Highly Erodible Land Conservation and Wetland Conservation (Individuals or Households)

Instructions For FSA-492

DATA NEEDED FOR THIRD-PARTY DETERMINATIONS

This form provides data to make determinations as to whether a wetland was converted by persons who have no current or former interest in the affected area.

Submit the original of the completed form in hard copy or facsimile to the appropriate USDA 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 12B.

Field Name / Item No.	Instruction
1 & 2 State and County	Enter State and County name.
3 Farm Serial Number	Enter the farm serial number.
4 Producer Information	Enter the name and address of the producer.
5 Phone Number	Enter the producer’s phone number.
6 Legal Description	Enter the legal description of the area in question. If you do not have a photo copy of the area, contact your USDA Service Center.
7 Has a wetland determination been…	Check "YES" or "NO" as applicable. Has a wetland determination been completed by NRCS? If "NO", a determination must be made before considering a third party request.
8 If a wetland determination has been…	Enter "YES" or "NO" as applicable. If a wetland determination has been completed, are the areas in question determined to be wetlands?
9 Remarks	Enter a description of actions that resulted in the drainage of the wetland by persons who have no current or former interest in the converted wetland for which the third party exemption is requested. Provide full details.
10 Has a crop been planted…	Check "YES" or "NO" as applicable. Has a crop been planted in the wetland in the current year? If "YES" enter date planted.
11 Is the request within…	Check yes or no as applicable. Is the request within the boundary of a drainage district?
12A 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.
12B Date	Enter the date signed.

Part B – COC Third-Party Determination to be completed by FSA Office.

Page 2 of 2