NRCS-LTP-151 Notice of Agreement or Contract Violation

U.S. DEPARTMENT OF AGRICULTURE
NATURAL RESOURCES CONSERVATION SERVICE

NOTICE OF AGREEMENT OR
CONTRACT VIOLATION

OMB N0. 0578-0013
NRCS- LTP-151
rev.

1 a. Participant(s) Name and Address:

A. State:
B. County:
C. Contract No.:
1 b. Participant(s) Name and Address:

1 c. Participant(s) Name and Address:

2. You are hereby notified that information has been received which indicates a violation of the above-identified contract as follows:

3. You may obtain a hearing before a hearing office designated by the State Conservationist or Administering Agency with respect to
such violation if you file a written request for such hearing in the local office of the Natural Resources Conservation Service or
Administering Agency at:

4. Not less than 30 days after you receive this notice. If you request such a hearing, the hearing officer will notify you in writing of the time,
date and place set for the hearing. You may be represented at such a hearing and will be given a full opportunity to present facts and
information relevant to the alleged violation, including oral or documentary evidence. If you fail to request a hearing within the time
specified above, you will have no further right to a hearing.
Request for information concerning this notice or the alleged contract violation should be referred to the above-mentioned NRCS or
Administering Agency office.
4 a. Date:

4 a. Contracting Officer Signature:

4 b. Date:

4 b. State Conservationist Signature or Administering Agency:
PRIVACY ACT AND PUBLIC BURDEN STATEMENT

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 7 CFR 631(GPCP); 7 CFR 632 (RAMP); 7 CFR 634 (RWCP); 7 CFR 636 (WHIP); 7 CFR 702
(CRSCP); 7 CFR 752 (WBP); 7 CFR 631 and 702 (IEQIP). The information will be used to notify a program participant of the indication of a contract or
agreement violation. This information may be 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, 641, 651,
1001; 15 USC 714m, and 31 USC 372, may be applicable to the information provided.
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, a person is not required to respond to, a collection of information
unless it displays a currently valid OMB control number. This valid OMB number for this information collection is 0578-0013. The time required to
complete this information collection is estimated to average 49.5 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 information.
NONDISCRIMINATION STATEMENT
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its program 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 Civil Rights, 1400 Independence
Avenue, SW., Washington, DC 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.

U.S. DEDEPARTMENT OF AGRICULTURE
NATURAL RESOURCES CONSERVATION SERVICE

NRCS –LTP-151

Notice of Agreement or
Contract Violation
OMB BURDEN STATEMENT
Federal Agencies may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid
OMB control number. Public reporting burden for this collection of information is estimated to average 49.5 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. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this
burden, to Department of Agriculture, Clearance Officer, OIRM (OMB NO. 0578-0013), Stop 7630, Washington, D.C. 20250-7630.