FSA-409A Measurement Service Request Register - Appendix

Form Approved – OMB No. 0560-0260 This form is available electronically. Expiration date (03/XX/2019)
FSA-409A U. S. DEPARTMENT OF AGRICULTURE (proposal 1) Farm Service Agency MEASUREMENT SERVICE REQUEST REGISTER				1. COUNTY      
				2. STATE      
This form is used to aid in accounting for measurement service requests in counties where a large volume of requests are received.
NOTE:	Public Burden Statement (Paperwork Reduction Act):  Public reporting burden for this collection is estimated to average 15 minutes per response, including reviewing instructions, gathering and maintaining the data needed, completing (providing the information), and reviewing the collection of information. You are not required to respond to the collection or FSA may not conduct or sponsor a collection of information unless it displays a valid OMB control number of 0560-0260.
3. FARM NUMBER		4. FARM OPERATOR	5. DATE MEASUREMENT SERVICE REQUEST RECEIVED	6. DATE MEASUREMENT SERVICE PERFORMED	7. DATE OPERATOR IS NOTIFIED OF DETERMINATION