AD-1068 Good Faith Determination-Highly Erobilble Land Activity

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This form is available electronically.
UNITED STATES DEPARTMENT OF AGRICULTURE
AD-1068
Farm Service Agency
(08-07-96)

Form Approved - OMB No. 0560-0004
1A. STATE NAME

1B. COUNTY NAME

GOOD FAITH DETERMINATION - HIGHLY ERODIBLE LAND ACTIVITY
NOTE: The following statement is made in accordance with the Privacy Act of 1974 (5 USC 552a) and the Paperwork Reduction Act of 1995, as amended. The authority for
requesting the following information is the Food Security Act of 1985 as amended and regulations promulgated under the Act (7 CFR Part 12). The information will be
used to determine eligibility for program benefits and other financial assistance administered by USDA agencies. Furnishing the requested information is voluntary.
However, failure to furnish the correct, complete information may result in a determination of ineligibility for certain program benefits and other financial assistance
administered by USDA agencies. This information maybe provided to other agencies, IRS, Department of Justice, or other State and Federal Law enforcement agencies,
and in response to a court magistrate or administrative tribunal. The provisions of criminal and civil fraud statutes, including 18 USC 286, 287, 371, 651, 1001; 15 USC
714m; and 31 USC 3729, maybe applicable to the information provided.
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it
displays a valid OMB control number. The valid OMB control number for this information collection is 0560-0004. The time required to complete this information collection
is estimated to average 5 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed,
and completing and reviewing the collection of information. RETURN THIS COMPLETED FORM TO YOUR COUNTY FSA OFFICE.

PART A - PRODUCER'S REQUEST
2. NAME AND ADDRESS OF PRODUCER (Including Zip Code):

3. TELEPHONE NO. (Including Area Code):

4. IDENTIFICATION NO.

5. FARM NO. WITH HELC DETERMINATION

6. CROP YEAR OF
DETERMINATION

7. DATE REFERRED TO
NRCS (MM-DD-YYYY)

8. Request for a good faith determination. (State the circumstances surrounding the activities on HEL. Include any evidence that the activities were performed in good faith
and without intent to violate the highly erodible land (HEL) conservation requirements and not as a scheme or device to avoid compliance.)

9A. PRODUCER'S SIGNATURE

9B. DATE (MM-DD-YYYY)

Note to producer: If a good faith request is approved by the county committee, eligibility will not be restored if the land is determined to be in violation of the highly
erodible land conservation provisions unless an agreement is signed and performed to apply practices according to NRCS requirements. Application for a good faith
determination does not preclude the opportunity to exercise appeal rights according to notice given with regard to the HEL determination.

PART B - NRCS INFORMATION
10. Describe any pertinent facts relating to the case that NRCS or the Soil and Water Conservation District has that may affect the COC determination

11A. SIGNATURE OF NRCS EMPLOYEE

11B. DATE (MM-DD-YYYY)

PART C - PAYMENT REDUCTION INFORMATION FOR SODBUSTER VIOLATIONS (NRCS AND FSA)
(Land that was converted from native vegetation i.e., rangeland or woodland, to crop production after December 23, 1985
(Sodbusted))
Information necessary for determining payment reduction for Sodbusted land

NRCS Data
12.
FIELD NUMBER

TOTALS
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13.
NRCS ERODIBILITY
INDEX

FSA Data
14.
SODBUSTED ACRES IN
VIOLATION

15.
WEIGHED AVERAGE
(Item 13 x Item 14)

16.
AVERAGE ERODIBILITY
(Item 15 divided by Item 14)

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AD-1068 (Page 2) (08-07-96)
PART C - CONTINUED
17. Circle the Payment Reduction amount, based on information in items 12 through 16.

NOTE: The prorated payment reduction amount for producers who meet good faith requirements shall not be less than $500 per
producer in accordance with the Federal Agriculture improvement and Reform Act of 1996.
SODBUSTED
ACRES IN
VIOLATION

GRADUATED PAYMENT REDUCTION TABLE FOR HEIL SODBUSTER VIOLATIONS
NRCS ERODIBILITY INDEX
8.0-8.9

9.0-14.9

15.0 and over

$500

.1 - 5.0
5.1 - 10.0
10.1 - 15.0
15.1 - 20.0
20.1 - 25.0
25.1 - 30.0
30.1 - 35.0
35.1 - 40.0
40.1 - 45.0
45.1 - 50.0
50.1 - 55.0
55.1 - 60.0
60.1 - 65.0
65.1 - 70.0
70.1 - 75.0
80.1 - 85.0
85.1 - 90.0
90.1 - 95.0
95.1 - 100.0
100.1 - 105.0
105.1 - 110.0
110.1 - 115.0
115.1 - 120.0
120.1 - 125.0
125.1 - 130.0
130.1 - 135.0
135.1 - 140.0
140.1 - 145.0
145.1 - 150.0
150.1 - AND OVER

$800
1100
1400
1700
2000
2300
2600
3200
3500
3800
4100
4400
4700

800
950
1100
1250
1400
1550
1700
1850
2000
2150
2300
2450
2600
2750
2900
3050
3200
3350
3500
3650
3800
3950
4100
4250
4400
4550
4700
4850
5000

$950
1400
1850
2300
2750
3200
3650
4100
4550

PART - D COC DETERMINATION
18. Based on information available, the COC determined
that a good faith effort to comply and without intent to violate:

a. Was made by the producer.

b. Was NOT made by the producer.

19. Reasons for the COC determination (Attach an additional sheet, if necessary.)

20A. SIGNATURE OF COC

20B. DATE (MM-DD-YYYY)

PART E - CONSERVATION PLAN
21. Referred to NRCS because the COC determined good faith.
DATE (MM-DD-YYYY):

22. A conservation plan was agreed upon by the producer and signed on.
DATE (MM-DD-YYYY):

23A. SIGNATURE OF NRCS EMPLOYEE

23B. DATE (MM-DD-YYYY)

24. DATE RETURNED TO FSA
(MM-DD-YYYY)

PART F - MULTI COUNTY INFORMATION
25. AMOUNT WITHHELD FROM EARNED BENEFITS
FOR SODBUSTER VIOLATIONS

26. CONTROL COF:
STATE

27. DATE MAILED TO CONTROL COF
COUNTY

(MM-DD-YYYY)

$
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, gender, religion, age, disability, political beliefs, sexual orientation,
and marital or family status. (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 USDA, Director, Office of Civil Rights, Room 326-W, Whitten Building, 1400
Independence Avenue, SW, Washington, D.C. 20250-9410 or call (202) 720-5964 (voice or TDD). USDA is an equal opportunity provider and employer.

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