HIGHLY
ERODIBLE
Producers use this form to
request an exemption for highly erodible land conservation provisions under USDA
programs.
Submit the original of the completed form in hard copy or facsimile to the appropriate FSA servicing office.
Customers
who have established electronic access credentials with USDA may electronically
transmit this form to the USDA servicing office, provided that (1) the
customer submitting the form is the only person required to sign the
transaction, or (2) the customer has an approved Power of Attorney (Form
FSA-211) on file with USDA to sign for other customers for the program and type
of transaction represented by this form.
Features
for transmitting the form electronically are available to those customers with
access credentials only. If you
would like to establish online access credentials with
USDA, follow the instructions provided at the USDA eForms web site.
Producers
must complete Items 1 through 9B.
Fld. Name/ Item
No. |
Instruction |
1A State
Name |
Enter the State name
where the farm is located. |
1B |
Enter the County name
where the farm is located. |
2 Producer Information
|
Enter the producer�s
name, address including Zip code, and telephone number including area
code. |
3 Identifica- tion Number |
Enter the producer�s
social security number or tax ID number. |
4 Farm
Number |
Enter the Farm Number
on which the exemption request is being made. |
5 Crop
Year |
Enter the crop year
for which the exemption request is being made. |
6 Cropland |
Enter the number of
acres for which the exemption request is being
made. |
7 Reason for
Request |
Enter the reason for
the request. Describe in
detail the conservation measures that are required but will not be applied
and the reasons they will not be applied. |
8A Producer�s
Signature |
Enter the producer�s
signature. If you are mailing
or faxing this form, print the form and manually enter your signature. If
this form is approved for electronic transmission and you have established
credentials with USDA to submit forms electronically, use the buttons
provided on the form for transmitting the form to the USDA servicing
office. |
8B Date |
Enter the date of
producer�s request. |
9A Landlord�s
Signature |
Landlord�s signature,
if applicable. |
9B Date |
Date of landlords�
signature. |
Items 10 � 27 are for FSA's use only.
File Type | text/html |
File Modified | 0000-00-00 |
File Created | 0000-00-00 |