Field Name /
|
Instruction |
Part A |
General Information |
1 Producer (Assignor's) Name and Address |
Enter the name and address (including Zip Code) of the producer (assignor) making the assignment. |
2 Assignee?s Name and Address |
Enter the name and address (including Zip Code) of the assignee. |
3 Producer (Assignor?s) Tax Identification Number (9 Digit Number) |
Enter the producer?s (assignor's) social security number or tax identification number. |
4 Assignee?s Tax Identification Number (9 Digit Number) |
Enter the social security number when the assignee is an individual or enter the employer tax ID when the assignee is a company or a financial institution.
NOTES:
????? SF-1199A or SF-3881 to an FSA office. |
Part B |
Applicable Program(s) |
5 Program |
Select the applicable program as displayed or enter an applicable multi-year program name:
Note:? All CRP, other than annual rental must be entered in Item 8. |
6 Assigned Amount of Each Applicable Year |
Enter the year and amount of payment benefits to be assigned from the applicable program listed under Item 5. |
7 State, County, and Reference Number, If Applicable |
If Assignment is applicable to only one FSA county office, or a particular farm or contract, enter the State, county and reference number, if applicable. |
8 Other Program Name |
Enter the names of any other program(s) not listed under Item 5. |
9 Program Year or Payment Year |
Enter the year of the applicable program year or payment year of the assigned program name entered. |
10 Assigned Amount |
Enter the amount of payment benefits to be assigned. |
11 State, County, and Reference Number, If Applicable |
If assignment is applicable to only one FSA county office, or a particular farm or contract, enter the State, county and reference number, if applicable. |
Part C |
Representation of Assignor and Assignee The producer and assignee shall read the certification statement carefully.
NOTE: By signing both parties acknowledge and agree to the terms and conditions set forth in Part C. |
12A Producer?s (Assignor's) Signature (By) |
Ensure that the producer's (assignor's) signature is completed. |
12B Title/Relationship of the Individual if Signing in a Representative Capacity |
If the signature is not the Producer?s, enter the Representative?s information. |
12C Date |
Enter date the producer (assignor) signs the form. |
13A Assignee?s Signature (By) |
Ensure that the assignee's signature is completed. |
13B Title/Relationship of the Individual if Signing in a Representative Capacity |
If the signature is not the Assignee?s, enter the Representative?s information. |
13C Date |
Enter date the assignee signs the form. |
Part D |
Revocation of Assignment The assignee must complete Part D to revoke an existing Assignment of Payment. |
14A-14B Assignee's Signature and Date |
Ensure that the assignee's signature and date to revoke the existing assignment are completed. |
Item 18
Field Name /
|
Instruction |
Page 2, Special Provisions |
Assignor and assignee must read the Special Provisions Relating to Assignments, and Privacy Act and Public Burden Statements on Page 2 of Form CCC-36. |
18 County Office Name and Address and Telephone Number |
If CCC-36 is mailed or delivered by a carrier to the FSA county office, the assignee shall make sure the FSA county office name and address with zip code and the telephone number are entered. |
Additional Information
Item |
Instruction |
Assignee |
An assignee is a person or entity to which the assignment of a payment is made. |
Assign?ment |
An assignment is the transfer of the right to receive a cash payment from a producer (assignor) who is participating in FSA or CCC farm programs to an assignee.
|
Assignor |
An assignor is any person (the producer) who:
|
File Type | application/msword |
File Title | Instructions For CCC-36 |
Author | maryann.ball |
Last Modified By | Ball, MaryAnn - FSA, Washington, DC |
File Modified | 2014-06-18 |
File Created | 2014-06-18 |