Land Contract Guarantee program and Emergency Equine Loss Loan (EM) Program - Direct Loan Making

Instructions for FSA-2309Instructions for FSA-2309

CERTIFICATION OF DISASTER LOSSES

Used by applicants to provide information pertaining to their losses caused by a

designated disaster.

Submit the original of the completed form in hard copy or facsimile to the

appropriate USDA Office. Customers who have established electronic access

credentials with USDA may electronically transmit this form to the USDA office,

provided that the customer submitting the form is the only person required to

sign the transaction.

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.

Applicants must complete Items 1, 4, 5A through 5E, 6 through 11D, and 12A and

12B.

FSA completes Items 2, 3, 5F, 5G and 11E.

Items 1 and 4 are completed by the applicant.

Item No./

Fld NameInstruction

1

Applicants NameEnter applicants name.

4

Date(s) and Nature of DisasterEnter the date(s) and nature of the

designated disaster.

Items 2 and 3 are for FSA use only.

Items 5A through 5E are completed by the applicant.

Item No./

Fld NameInstruction

5A(1)

Crop ProductionList cash crops.

5A(2)

Crop ProductionList feed crops.

5A(3)

Crop ProductionList other crops (i.e. pasture).

5(B)

UnitsEnter the unit of crop production, i.e. tons, bushels, or lbs.

5C

AcresEnter the number of acres for the crops listed in Item 5A.

5D

YieldEnter the yield per acre for the crops listed in Item 5A.

5E

3 Year Actual

ProductionEnter the year (i.e. (1) Year 2002, (2) Year 2003 and (3) Year

2004) and the yield per acre and source code for each of the 3 years.

Items 5F through 5G are for FSA use only.

Items 6 through 11D are completed by the applicant.

Item No./

Fld Name Instruction

6

EnterpriseEnter the single farming enterprise that suffered disaster

losses and is essential to the success of the total farming operation.

7A (1)

Dwelling(s)Enter a description of the damages and losses to the property.

(Attach actual estimate for repair or replacement of the damaged

property.)

7A (2)

Dollar ValueEnter estimated dollar value of losses for dwelling(s).

7B (1)

Household Furnishings, Equipment, Personal EffectsEnter a description of

the damages and losses to the property. (Attach actual estimate for repair

or replacement of the damaged property.)

7B (2)

Dollar ValueEnter estimated dollar value of losses for household

furnishings, equipment and personal effects.

7C (1)

Farming BuildingsEnter the description of the damages and losses to the

farming building(s). (Specify the type of building and attach estimates

for the repair or replacement of the damaged building(s).)

7C (2)

Dollar ValueEnter the estimated dollar value of the losses for the

buildings.

7D (1)

Farm Machinery/ EquipmentEnter the description of the damages and losses

to farm machinery. (Specify the make, model and year and attach actual

estimate for repair or replacement of the damaged machinery and

equipment.)

7D (2)

Dollar ValueEnter the estimated dollar value of the losses for the farm

machinery and equipment.

7E (1)

Supplies, Stored Crops and Livestock ProductsEnter the description of the

damages and losses to supplies, harvested or stored crops, and livestock

products.

7E (2)

Dollar ValueEnter the estimated dollar value of the losses for supplies,

harvested or stored crops, and livestock products.

7F (1)

Livestock and PoultryEnter the description of the damages and losses to

livestock and poultry. (Specify the type and number damaged or destroyed.)

7F (2)

Dollar ValueEnter the estimated dollar value of the losses to livestock

and poultry.

7G (1)

Aquatic OrganismsEnter the description of the damage and losses to aquatic

organisms. (Specify the type and number damaged or destroyed.)

7G (2)

Dollar ValueEnter the estimated dollar value of the losses to aquatic

organisms.

7H (1)

Perennial CropsEnter the description of damage and losses to perennial

crops. (Specify the types and number.)

7H (2)

Dollar ValueEnter the estimated dollar value of the losses to perennial

crops. (Include the cost to clear debris, prepare the land for

replanting, and to reestablish the crop.)

7 I (1)

Other Farm Property Enter the description of damage and losses to other

farm property, e.g., fences, land damage, debris removal.

7 I (2)

Dollar ValueEnter the estimated dollar value of the losses to other farm

property.

8

Total Physical LossesEnter the total dollar amount of claimed physical

losses.

9

RemarksUse this space to add any additional information.

10A

SourceList the source of any claims or settlements, such as insurance

claims and settlements, or any other compensation such as disaster program

payments or FCIC settlements received or to be received for losses

incurred by the disaster.

10B

Crop or PropertyEnter the crop or property for which the payment was

received.

10C

Dollar AmountEnter the dollar amount received for the losses incurred by

the disaster.

10D

Total CompensationEnter the sum total of all entries in Column C.

11A

Farm NumberList the FSA Farm Number.

11B

Farm LocationEnter the County where farm is located.

11C

Name of Farm OperatorEnter the name of farm operator as reflected in FSA

records.

11D

Operators ShareEnter the operators percentage of ownership in the crops

produced on each farm.

Item 11E is for FSA use only.

Items 12A and 12B are completed by the applicant.

Item No./ Fld Name

Instruction

12A

SignatureEnter the applicants signature.

If you are mailing or faxing this form, print the form and manually enter

your signature. This form is approved for electronic transmission; if you

have established credentials with USDA to submit forms electronically, use

the buttons provided on the form for transmitting the form to the USDA

office.

12B

DateEnter the date the applicant signed the form.