AD-245B Addendum to AD-245 to Certify to the Actively Engaged, D

This form is available electronically. Form Approved - OMB No. 0560-0082

AD-245A U.S. DEPARTMENT OF AGRICULTURE (Proposal 6) Farm Service Agency ADDENDUM TO AD-245 TO CERTIFY TO THE ACTIVELY ENGAGED, DIRECT ATTRIBUTION AND ADJUSTED GROSS INCOME PROVISIONS					1A. State Code    		1B. County Code     
					2. AD-245 Control Number      
					3. Farm Number      
4. CERTIFICATION STATEMENT
This AD-245 Addendum is entered into by the Farm Service Agency (FSA) and the undersigned producer(s) who have enrolled into the Emergency Conservation Program (ECP) under the AD-245, listed in Item 2, above. By signing this AD-245 Addendum, the producer(s) and FSA understand and agree that: the Actively Engaged/Payment Eligibility provisions of section 1001A of the Food Security Act of 1985, as amended, will be used to determine one’s status as an agricultural producer for purposes of this AD-245. the Direct Attribution provisions of Section 1001 of the Food Security Act of 1985, as amended, provide that payments are attributed to a person by taking into account the direct and indirect ownership interests of the person in a legal entity that is eligible to receive payments. the Direct Attribution provisions of Section 1001 of the Food Security Act of 1985, as amended, will be utilized by FSA with regard to payments made under the AD-245 listed in Item 2, above. the Adjusted Gross Income (AGI) provisions of Section 1001D of the Food Security Act 1985, as amended, provide that a person or legal entity is not eligible to receive conservation program benefits if the average adjusted gross income of that person or legal entity exceeds $1 million. as determined by FSA, the AGI provisions of Section 1001D of the Food Security Act, as amended, may apply to the AD-245 listed in Item 2, above, depending on the funding source for the AD-245. FSA intends to publish a final rule for Direct Attribution, AGI and Actively Engaged/Payment Eligibility in the Federal Register. Following publication of that final rule, the producer may terminate the AD-245 listed in Item 2, above, within 60 days of being notified of the opportunity to do so by FSA. If the producer terminates the AD-245, the FSA will not require refunds of ECP payments associated with the AD-245, and the producer may reapply for ECP. It is so agreed and understood.
4A. Producer's Signature (By) 			4B. Title/Relationship (Individual Signing in the representative capacity)      			5. Date (MM-DD-YYYY)       
4A. Producer's Signature (By)			4B. Title/Relationship (Individual Signing in the representative capacity)      			5. Date (MM-DD-YYYY)       
4A. Producer's Signature (By)			4B. Title/Relationship (Individual Signing in the representative capacity)      			5. Date (MM-DD-YYYY)     
4A. Producer's Signature (By)			4B. Title/Relationship (Individual Signing in the representative capacity)      			5. Date (MM-DD-YYYY)       
5A. Signature of CCC Representative		5B. Date (MM-DD-YYYY)       		5C. County FSA Office Name and Address (Including ZIP Code) Telephone No. (Including Area Code):      
NOTE:	The primary authority for requesting and safeguarding the information described on this form is the Food, Conservation, and Energy Act of 2008 (Pub. L. 110-246). Additionally, the authority for requesting this information is 7 CFR Part 1400 and 7 CFR Part 701.  The information requested is necessary for AD-245 approval.  Furnishing the requested information is voluntary.  Failure to furnish the requested information will result in a determination of ineligibility for certain program benefits and other financial assistance administered by USDA.  The information collected as a result of this form may be released to USDA employees, USDA contractors, or authorized USDA cooperators who are bound to safeguard the information under Section 1619 of the Food, Conservation and Energy Act, the Privacy Act of 1974, the E-Government Act of 2002 and related authorities.   This information collection is exempted from the Paperwork Reduction Act, as it is required for administration of the Food, Conservation, and Energy Act of 2008 (see Pub. L. 110-246, Title I, Subtitle F - Administration).  The provisions of criminal and civil fraud statutes, including 18 USC 286, 287, 371, 641, 651, 1001; 15 USC 714; and 31 USC 3729, may be applicable to the information provided.  RETURN THIS COMPLETED FORM TO YOUR COUNTY FSA OFFICE.
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part of an individual's income is derived from any public assistance program. (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact USDA's TARGET Center at (202) 720-2600 (voice and TDD). To file a complaint of discrimination, write to USDA, Director, Office of Civil Rights, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.