
statutory  or common law duty of loyalty to the Company; conviction  for  a
felony; or any significant violation of Company policy or any inappropriate
workplace  conduct  that  seriously disrupts  or  interferes  with  Company
operations;   provided,   however,  that  if  the   policy   violation   or
inappropriate  conduct  can be cured, then the  Executive  shall  be  given
written  notice  of  the policy violation or inappropriate  conduct  and  a
reasonable opportunity to cure, which shall be at a minimum 45 days.

(c) "Company" means IMC Global Inc. and its subsidiaries, as they may exist
from time to time.

(d) "Effective Date" means the date first set forth above.

(e) "Good Reason" for termination of employment by the Executive shall mean
any of the following reasons explained below in paragraphs 1, 2 and 3.   In
each  case,  to  constitute  a termination for Good  Reason  entitling  the
Executive  to  Severance  Benefits  as  described  in  Section  3  of  this
Agreement, the following must occur:

(i)   Within  90  days  after the Executive has or reasonably  should  have
knowledge  that  Good Reason exists, the Executive must  give  the  Company
written  notice  specifying the grounds for her  belief  that  Good  Reason
exists;

(ii)  The Company shall then have a reasonable opportunity, which shall  be
at least 45 days, to cure; and

(iii) If the Company cures the Good Reason within the cure period, then the
Executive shall have no right to terminate employment for Good Reason.   If
the  Company  does  not cure the Good Reason within the cure  period,  then
within 14 days of the completion of the cure period, the Executive may give
written  notice of her intent to terminate her employment for Good  Reason.
The  effective  date  of  such termination for Good  Reason  shall  be  two
calendar  months after the date of the notice to terminate.   At  its  sole
discretion,  the Company shall have the right to accelerate the termination
date  by paying the Executive her base pay for the balance of the two-month
notice period.

1.   the  continued failure by the Company, after notice and  a  reasonable
opportunity to cure, to (i) maintain for the initial term of this Agreement
the  Executive's Base Salary at a rate equal to or higher than the rate  in
effect  on  the Effective Date and for any subsequent term of the Agreement
maintain the Executive's Base Salary at a rate equal to or higher than  the
rate  in  effect on the Effective Date; provided, however, that during  any
such  subsequent  term, Good Reason shall not exist as the  result  of  any
decrease in Base Salary if such decrease is incident to a general reduction
applied  to  corporate officers at a similar level as the  Executive  on  a
proportionate  and  nondiscriminatory basis;  (ii)  provide  for  continued
participation  on a comparable basis by the Executive in  an  annual  bonus
plan  maintained by the Company in which corporate officers  at  a  similar
level  as  the  Executive participate; (iii) provide for  participation  in
stock option and other equity incentive plans or programs maintained by the
Company from time to time in which corporate officers at a similar level as
the  Executive participate; (iv) provide for participation in  all  Company
sponsored group or executive medical, dental, life, disability, retirement,
profit-sharing,  thrift,  non-qualified, deferred compensation,  and  other
plans maintained by the Company to the same extent as corporate officers at
a  similar  level as the Executive participate; (v) provide  vacation,  and
perquisites  substantially equivalent to those provided by the  Company  to
corporate officers at a similar level as the Executive; or (vi) obtain  the
express  unconditional assumption of this Agreement as required by  Section
8,  it  being understood that nothing contained in this clause  alters  the
Company's obligations under Section 8 of this Agreement; or


2.  a  significant adverse change, without the Executive's written  consent
that  continues  after  notice and a reasonable  opportunity  to  cure,  in
working  conditions or status, including but not limited to  a  significant
adverse change in the nature or scope of the Executive's authority, powers,
functions, duties or responsibilities; provided, however, a change  in  the
Company's  status  such  that  it  no  longer  has  any  equity  securities
registered under Section 12(b) or 12(g) of the Securities Exchange  Act  of
1934,  as amended, or that it becomes a subsidiary of another entity  which
directly  results  in  changes in the nature or scope  of  the  Executive's
authority, powers, functions, duties or responsibilities shall not  in  and
of itself constitute Good Reason hereunder; or

3.  a  change, without the Executive's consent, in the Executive's  primary
employment  location  to a location that is more than  50  miles  from  the
primary  location  of the Executive's employment as in  effect  immediately
prior to the Effective Date.

(f)  "Severance Event" shall be deemed to have occurred if,  and  only  if,
during the Term of this Agreement, which includes the initial term and  any
extension  or  renewals  as  provided in Section  2,  (i)  the  Executive's
employment  is terminated by the Company other than for Cause or  upon  the
Executive's  death or inability to perform the essential functions  of  her
position  with  or without reasonable accommodation or (ii)  the  Executive
terminates  her  employment for Good Reason.  If, however, the  Executive's
employment  is  terminated whether by the Executive with  or  without  Good
Reason or by the Company with or without Cause in connection with a "change
in  control" of the Company, as such phrase is defined in Section 5 of this
Agreement,  such  termination  shall  not  constitute  a  Severance  Event;
provided,  however, the Executive's employment shall not be  considered  to
have terminated in connection with a change in control of the Company as so
defined unless such change in control has occurred in such manner and  such
time  as  to have made Section 5 of this Agreement effective prior  to  the
Executive's termination.

2.    Term.    The  term of this Agreement shall commence on the  Effective
Date  and shall terminate on the second anniversary of the Effective  Date;
provided,  however,  that unless the Company gives written  notice  of  its
intent to terminate the Agreement at least one calendar month prior to  the
second  anniversary  of  the  Effective Date, this  Agreement  shall  renew
automatically for an additional one year term and shall continue  to  renew
automatically  for additional one year terms unless written notice  of  the
Company's  intent to terminate the Agreement is given to the  Executive  at
least one calendar month prior to the expiration of the then current term.

3.    Severance Benefits.  Upon the occurrence of a Severance Event and the
execution  of a general release (substantially in the form attached  hereto
as  Exhibit A) of all claims against the Company and other related entities
or  persons   without additional consideration, and upon the expiration  of
any  applicable  revocation  period, the Executive  shall  be  entitled  to
receive the following "Severance Benefits":

(a)  An  amount  equal  to  the target award for the  Executive  under  the
Company's  Management Incentive Compensation Program ("MICP"), or successor
annual bonus plan in effect from time to time, for the fiscal year in which
the  Severance Event Occurs reduced pro rata for that portion of the fiscal
year  not completed as of the end of the month in which the Severance Event
occurs;

(b)  An  amount  equal  to  the target award for the  Executive  under  the
Company's  1996 Long-Term Incentive Plan, or successor long-term  incentive
plan  in  effect  from  time  to time, for the fiscal  year  in  which  the
Severance Event occurs reduced pro rata for that portion of the fiscal year
not  completed  as  of  the end of the month in which the  Severance  Event
occurs;

(c)  An amount equal to two times the Executive's then current Base Salary,
payable in accordance with regular payroll procedures of the Company;

(d)  An amount equal to two times the highest annual bonus earned under the
Company's  Management Incentive Compensation Program, or  successor  annual
bonus  plan  in  effect  from time to time, during  the  three  consecutive
complete  bonus years immediately preceding the date on which the Severance
Event  occurs;  provided, however, that in the event that  the  Executive's
employment  is  terminated prior to the completion of three complete  bonus
years,  any  prorated  annual bonus received  by  the  Executive  shall  be
annualized  and  the  bonus  years  in  which  the  Executive's  employment
commences  or terminates shall be deemed to be "complete bonus  years"  for
purposes  of  determining the highest annual bonus earned by the  Executive
during  the  three complete bonus years immediately preceding the  date  on
which the Severance Event occurs;

(e)  If  the  Executive  timely and appropriately exercises  her  right  to
continue  her  coverage under the Company's medical  and  dental  plans  as
provided under the Consolidated Omnibus Budget Reconciliation Act of  1985,
as  amended ("COBRA"), then the Company will pay the employer portion  (and
the  Executive  will  pay the employee portion) of such  premiums  for  the
Executive until the earlier of:  (i) the expiration of the two year  period
following  the date of the Severance Event and (ii) the date on  which  the
Executive  is  no  longer eligible to continue such coverage  under  clause
4980B(f)(2)(B)(ii),  (iii), (iv) or (v) of COBRA.  Except  as  provided  in
this  paragraph, the Executive's continued participation and coverage under
the group health insurance plans shall be governed by COBRA; and

(f)  The Company shall continue the Executive's coverage under its life and
disability  insurance policies until the earlier of (i) the  expiration  of
the two year period following the date of termination and (ii) the date  on
which  the Executive becomes eligible to participate in and receive similar
benefits under a plan or arrangement sponsored by another employer or under
any  Company sponsored retirement plan.  Participation shall be on the same
terms and conditions as are applicable to active employees.

Severance  Benefits shall be subject to all applicable federal,  state  and
local  deductions and withholdings.  Those Severance Benefits described  in
paragraphs  (a) and (b) shall be paid in a lump sum within 30 days  of  the
Severance  Event.  At the option of the Company, the present value  of  the
Severance Benefits described in paragraphs 3 (c) and (d) above may be  paid
in  a  lump  sum  at any point during the Severance Benefits  period.   The
Company's obligation to continue Severance Benefits shall cease immediately
if  the  Company has or would have had grounds to terminate the Executive's
employment  immediately  for Cause.  In the event  the  Executive  dies  or
becomes  disabled  before  all Severance Benefits  are  paid  to  her,  the
remaining amounts due to her under Sections 3(c) and 3(d) shall be  reduced
by  the  proceeds the Executive's estate receives under any life  insurance
policy  with respect to which the premiums are paid by the Company  or  any
benefits  the Executive receives under any Company disability  policy;  but
subject to such reductions, those remaining amounts, if any, shall be  paid
to  the Executive or her estate.  If any family member of the Executive  is
receiving medical and/or dental coverage under Section 3(e) at the time  of
the  Executive's death or disability and such family member  constitutes  a
"qualified  beneficiary" under COBRA, such medical and/or  dental  coverage
shall continue in accordance with the requirements of COBRA, provided  that
such  family  member pays the full cost of the premium for  such  coverage.
The  Executive  understands and acknowledges that  the  Severance  Benefits
constitute her sole benefits upon termination.

4.  Exclusivity of Services and Confidential/ Proprietary Information.

(a)  Executive acknowledges that during her employment with the Company she
has  developed, acquired, and had access to and will develop,  acquire  and
have   access  to  trade  secrets  or  other  proprietary  or  confidential
information  belonging to the Company and that such information  gives  the
Company  a substantial business advantage over others who do not have  such
information.    Accordingly,  the  Executive  agrees   to   the   following
obligations that she acknowledges to be reasonably designed to protect  the
Company's   legitimate   business  interests   without   unnecessarily   or
unreasonably restricting her post-employment opportunities:

(i)   during  employment with the Company and for a  period  of  two  years
following  the  Executive's termination of employment,  regardless  of  the
reason  for  the termination or by whom initiated, she will not  engage  or
assist  others  in  engaging in competition with the Company,  directly  or
indirectly, whether as an employer, proprietor, partner, stockholder (other
than  the  holder  of  less  than 5% of the  stock  of  a  corporation  the
securities of which are traded on a national securities exchange or in  the
over-the-counter  market), director, officer, employee, consultant,  agent,
or  otherwise,  in  the  business  of producing  and  distributing  potash,
phosphate,  animal  feed  ingredients or  salt  or  any  other  significant
business  in which the Company is engaged or is preparing to engage  in  at
the time of termination;

(ii)   during  employment with the Company and for a period  of  two  years
following  the  Executive's termination of employment,  regardless  of  the
reason  for the termination or by whom initiated, she will not solicit,  in
competition with the Company, directly or indirectly, any person who  is  a
client,  customer or prospect (as such terms are defined below) (including,
without  limitation, purchasers of the Company's products) for the  purpose
of  performing  services and/or providing goods and services  of  the  kind
performed  and/or provided by the Company in the business of producing  and
distributing  potash, phosphate, animal feed ingredients  or  salt  or  any
other  significant business in which the Company is engaged or is preparing
to engage in at the time of termination;

(iii)  during  employment with the Company and for a period  of  two  years
following  the  Executive's termination of employment,  regardless  of  the
reason  for  the termination or by whom initiated, she will not  induce  or
persuade  or  attempt to induce or persuade any employee or  agent  of  the
Company  to  terminate her or her employment, agency, or other relationship
with  the  Company in order to enter into any employment  agency  or  other
relationship in competition with the Company;

(iv)   the covenants contained in this Section 4(a) shall apply within  any
jurisdiction  of  North America, it being understood  that  the  geographic
scope  of the business and strategic plans of the Company extend throughout
North America and are not limited to any particular region thereof and that
such business may be engaged in effectively from any location in such area;
and

(v)    as used herein, the terms "client," "customer" and "prospect"  shall
be defined as any client, customer or prospect of any business in which the
Company  is  or has been substantially engaged within the one  year  period
prior to the Executive's termination of employment (a) to which or to  whom
the Executive submitted or assisted in the submission of a presentation  or
proposal of any kind on behalf of the Company; (b) with which or with  whom
the  Executive  had  substantial contact relating to the  business  of  the
Company;   or  (c)  about  which  or  about  whom  the  Executive  acquired
substantial  confidential  or  other information  as  a  result  of  or  in
connection with the Executive's employment, at any time during the one year
period preceding the Executive's termination of employment for any reason.

Notwithstanding the foregoing, if the Company consents in writing, it shall
not  be  a  violation of this Section 4(a) for the Executive to  engage  in
conduct otherwise prohibited by this Section.

(b)   The  Executive agrees that she will not at any time during employment
or  thereafter  for  the  longest time permitted by  applicable  law,  use,
disclose,  or take any action which may result in the use or disclosure  of
any  trade secrets or other proprietary or confidential information of  the
Company,  except to the extent that the Company may specifically  authorize
in writing. This obligation shall not apply when and to the extent that any
trade  secret,  proprietary  or confidential  information  of  the  Company
becomes  publicly  available  other than due  to  the  Executive's  act  or
omission.   In  connection with this Section 4, the Executive has  executed
and  shall abide by the terms of the separate agreement attached hereto  as
Exhibit B.

(c)  The Executive agrees that upon termination of her employment she  will
immediately  surrender  and return to the Company  all  records  and  other
documents obtained by her, entrusted to her, or otherwise in her possession
or  control  during  the course of her employment by the Company,  together
with all copies thereof; provided, however, that  subject to Company review
and  authorization, the Executive may retain copies of  such  documents  as
necessary  for  the  Executive's personal records for  federal  income  tax
purposes.

(d)  The  Executive  acknowledges that the  provisions  contained  in  this
Section 4 are reasonable and necessary because of the substantial harm that
would  be  caused to the Company by the Executive engaging in  any  of  the
activities prohibited or restricted herein.  Nevertheless, it is the intent
and  understanding of each party hereto that if, in any action  before  any
court,  agency or other tribunal legally empowered to enforce the covenants
contained  in  this Section 4, any term, restriction, covenant  or  promise
contained  therein is found to be unenforceable due to unreasonableness  or
due  to  any other reason, then such term, restriction, covenant or promise
shall be deemed modified to the extent necessary to make it enforceable  by
such court or agency.

(e)  The  Executive  acknowledges that her breach of this  Section  4  will
result  in  immediate  and  irreparable  harm  to  the  Company's  business
interests,  for  which damages cannot be calculated easily  and  for  which
damages  are an inadequate full remedy.  Accordingly, and without  limiting
the  right  of the Company to pursue all other legal or equitable  remedies
available for the violation by the Executive of the covenants contained  in
this  Section 4, it is expressly agreed that remedies other than injunctive
relief cannot fully compensate the Company for the irreparable injury  that
the Company could suffer due to any such violation, threatened violation or
continuing  violation and that the Company shall be entitled to  injunctive
relief,  without the necessity of proving actual monetary loss, to  prevent
any such violation, threatened violation or continuing violation thereof.

5.   Change in Control.

(a)  Effective  Date.  For purposes of this Section 5, the term  "Effective
Date"  shall mean the date on which a Change in Control of the Company  (as
defined  in  Section  5(i))  occurs.   This  Section  5  shall  not  become
effective,  and  the  Company shall have no obligation  hereunder,  if  the
employment  of the Executive with the Company shall terminate  prior  to  a
Change in Control of the Company.  If there is a Change in Control and this
Section  becomes effective, then this Section shall govern  the  terms  and
conditions  of the Executive's employment and termination thereof  and  the
provisions of Sections 1, 2, 3, and 4 of this Agreement shall no longer  be
effective.

(b) Right to Change in Control Severance Benefits.  The Executive shall  be
entitled  to receive from the Company Change in Control Severance  Benefits
as  described in Section 5(g) herein, if during the term of this  Agreement
there  has  been  a  Change  in  Control of the  Company  and  there  is  a
Termination  (as  defined in Section 5(f)) prior to the expiration  of  the
Employment Term (as defined in Section 5(c)).

(c)  Employment Term.  For purposes of this Section 5, the term "Employment
Term"  shall  mean  the  period commencing on the Effective  Date  of  this
Section  5  and ending on the earlier to occur of (1) the last day  of  the
month  in which occurs the third anniversary of the Effective Date of  this
Section  5 or (2) the last day of the month in which the Executive  attains
mandatory  retirement  age pursuant to the terms of a mandatory  retirement
plan  of the Company as such were in effect and applicable to the Executive
immediately prior to the Effective Date of this Section 5.

(d) Employment.  The Company hereby agrees to continue the Executive in its
employ,  and  the Executive hereby agrees to remain in the  employ  of  the
Company,  until  the  expiration  of  the  Employment  Term.   During   the
Employment  Term, the Executive shall exercise such position and  authority
and perform such responsibilities as are commensurate with the position and
authority  being  exercised  and duties being performed  by  the  Executive
immediately  prior to the Effective Date of this Section 5, which  services
shall  be  performed  at  the  location where the  Executive  was  employed
immediately prior to the Effective Date of this Section 5 or at such  other
location  as  the  Company  may  reasonably  require;  provided,  that  the
Executive  shall not be required to accept another location that she  deems
unreasonable in the light of her personal circumstances.

(e)  Compensation and Benefits.  During the Employment Term, the  Executive
shall receive the following compensation and benefits:

1.  She shall receive an annual base salary which is not less than her Base
Salary immediately prior to the Effective Date of this Section 5, with  the
opportunity  for  increases, from time to time  thereafter,  which  are  in
accordance with the Company's regular executive compensation practices.

2.  She  shall  be eligible to participate on a reasonable  basis,  and  to
continue  her  existing participation, in annual incentive,  stock  option,
restricted   stock,   long-term  incentive  performance   and   any   other
compensation  plan which provides opportunities to receive compensation  in
addition  to  her Base Salary which is the greater of (i) the opportunities
provided  by the Company for executives with comparable duties or (ii)  the
opportunities   under  any  such  plans  in  which  she  was  participating
immediately prior to the Effective Date of this Section 5.

3.  She  shall be entitled to receive and participate in salaried  employee
benefits  (including,  but  not  limited to,  medical,  life  and  accident
insurance,  investment,  stock  ownership  and  disability  benefits)   and
perquisites  which  are  the  greater of  (i)  the  employee  benefits  and
perquisites provided by the Company to executives with comparable duties or
(ii) the employee benefits and perquisites to which she was entitled or  in
which  she  participated immediately prior to the Effective  Date  of  this
Section 5.

4.  She  shall  be  entitled  to continue to accrue  credited  service  for
retirement benefits and to be entitled to receive retirement benefits under
and  pursuant to the terms of the Company's qualified retirement  plan  for
salaried  employees, the Company's supplemental executive retirement  plan,
and  any successor or other retirement plan or agreement in effect  on  the
Effective  Date of this Section 5 in respect of her retirement, whether  or
not a qualified plan or agreement, so that her aggregate monthly retirement
benefit  from all such plans and agreements (regardless when she begins  to
receive such benefit) will be not less than it would be had all such  plans
and  agreements in effect immediately prior to the Effective Date  of  this
Section  5  continued to be in effect without change until  and  after  she
begins to receive such benefit.

(f)  Termination.  The term "Termination" shall mean termination, prior  to
the  expiration of the Employment Term, of the employment of the  Executive
with  the Company for any reason other than death, disability (as described
below),  cause (as described below), or voluntary resignation (as described
below).

1. The term "disability" means physical or mental incapacity qualifying the
Executive for long-term disability under the Company's long-term disability
plan.

2.  The  term  "cause" means (i) the willful and continued failure  of  the
Executive substantially to perform her duties with the Company (other  than
any  failure  due  to  physical or mental incapacity) after  a  demand  for
substantial performance is delivered to her by the Board of Directors which
specifically identifies the manner in which the Board believes she has  not
substantially  performed her duties or (ii) willful  misconduct  materially
and demonstrably injurious to the Company.  No act or failure to act by the
Executive shall be considered "willful" unless done or omitted to  be  done
by  her not in good faith and without reasonable belief that her action  or
omission was in the best interest of the Company.  The unwillingness of the
Executive  to accept any or all of a change in the nature or scope  of  her
position,  authorities or duties, a reduction in her total compensation  or
benefits, a relocation that she deems unreasonable in light of her personal
circumstances, or other action by or request of the Company in  respect  of
her  position, authority or responsibility that she reasonably deems to  be
contrary to this Agreement, may not be considered by the Board of Directors
to be a failure to perform or misconduct by the Executive.  Notwithstanding
the  foregoing,  the Executive shall not be deemed to have been  terminated
for  cause for purposes of this Section 5 unless and until there shall have
been  delivered to her a copy of a resolution, duly adopted by  a  vote  of
three-quarters of the entire Board of Directors of the Company at a meeting
of  the Board called and held (after reasonable notice to the Executive and
an  opportunity  for the Executive and her counsel to be heard  before  the
Board) for the purpose of considering whether the Executive has been guilty
of  such  a  willful  failure  to perform or  such  willful  misconduct  as
justifies  termination for cause hereunder, finding that in the good  faith
opinion  of  the Board the Executive has been guilty thereof and specifying
the particulars thereof.

3.  The resignation of the Executive shall be deemed "voluntary" if  it  is
for any reason other than one or more of the following:

(a)  The  Executive's  resignation  or  retirement  (other  than  mandatory
retirement, as aforesaid) is requested by the Company other than for cause;

(b)  Any  significant  change in the nature or  scope  of  the  Executive's
position,  authorities or duties from those described in  Section  5(d)  of
this Agreement;

(c)  Any reduction in her total compensation or benefits from that provided
in Section 5(e);

(d) The breach by the Company of any other provision of this Section 5; or

(e)  The reasonable determination by the Executive that, as a result  of  a
Change  in  Control  of  the Company and a change in circumstances  in  her
position,  she  is  unable to exercise the authorities  and  responsibility
attached  to  her  position  and  contemplated  by  Section  5(d)  of  this
Agreement.

4.  Termination  that entitles the Executive to the payments  and  benefits
provided  in Section 5(g) shall not be deemed or treated by the Company  as
the  termination  of the Executive's employment or the  forfeiture  of  her
participation,  award or eligibility for the purpose of any plan,  practice
or agreement of the Company referred to in Section 5(e).

(g)  Change in Control Severance Payments.  In the event of and  within  30
days  following  Termination, the Company shall pay to  the  Executive  the
following benefits (collectively, "Change in Control Severance Payments"):

1. Her Base Salary and all other benefits due her as if she had remained an
employee  pursuant to this Section 5 through the remainder of the month  in
which  Termination  occurs,  less applicable withholding  taxes  and  other
authorized payroll deductions;

2.  An  amount  equal  to  the target award for  the  Executive  under  the
Company's  annual  bonus  plan for the fiscal  year  in  which  Termination
occurs,  reduced pro rata for that portion of the fiscal year not completed
as  of the end of the month in which Termination occurs; provided, however,
that  if the Executive has deferred her award for such year under the plan,
the  payment due the Executive under this Paragraph (2) shall  be  paid  in
accordance with the terms of the deferral;

3.  An  amount  equal  to  the target award for  the  Executive  under  the
Company's long-term incentive plan for the fiscal year in which Termination
occurs,  reduced pro rata for that portion of the fiscal year not completed
as of the end of the month in which Termination occurs;

4. A lump sum severance allowance in an amount which is equal to the sum of
the  amounts determined in accordance with the following subparagraphs  (a)
and (b):

(a)  an amount equal to three times the Executive's Base Salary at the rate
in effect immediately prior to Termination; and

(b)  an  amount equal to three times the highest annual bonus earned  under
the  Company's  Management  Incentive Compensation  Program,  or  successor
annual bonus plan in effect from time to time, during the three consecutive
complete  bonus years immediately prior to Termination; provided,  however,
that  in  the event that the Executive's employment is terminated prior  to
the  completion  of three complete bonus years, any prorated  annual  bonus
received by the Executive shall be annualized and the bonus years in  which
the  Executive's employment commences or terminates shall be deemed  to  be
"complete bonus years" for purposes of determining the highest annual bonus
earned  by  the Executive during the three complete bonus years immediately
prior to Termination.

(h) Non-Competition and Confidentiality.  The Executive agrees that:

1.  There shall be no obligation on the part of the Company to provide  any
further  Change  in  Control Severance Benefits  (other  than  payments  or
benefits already earned or accrued) described in Section 5(g) if, when  and
so  long as the Executive shall be employed by or otherwise engage  in  any
business which is competitive with any business of the Company or of any of
its subsidiaries, as such business existed as of the Effective Date of this
Section 5, in which the Executive was engaged during her employment, and if
such  employment  or  activity is likely to cause  serious  damage  to  the
Company or any of its subsidiaries; and

2.  during  and  after  the  Employment  Term,  she  will  not  divulge  or
appropriate  to her own use or the use of others any secret or confidential
information  pertaining to the businesses of the  Company  or  any  of  its
subsidiaries  obtained  during her employment  by  the  Company,  it  being
understood that this obligation shall not apply when and to the extent  any
of  such information becomes publicly known or available other than because
of her act or omission.

(i)  Definition of "Change in Control".  "Change in Control" of the Company
means,  and shall be deemed to have occurred upon,  the first to  occur  of
any of the following events:

1.  the  acquisition  by  any individual, entity  or  group  (a  "Person"),
including  any "person" within the meaning of Section 13(d)(3) or  14(d)(2)
of the Securities Exchange Act of 1934, as amended (the "Exchange Act"), of
beneficial ownership within the meaning of Rule 13d-3 promulgated under the
Exchange  Act, of 15% or more of either (i) the then outstanding shares  of
common  stock of the Company (the "Outstanding Common Stock") or  (ii)  the
combined  voting power of the then outstanding securities  of  the  Company
entitled  to  vote generally in the election of directors (the "Outstanding
Voting Securities"); excluding, however, the following: (A) any acquisition
directly  from  the Company (excluding any acquisition resulting  from  the
exercise  of  an  exercise,  conversion or exchange  privilege  unless  the
security  being so exercised, converted or exchanged was acquired  directly
from  the Company), (B) any acquisition by the Company, (C) any acquisition
by  an employee benefit plan (or related trust) sponsored or maintained  by
the  Company  or  any  corporation controlled by the  Company  or  (D)  any
acquisition  by  any corporation pursuant to a transaction  which  complies
with clauses (i), (ii) and (iii) of subsection (3) of this Section 5(i);

2.  Individuals who, as of the effective date of this Section 5, constitute
the  Board  of  Directors (the "Incumbent Board") cease for any  reason  to
constitute at least a majority of such Board; provided, that any individual
who  becomes a director of the Company subsequent to the effective date  of
this Section 5, whose election, or nomination for election by the Company's
stockholders,  was  approved by the vote of at  least  a  majority  of  the
directors  then comprising the Incumbent Board shall be deemed a member  of
the  Incumbent  Board; and provided further, that any  individual  who  was
initially elected as a director of the Company as a result of an actual  or
threatened  election  contest, as such terms are used  in  Rule  14a-11  of
Regulation 14A promulgated under the Exchange Act, or any other  actual  or
threatened  solicitation of proxies or consents by  or  on  behalf  of  any
Person  other than the Board shall not be deemed a member of the  Incumbent
Board;

3.  approval by the stockholders of the Company of a reorganization, merger
or  consolidation  of the Company or sale or other disposition  of  all  or
substantially all of the assets of the Company (a "Corporate Transaction");
excluding,  however, a Corporate Transaction pursuant to which (i)  all  or
substantially  all  of the individuals or entities who are  the  beneficial
owners,  respectively, of the Outstanding Common Stock and the  Outstanding
Voting  Securities  immediately prior to such  Corporate  Transaction  will
beneficially  own, directly or indirectly, more than 60% of,  respectively,
the  outstanding shares of common stock, and the combined voting  power  of
the  outstanding securities of such corporation entitled to vote  generally
in  the  election  of  directors, as the case may be,  of  the  corporation
resulting from such Corporate Transaction (including, without limitation, a
corporation which as a result of such transaction owns the Company  or  all
or substantially all of the Company's assets either directly or indirectly)
in  substantially  the same proportions relative to  each  other  as  their
ownership,  immediately  prior  to  such  Corporate  Transaction,  of   the
Outstanding Common Stock and the Outstanding Voting Securities, as the case
may be, (ii) no Person (other than:  the Company; any employee benefit plan
(or   related  trust)  sponsored  or  maintained  by  the  Company  or  any
corporation controlled by the Company; the corporation resulting from  such
Corporate Transaction; and any Person which beneficially owned, immediately
prior to such Corporate Transaction, directly or indirectly, 25% or more of
the  Outstanding Common Stock or the Outstanding Voting Securities, as  the
case may be) will beneficially own, directly or indirectly, 25% or more of,
respectively,  the  outstanding shares of common stock of  the  corporation
resulting from such Corporate Transaction or the combined voting  power  of
the  outstanding securities of such corporation entitled to vote  generally
in  the election of directors and (iii) individuals who were members of the
Incumbent Board will constitute at least a majority of the members  of  the
board  of  directors  of  the  corporation resulting  from  such  Corporate
Transaction; or

4. the consummation of a plan of complete liquidation or dissolution of the
Company.

(j) Excise Tax Payments.  If any of the payments to be made under Section 5
or  any payments which are construed as being made under Section 5, will be
subject  to  the  tax  (the "Excise Tax") imposed by Section  4999  of  the
Internal Revenue Code of 1986, as amended  (the "Code") (or any similar tax
that  may hereafter be imposed), the Company shall pay to the Executive  at
the time specified in Paragraph 1 below an additional amount (the "Gross-up
Payment")  such  that  the  net amount retained  by  the  Executive,  after
deduction of any Excise Tax on the Total Payments (as hereinafter  defined)
and  any federal, state and local income tax and Excise Tax upon the Gross-
up  Payment  provided for by this paragraph, but before deduction  for  any
federal,  state  or  local income tax on the Change  in  Control  Severance
Payments, shall be equal to the Total Payments.

1.  For  purposes  of  determining whether any of  the  Change  in  Control
Severance Payments will be subject to the Excise Tax and the amount of such
Excise  Tax, (i) any other payments or benefits received or to be  received
by  the  Executive in connection with a Change in Control (as that term  is
defined  in Section 5(i)) of the Company or the Executive's termination  of
employment  (whether pursuant to the terms of this Agreement or  any  other
plan,  arrangement or agreement with the Company, any person whose  actions
result in a Change of Control of the Company or any person affiliated  with
the  Company  or such person) (which, together with the Change  in  Control
Severance Payments, shall constitute the "Total Payments") shall be treated
as  "parachute  payments" within the meaning of Section 280G(b)(2)  of  the
Code,  and  all "excess parachute payments" within the meaning  of  Section
280G(b)(1)  of  the  Code shall be treated as subject to  the  Excise  Tax,
unless  in the opinion of tax counsel selected by the Company's independent
auditors  such  other payments or benefits (in whole or  in  part)  do  not
constitute parachute payments, or such excess parachute payments (in  whole
or  in  part)  represent  reasonable  compensation  for  services  actually
rendered within the meaning of Section 280G(b)(4) of the Code in excess  of
the base amount within the meaning of Section 280G(b)(3) of the Code or are
otherwise  not  subject to the Excise Tax, (ii) the  amount  of  the  Total
Payments which shall be treated as subject to the Excise Tax shall be equal
to  the  lesser of (A) the total amount of the Total Payments  or  (B)  the
amount   of  excess  parachute  payments  within  the  meaning  of  Section
280G(b)(1)  of  the Code (after applying clause (i) above), and  (iii)  the
value of any non-cash benefits or any deferred payment or benefit shall  be
determined  by  the Company's independent auditors in accordance  with  the
principles of Sections 280G(d)(3) and (4) of the Code.

2.  For  purposes  of determining the amount of the Gross-up  Payment,  the
Executive  shall  be  deemed to pay federal income  taxes  at  the  highest
marginal rate of federal income taxation for the calendar year in which the
Gross-up  Payment is to be made and the applicable state and  local  income
taxes  at  the highest marginal rate of taxation for the calendar  year  in
which  the Gross-up Payment is to be made, net of the maximum reduction  in
federal  income taxes which could be obtained from deduction of such  state
and  local  taxes.   In  the  event that the  Excise  Tax  is  subsequently
determined to be less than the amount taken into account hereunder  at  the
time the Gross-up Payment is made, the Executive shall repay to the Company
at  the  time  that the amount of such reduction in Excise Tax  is  finally
determined  the  portion  of  the Gross-up  Payment  attributable  to  such
reduction  (plus  the portion of the Gross-up Payment attributable  to  the
Excise  Tax  and  federal and state and local income  tax  imposed  on  the
portion  of  the  Gross-up Payment being repaid by the  Executive  if  such
repayment  results in a reduction in Excise Tax and/or a federal and  state
and  local  income  tax deduction), plus interest on  the  amount  of  such
repayment  at the rate provided in Section 1274(b)(2)(B) of the  Code.   In
the event that the Excise Tax is determined to exceed the amount taken into
account  hereunder at the time the Gross-up Payment is made  (including  by
reason  of  any  payment,  the  existence or  amount  of  which  cannot  be
determined at the time of the Gross-up Payment), the Company shall make  an
additional  Gross-up Payment in respect of such excess (plus  any  interest
payable  with respect of such excess) at the time that the amount  of  such
excess is finally determined.

3.  The Gross-up Payment or portion thereof provided for in Paragraphs 1and
2 above shall be paid not later than the thirtieth day following payment of
any amounts under this Section 5; provided, however, that if the amount  of
such Gross-up Payment or portion thereof cannot be finally determined on or
before  such  day, the Company shall pay to the Executive on  such  day  an
estimate, as determined in good faith by the Company, of the minimum amount
of  such  payments  and shall pay the remainder of such payments  (together
with interest at the rate provided in Section 1274(b)(2)(B) of the Code) as
soon  as  the amount thereof can be determined, but in no event later  than
the forty-fifth day after payment of any amounts under this Section 5.

4.  In  the  event  that the amount of the estimated payments  exceeds  the
amount  subsequently  determined  to  have  been  due,  such  excess  shall
constitute a loan by the Company to the Executive, payable on the fifth day
after demand by the Company (together with interest at the rate provided in
Section 1274(b)(2)(B) of the Code).

5.  All  Gross-up  Payments will be paid to the Executive  from  the  Trust
established under the Trust Agreement between IMC Global Inc. and  Wachovia
Bank  Trust  Company, N.A., which has been established to  protect  payment
obligations  of  the Company under this Agreement.  Any repayment  due  the
Company  from  the Executive as a result of the circumstances described  in
the last sentence of the preceding paragraph shall be made by the Executive
after the Executive has  received such excess amounts from the Trust.

6.  If  there  are any changes in the Code which otherwise would  or  might
affect the workings of this Section 5(j), then Section 5(j) shall be deemed
to  be  revised  in such a way as to provide to the Executive  the  maximum
benefits  she  would be entitled to receive under the current  language  of
Section 5(j) and the Code.

(k) Enforcement Costs.  The Company is aware that upon the occurrence of  a
Change  in Control, the Board of Directors or a stockholder of the  Company
may then cause or attempt to cause the Company to refuse to comply with its
obligations  under  this Section 5, or may cause or attempt  to  cause  the
Company  to  institute, or may institute, litigation seeking to  have  this
Section  5  declared unenforceable, or may take, or attempt to take,  other
action  to  deny the Executive the benefits intended under this Section  5.
In  these circumstances, the purpose of this Section 5 could be frustrated.
It is the intent of the parties that the Executive not be required to incur
the  legal  fees and expenses associated with the protection or enforcement
of  her  rights  under this Section 5 by litigation or other  legal  action
because  such costs would substantially detract from the benefits  intended
to  be  extended to the Executive hereunder, nor be bound to negotiate  any
settlement  of her rights hereunder under threat of incurring  such  costs.
Accordingly, if at any time after the Effective Date of this Section 5,  it
should appear to the Executive that the Company is or has acted contrary to
or  is  failing  or has failed to comply with any of its obligations  under
this Section 5 for the reason that it regards this Section 5 to be void  or
unenforceable or for any other reason, or that the Company has purported to
terminate  her  employment for cause or is in the course  of  doing  so  in
either case contrary to this Section 5, or in the event that the Company or
any  other  person  takes  any action to declare this  Section  5  void  or
unenforceable, or institutes any litigation or other legal action  designed
to deny, diminish or to recover from the Executive the benefits provided or
intended  to be provided to her hereunder, and the Executive has  acted  in
good  faith  to perform her obligations under this Section 5,  the  Company
irrevocably authorizes the Executive from time to time to retain counsel of
her  choice  at  the expense of the Company to represent her in  connection
with  the  protection  and enforcement of her rights  hereunder,  including
without  limitation  representation in connection with termination  of  her
employment contrary to this Section 5 or with the initiation or defense  of
any  litigation or other legal action, whether by or against the  Executive
or  the  Company  or  any director, officer, stockholder  or  other  person
affiliated with the Company, in any jurisdiction.  The reasonable fees  and
expenses  of  counsel  selected from time  to  time  by  the  Executive  as
hereinabove  provided shall be paid or reimbursed to the Executive  by  the
Company on a regular, periodic basis upon presentation by the Executive  of
a  statement or statements prepared by such counsel in accordance with  its
customary practices, up to a maximum aggregate amount of $200,000.  Counsel
so  retained by the Executive may be counsel representing other officers or
key  executives  of  the  Company in connection  with  the  protection  and
enforcement of their rights under similar agreements between them  and  the
Company,  and, unless in her sole judgement use of common counsel could  be
prejudicial  to her or would not be likely to reduce the fees and  expenses
chargeable hereunder to the Company, the Executive agrees to use  her  best
efforts  to  agree with such other officers or executives to retain  common
counsel.

(l)  Successors  and  Assigns.  Except as otherwise provided  herein,  this
Section  5  shall be binding upon and inure to the benefit of the Executive
and  his legal representatives, heirs, and assigns; provided, however, that
in  the event of the Executive's death prior to payment or distribution  of
all amounts, distributions, and benefits due him under this Section 5, each
such  unpaid amount and distribution shall be paid in accordance with  this
Section  5  to  the  person or persons designated by the Executive  to  the
company  to  receive  such payment or distribution and  in  the  event  the
Executive  has  made no applicable designation, to the  person  or  persons
designated by the Executive as the beneficiary or beneficiaries of proceeds
of  life insurance payable in the event of the Executive's death under  the
Company's group life insurance plan.

6.    Dispute Resolution.  The Executive and the Company shall not initiate
arbitration  or other legal proceeding (except for any claim under  Section
4)  against  the other party or against any directors, officers, employees,
agents or representatives of the Company or its affiliates, relating in any
way  to this Agreement, to the Executive's retention by the Company, to the
termination of this Agreement or of such retention, or to any or all  other
claims  for employment or other discrimination under any federal, state  or
local law, regulation, ordinance or executive order until 30 days after the
party  against  whom the claim(s) is made ("respondent")  receives  written
notice  from  the  claiming party of the specific nature of  any  purported
claim(s) and, to the extent known or reasonably anticipated, the amount  of
any  purported  damages attributable to each such claim(s).  The  Executive
and  the  Company  further agree that if respondent  submits  the  claiming
party's   claim(s)  to  the  CPR  Institute  for  Dispute   Resolution   or
JAMS/Endispute for nonbinding mediation prior to the expiration of such  30
day period, the claiming party may not institute arbitration or other legal
proceedings against respondent until the earlier of: (a) the completion  of
good-faith  mediation efforts or (b) 90 days after the date  on  which  the
respondent  received  written  notice  of  the  claimant's  claim(s).   The
mediation shall be conducted in Chicago, Illinois or such other location to
which  the  parties may agree.  The Company agrees to pay the cost  of  the
mediator's services.

Subject to the foregoing, the Executive and the Company agree that any  and
all  claims  or disputes relating to this Agreement, to the termination  of
this  Agreement  or  to such retention, to the Executive's  termination  of
employment  or  to her retention, that one party or that the Executive  may
have against any directors, officers, employees, agents, or representatives
of  the Company or its affiliates, including without limitation, claims for
employment or other discrimination under any federal, state, or local  law,
regulation,   ordinance,  or  executive  order,  shall  be  submitted   for
arbitration and resolved by an arbitrator selected in accordance  with  the
rules  and  procedures  of  the CPR Institute  for  Dispute  Resolution  or
JAMS/Endispute,  it  being understood and agreed  that  no  more  than  one
arbitrator shall be retained for any arbitration conducted hereunder.   The
arbitration  proceeding  shall be conducted in Chicago,  Illinois  or  such
other  location to which the parties may agree.  If either party pursues  a
claim  and  such claim results in an arbitrator's decision or  award,  both
parties  agree to accept such decision or award as final and  binding,  and
judgment  upon  the  decision or award rendered by the  arbitrator  may  be
entered in any court having jurisdiction thereof.  The parties shall  share
the  cost  of  the  arbitrator's  services.   Notwithstanding  any  of  the
foregoing  provisions of this Section, the Company may  in  its  discretion
immediately  pursue any and all available legal and equitable remedies  for
the  Executive's  breach,  threatened breach or continuing  breach  of  any
provision of Section 4 in any court, agency, or other tribunal of competent
jurisdiction.

7.    Entire  Agreement, Amendment, Waiver. This Agreement constitutes  the
entire agreement between the Company and the Executive with respect to  the
subject matter hereof.  This Agreement supersedes any prior agreements made
between the parties with respect to the subject matter hereof.  The parties
may  not  amend this Agreement except by written instrument signed by  both
parties.  No waiver by either party at any time of any breach by the  other
of  any provision of this Agreement shall be deemed a waiver of similar  or
dissimilar provision at the same time or any prior or subsequent time.

8.    Assumption.  This Agreement shall inure to benefit of, and be binding
upon,  the  successors  and assignees of the Company.   The  Company  shall
require any successor or assignee, whether direct or indirect, by purchase,
merger,  consolidation  or otherwise, to all or substantially  all  of  the
business or assets of the Company, expressly and unconditionally to  assume
and agree to perform the Company's obligations under this Agreement.

9.    Notice.  Any  notice,  request, or other  communication  required  or
permitted  to be given hereunder shall be made to the addresses hereinafter
set  forth  or  to any other address designated by either  of  the  parties
hereto by notice similarly given:

If to the Company:                         If to the Executive:
Senior Vice President, Human Resources
IMC Global Inc.
2100 Sanders Road
Northbrook, IL 60062

All  such notices, requests or other communications shall be sufficient  if
made  in  writing  either (i) by personal delivery to  the  party  entitled
thereto, (ii) by registered or certified mail, return receipt requested  or
(iii)   by   express  courier  service.   The  notice,  request  or   other
communication  shall  be deemed effective upon personal  delivery  or  upon
actual  or  constructive  receipt  by the  party  entitled  thereto  if  by
registered or certified mail or express courier service; provided, however,
that  a  notice,  request  or other communication  received  after  regular
business  hours  shall  be deemed to be received  on  the  next  succeeding
business day of the Company.

10.   Severability.  The provisions of this Agreement shall be regarded  as
durable,  and  if any provision or portion thereof is declared  invalid  or
unenforceable  by  a  court  of competent jurisdiction,  the  validity  and
enforceability  of  the remainder and applicability thereof  shall  not  be
affected.

11.   Applicable Law.  This Agreement shall at all times be governed by and
construed,  interpreted and enforced in accordance with the  internal  laws
(as opposed to the conflict of laws provisions) of the State of Illinois.


IN  WITNESS WHEREOF, the Company has caused this Agreement to be signed  by
its duly authorized officer and the Executive has signed this Agreement  as
of the day and year first above written.

IMC GLOBAL INC.

By:________________________   __________________________

Title: Chairman of the Board of
       Directors and Chief Executive
       Officer


                                                              EXHIBIT A
                     WAIVER AND RELEASE OF CLAIMS

      In  exchange for the Severance Benefits described in the attached
Executive Severance Agreement (the "Agreement"), which I acknowledge  I
would  not  otherwise be entitled to receive, I freely and  voluntarily
agree to this WAIVER AND RELEASE OF CLAIMS ("WAIVER"):

1.    My  employment  with  IMC Global Inc.  will  terminate  effective
_______________________.

2.    I  acknowledge  that  the  Severance Benefits  described  in  the
attached  Agreement are the sole payments to which I  am  entitled  and
that I am not entitled to any additional severance payments.

3.    I,  and anyone claiming through me, hereby waive and release  any
and  all claims that I may have ever had or that I may now have against
IMC  Global  Inc.,  its  parents, divisions, partnerships,  affiliates,
subsidiaries,  and  other  related entities and  their  successors  and
assigns,  and past, present and future officers, directors,  employees,
agents  and  attorneys of each of them in their individual or  official
capacity  (hereinafter collectively referred to as "Released Parties").
Among the claims that I am waiving are claims relating to my employment
or  termination of employment, including, but not limited to, claims of
discrimination  in  employment brought under the Age Discrimination  in
Employment  Act,  Title  VII  of the Civil  Rights  Act  of  1964,  the
Americans  With  Disabilities  Act or other  federal,  state  or  local
employment   discrimination,  employment,  wage  laws,  ordinances   or
regulations or any common law or statutory claims of wrongful discharge
or  breach  of  contract or any other common law or  statutory  claims;
whether for damages, lost wages or for any other relief or remedy.

4.    I understand and agree that this WAIVER will be binding on me and
my  heirs, administrators and assigns.  I acknowledge that I  have  not
assigned any claims or filed or initiated any legal proceedings against
any of the Released Parties.

5.   Except as may be required by law, I agree that I will not disclose
the  existence or terms of this WAIVER to anyone except my  accountant,
attorney  or  spouse,  each  of  whom  shall  also  be  bound  by  this
confidentiality provision.

  6.  I understand that I have twenty-one (21) days to consider whether
to  sign this WAIVER and return it to B. Russell Lockridge, Senior Vice
President,  Human Resources of IMC Global Inc.  IMC Global Inc.  hereby
advises  me of my right to consult with an attorney before signing  the
WAIVER and I acknowledge that I have had an opportunity to consult with
an  attorney and have either held such consultation or have  determined
not to consult with an attorney.

7.    I  understand that I may revoke my acceptance of this  WAIVER  by
delivering notice of my revocation to B. Russell Lockridge within seven
(7)  days  of  the  day  I sign the WAIVER.  If  I  do  not  revoke  my
acceptance  of this WAIVER within seven days of the day I sign  it,  it
will be legally binding and enforceable.

IMC GLOBAL INC.                         AGREED AND ACCEPTED:

By: __________________________          ___________________________

Title:  ________________________        ___________________________
                                        Print Name

Date:_________________________          Date:_______________________