NRCS-LTP-152 Transfer Agreement

U.S. DEPARTMENT OF AGRICULTURE
NATURAL RESOURCES CONSERVATION SERVICE

OMB No. 0578-0019
NRCS- LTP-152
rev.

TRANSFER AGREEMENT
1. PROGRAM:

3. COUNTY:

2. STATE:

4. CONTRACT NO.:

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

5 a. PRESENT PARTICIPANT NAME AND ADDRESS:

5 b. NEW PARTICIPANT NAME AND ADDRESS:

The undersigned hereby certify that the present participant has transferred to the new participant the following right and
interest in the land unit described in the above-numbered contract
By this transfer, it is agreed:
1. The new participant agrees to be bound by all the terms and conditions of the above numbered contract.
2. The new participant agrees that this right to cost shares or other assistance under the above-numbered
contract shall be the same as the rights of the present participant.
3. The Natural Resources Conservation Service agrees to provide cost sharing and other assistance
necessary to the new and present participants under the above-numbered contract. Cost sharing and
assistance provided under this transfer agreement shall be in accordance with applicable program rules
and regulations.
6 a. Signature of Present Participant:

6 b. Date:

6 c. Social Security No. or Tax ID No. if applicable:
7 a. Signature of New Participant:

7 b. Date:

7 c. Social Security No. or Tax ID No. if applicable:
8. APPROVED BY:
8 a. Signature Contracting Officer:

8 b. Date:

PUBLIC BURDEN STATEMENT
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-152

Transfer Agreement

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.