Field Name /
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Instruction |
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Part A - General Information |
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1 Producer (Assignor's) Name and Address |
Enter the name and address (including Zip Code) of the producer (assignor) making the assignment. |
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2 Assignee’s Name and Address |
Enter the name and address (including Zip Code) of the assignee. |
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3 Producer (Assignor’s) Tax ID Number |
Enter the producer’s (assignor's) social security number or tax identification number. |
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4 Assignee’s Tax Identification No. |
Enter assignee’s tax ID, either 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-3881 to the administrative county office. |
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Field Name /
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Instruction |
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Part B - Applicable Program(s) |
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5 Program |
Select the applicable program as displayed or enter an applicable program name:
- Livestock Indemnity Program (LIP)
- Noninsured Crop Disaster Assistance Program (NAP) |
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6 Assigned Amount of Each Applicable Year |
Enter the year and estimated amount of payment that benefits are to be assigned to the applicable program listed under Item 5. |
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7 State, County and Reference Number, If Applicable |
Enter the State, county and reference number, if applicable. |
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8 Other Program Name |
Enter the names of any other program(s) not listed under Item 5. |
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9 Program Year or Payment Year |
Enter the year of the applicable program year or payment year of the assigned program name entered. |
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10 Assigned Amount |
Enter the estimated amount of payment that benefits are to be assigned. |
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11 State and County Reference Number, If Applicable |
Enter the State and county reference number, if applicable. |
Field Name /
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Instruction |
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. |
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12A-12B Producer’s (Assignor's) Signature and Date |
Ensure that the producer's (assignor's) signature and date are completed. |
13A-13B Assignee’s Signature and Date |
Ensure that the assignee's signature and date are completed. |
Part D - Revocation of Assignment The assignee must complete Part D to revoke an existing Assignment of Payment. |
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14A-14B Assignee's Signature and Date |
Ensure that the assignee's signature and date to revoke the existing assignment are completed. |
Items 15-17 are for FSA use only. |
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Page 2, Special Provisions |
Assignor and assignee must read the Special Provisions Relating to Assignments, Item 18 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 administrative 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 |
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Assignee |
An assignee is a person or entity to which the assignment of a payment is made. |
Assignment |
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.
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Assignor |
An assignor is any person (the producer) who:
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File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | Instructions for form CCC-36 |
Author | Beverly Harold |
File Modified | 0000-00-00 |
File Created | 2021-01-21 |