Customers who have established electronic access credentials with USDA may electronically transmit this form to the USDA servicing office, provided that (1) the customer submitting the form is the only person required to sign the transaction, or (2) the customer has an approved Power of Attorney (Form FSA-211) on file with USDA to sign for other customers for the program and type of transaction represented by this form.
Features for transmitting the form electronically are available to those customers with access credentials only. If you would like to establish online access credentials with USDA, follow the instructions provided at the USDA eForms web site.
Producers must complete Items 5, items 13 through 16, items 19 through 22, items 25 through 27, items 30 through 34,
Fld Name /
|
Instruction |
1 Recording State |
Enter the producer’s recording state. |
2 Program Year |
Enter the applicable program year. |
3 Recording County |
Enter the producer’s recording county. |
4 Application Number |
Application Number will be assigned by the automated system. |
Part B – Producer Information |
|
5 Producer’s Name, Address (City, State, and Zip Code), and Phone Number |
Enter the producer’s name, address. Including the ZIP code, and Phone Number. |
Part D – Non-Specialty Crop & Wool Information |
|
13 Commodity |
Enter the eligible non-specialty crop or wool. |
14 Unit of Measure |
Enter the applicable unit of measure for the commodity entered in item 13. |
15 2019 Total Production
|
Enter the 2019 total production from all farms entered for the commodity entered in item 13. |
16 2019 Production Not Sold (as of Jan 15,2020)
|
Enter the 2019 production from all farms not sold of non-specialty crops or wool to be eligible to submit loss claim as of January 15, 2020. |
17 COC Adjusted 2019 Total Production (COC USE ONLY) |
COC may enter the adjusted 2019 total production, if applicable.
Note: An entry is only required when COC determines the 2019 total production is different than what is certified to by the producer in item 15. |
18 COC Adjusted 2019 Production Not Sold (as of Jan 15, 2020) |
COC may enter the adjusted 2019 production not sold, if applicable.
Note: An entry is only required when COC determines the 2019 production not sold is different than what is certified to by the producer in item 16. |
Part E – Livestock Information |
|
19 Livestock |
Enter the name of the eligible livestock.
Eligible livestock categories are:
Feeder Cattle: < 600 lbs (cattle weighing less than 600 pounds)
Feeder Cattle: > 600 lbs (cattle weighing 600 pounds or more but less than "Slaughter Cattle: Fed Cattle")
Slaughter Cattle: Fed Cattle (cattle weighing 1,200 pounds or more and are intended for slaughter)
Slaughter Cattle: Mature Cattle (culled cattle raised or maintained for breeding purposes, but which were removed from inventory and are intended for slaughter)
All Other Cattle (commercially raised or maintained bovine animals not meeting the definition of another category of cattle, excluding beefalo, bison, and animals used for dairy production or intended for dairy production)
Pigs: < 120 lbs (any swine weighing less than 120 pounds)
Hogs: > 120 lbs (any swine 120 pounds or more)
Lambs & Yearlings: Less Than 2 Years Old (all sheep less than 2 years old) |
20 Unit of Measure |
Enter the applicable unit of measure, for the livestock entered in Item 19. The unit of measure for livestock is “Head”. |
21 Sales (Between Jan 15, 2020 – April 15, 2020) of Inventory Owned as of Jan 15, 2020. |
Enter the total sales between January 15, 2020 and April 15, 2020, of owned unpriced inventory as of Jan 15, 2020 for the livestock entered in Item 19, if applicable.
Note: Offspring from owned inventory as of January 15, 2020 that were sold between January 15 and April 15, 2020 are eligible. |
22 Inventory (Highest Between April 16, 2020 – May 14, 2020)
|
Enter the highest owned inventory between April 16, 2020, and May 14, 2020, for the livestock entered in Item 19, if applicable. |
23 COC Adjusted Sales (Between Jan 15, 2020 – April 15, 2020) of Inventory Owned as of Jan 15, 2020. (COC USE ONLY) |
COC will enter the adjusted total sales between January 15, 2020, and April 15, 2020, for owned unpriced inventory as of Jan 15, 2020, and any sales of offspring from owned inventory, if applicable.
Note: An entry is only required when COC determines the total sales is different than what is certified to by the producer in Item 21. |
24 COC Adjusted Inventory (Highest Between April 16, 2020 – May 14, 2020) (COC USE ONLY) |
COC will enter the adjusted owned inventory, if applicable.
Note: An entry is only required when COC determines the inventory is different than what is certified to by the producer in Item 22. |
Part F – Value Loss Information |
|
25 Commodity |
Enter the eligible value loss commodity. |
26 Value of Sales (Jan 15, 2020 – April 15, 2020) |
Enter the total value of sales from all farms between January 15, 2020, and April 15, 2020, for the value loss commodity entered in item 25. |
27 Value of Inventory (as of April 15, 2020) |
Enter the total value of marketable inventory from all farms as of April 15, 2020, for the value loss commodity entered in item 25. |
28 COC Adjusted Value of Sales (Jan 15, 2020 – April 15, 2020) (COC USE ONLY) |
COC may enter the adjusted value of sales between January 15, 2020, and April 15, 2020, if applicable.
Note: An entry is only required when COC determines the total value of sales is different than what is certified to by the producer in item 26. |
29 COC Adjusted Value of Inventory (as of April 15, 2020) (COC USE ONY) |
COC may enter the adjusted value of inventory as of April 15, 2020, if applicable.
Note: An entry is only required when COC determines the value of inventory is different than what is certified to by the producer in item 27. |
Part G – Specialty Crops (COC Determination Not Required) |
|
30 Commodity |
Enter the eligible specialty crop. |
31 Unit of Measure |
Enter the unit of measure for the crop in item 30. |
32 Volume of Production Sold (Jan 15, 2020 – April 15, 2020) |
Enter the total volume of production sold between January 15, 2020, and April 15, 2020, for the crop in item 30. |
33 Volume of Production Shipped that Spoiled or Unpaid (Jan 15, 2020 – April 15, 2020) |
Enter the total volume of production shipped that spoiled or went unpaid between January 15, 2020, and April 15, 2020, for the crop in Item 30. |
34 Acres with Production Not Shipped or Sold (Jan 15, 2020 – April 15, 2020) |
Enter the total number of per unit of output basis left in the field or harvested but not shipped between January 15, 2020, and April 15, 2020, for the crop in item 30 |
35 AMS Adjusted Volume of Production Sold (Jan 15, 2020 – April 15, 2020) (AMS USE ONLY) |
Leave blank. AMS will enter an adjusted number if application is selected for audit.
Note: No action required by producer. |
36 AMS Adjusted Volume of Production Shipped that Spoiled or Unpaid (Jan 15, 2020 – April 15, 2020) (AMS USE ONLY)
|
Leave blank. AMS will enter an adjusted number if application is selected for audit.
Note: No action required by producer, |
37 AMS Adjusted Acres with Production Not Shipped or Sold (Jan 15, 2020 – April 15, 2020) (AMS USE ONLY) |
Leave blank. AMS will enter an adjusted number if application is selected for audit.
Note: No action required by producer. |
Page
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | Template Users: Select the text for each of the instruction components below and type over it without changing the font type, |
Author | Preferred Customer |
File Modified | 0000-00-00 |
File Created | 2021-01-14 |