CCC-37 Joint Payment Authorization

This form is available electronically.

Form Approved - OMB No. 0560-0183

CCC-37

U.S. DEPARTMENT OF AGRICULTURE
Commodity Credit Corporation

(09-09-09)

JOINT PAYMENT AUTHORIZATION
See Page 2 for Privacy Act and Public Burden Statements.

PART A - GENERAL INFORMATION
2. Joint Payee’
s Name and Address (Including Zip Code)

1. Producer's Name and Address (Including Zip Code)

3. Producer's Tax Identification Number (9 Digit Number)

PART B –APPLICABLE PROGRAM(S)
4.
Program

Conservation
Reserve Program
Annual Rental (CRP)

5.
Program Year or
Payment Year

6.
State, County, and
Reference Number,
If Applicable

FROM
TO

Other:

Other (All CRP, other than
annual rental):

FROM

TO

TO
FROM

Other:

TO

TO

FROM

Loan Deficiency
Payment (LDP)

6.
State, County, and
Reference Number,
If Applicable

TO

FROM

Direct and CounterCyclical Payment (DCP)

5.
Program Year or
Payment Year
FROM

Other:

FROM

Milk Income Loss
Contract (MILC)

4.
Program

FROM

Other:

TO

TO

FROM

FROM

Other:

TO

TO

PART C –JOINT PAYMENT AUTHORIZATION
The undersigned producer and joint payee request that CCC or FSA, as applicable, make the payments specified in Item 4 payable jointly to
the specified producer and the undersigned joint payee. Both the producer and the joint payee agree that this agreement in no way affects the right of
offset by CCC, FSA, or any other Government agency, regardless of the date the debt was incurred. Both the producer and joint payee understand
and agree that if the producer files a Form CCC-36, Assignment of Payment, with CCC or FSA, for any program covered by this joint payment
authorization, regardless of the date the assignment was filed, the assignment takes precedence and will be honored by CCC and FSA as though the
assignment was filed prior to the joint payment authorization. Additional payments or remaining amounts due after assignments have been honored will be
made payable to the joint payees identified on this form, subject to the aforementioned right of offset by Government agencies.
This authorization may be revoked at any time by the joint payee by completing Part D of this form or by submitting a written request signed by the joint
payee to the local FSA Office making the payment.
7A. Producer's Signature (By)

7B. Title/Relationship of the Individual if Signing in a
Representative Capacity

7C. Date (MM-DD-YYYY)

8A. Joint Payee’
s Signature (By)

8B. Title/Relationship of the Individual if Signing in a
Representative Capacity

8C. Date (MM-DD-YYYY)

PART D - REVOCATION OF JOINT PAYMENT AUTHORIZATION
Revocation of this authorization requires the signature of the joint payee. Joint payment authorization above is hereby revoked.
9A. Joint Payee’
s Signature (By)
9B. Title/Relationship of the Individual if Signing in a
Representative Capacity

9C. Date (MM-DD-YYYY)

FOR COUNTY OFFICE USE ONLY
10. Receiving State and County

11. Date Filed (MM-DD-YYYY)

COUNTY FSA COMMITTEE

JOINT PAYEE

PRODUCER

12. Time Filed

CCC-37 (09-09-09)

Page 2

SPECIAL PROVISIONS RELATING TO JOINT PAYMENT AUTHORIZATION

A.

The original of this joint payment authorization, properly executed, must be filed in the Farm Service Agency office.

B.

CCC and FSA will recognize only 1 joint payment authorization at any given time per producer for each program
per program year or group of years if multi-year is selected.

C.

Neither the United States of America, the Commodity Credit Corporation, the Secretary of Agriculture, any disbursing
officer, nor any other Government employee or official shall be subject to any suit or liable for payment of any amount if
payment is inadvertently made to the producer without regard to this joint payment authorization.

D.

This joint payment authorization does not extend to any successor of the joint payee.

E.

This joint payment authorization is effective for all counties unless specify on Item 6.

F.

This joint payment authorization is subject to offset for any delinquent Federal debt owed by the producer.

13A. COUNTY FSA OFFICE NAME AND ADDRESS (Including Zip Code)

13B. TELEPHONE NO. (Including area code):
NOTE:

The follow ing statement is made in accordance w ith the Priv acy Act of 1974 (5 USC 552a - as amended). The author ity for requesting the
infor mation identified on this form is the Commodity Credit Corporation Charter Act (15 U.S.C. 714). The information w ll be used to allow the
producer to authorize CCC to make a program payment to a joint pay ee. The information collected on this form may be disclosed to other Federal,
State, Loc al government agencies, Tribal agenc ies, and nongovernmental entities that hav e been authorized access to the information by statute or
regulation and/or as descr ibed in applicable R outine Us es identified in the System of Records Notic e for USD A/FSA-2, Far m R ecords File
(Automated) . Providing the requested information is voluntary. However, failure to furnish the requested information w ill result in a determination
that a payment to the joint payee cannot be made.
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not requir ed to r espond to, a c ollection
of infor mation unless it dis plays a valid OMB contr ol number. The valid OMB contr ol number for this information collection is 0560-0183. The time
requir ed to complete this information c ollection is estimated to average 10 minutes per respons e, inc luding the time for rev iew ing instructions,
searching existing data sources, gather ing and maintaining the data needed, and completing and r ev iew ing the collection of information. RETUR N
THIS COMPLETED FORM TO YOUR COU NTY 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 Adjudication and Compliance, 1400 Independence Avenue,
SW., Washington, DC 20250-9410, or call toll-free at (866) 632-9992 (English) or (800) 845-6136 (Spanish) or (800) 877-8339 (TDD) or (866) 377-8642
(Federal-relay). USDA is an equal opportunity provider and employer.