CCC-37 Joint Payment Authorization

Emergency Conservation Program and Biomass Crop Assistance Program (BCAP)

CCC0037_150630V03

Emergency Conservation Program and Biomass Crop Assistance Program (BCAP)

OMB: 0560-0082

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This form is available electronically. Form Approved - OMB No. 0560-0183

See Page 2 for Privacy Act and Public Burden Statements.

CCC-37

(06-30-15)


U.S. DEPARTMENT OF AGRICULTURE

Commodity Credit Corporation



JOINT PAYMENT AUTHORIZATION



PART A - GENERAL INFORMATION


1. Producer's Name and Address (Including Zip Code)

     

2. Joint Payee’s Name and Address (Including Zip Code)

     


3. Producer's Tax Identification Number (9 Digit Number)

     



PART B – APPLICABLE PROGRAM(S)


4.

Program

5.

Program Year or

Payment Year

6.

State, County, and Reference Number,

If Applicable

4.

Program

5.

Program Year or

Payment Year

6.

State, County, and Reference Number,

If Applicable


Agricultural Risk Coverage (ARC

FROM

    

     

Other:

     

FROM

    

     


TO

     

TO

     


Price Loss Coverage (PLC)

FROM

    

     

Other:

     

FROM

    

     


TO

     

TO

     


Conservation Reserve Program

Annual Rental (CRP)

FROM

    

     

Other:

     

FROM

    

     


TO

     

TO

     


Emergency Assistance Livestock Honey Bee and Farm-Raised Fish Program (ELAP)


FROM

    

     

Other:

     

FROM

    

     

TO

     

TO

     

Livestock Forage Program (LFP)


FROM

    

     

Other:

     

FROM

    

     

TO

     

TO

     

Livestock Indemnity Program (LIP)


FROM

    

     

Other:

     

FROM

    

     

TO

     

TO

     

eLoan Deficiency Web Payment (eLDP)

FROM

    

     

Other:

     

FROM

    

     

TO

     

TO

     

Noninsured Crop Disaster Assistance Program (NAP)

FROM

    

     

Other:

     

FROM

    

     

TO

     

TO

     

Other (All CRP, other than annual rental):

     

FROM

    

    

Other:

     

FROM

    

     

TO

     

TO

     

PART C – JOINT PAYMENT AUTHORIZATION


The undersigned producer and joint payee request that CCC or FSA, as applicable, make the payments specified in Item 4 payable jointly to

the specified producer and the undersigned joint payee. Both the producer and the joint payee agree that this agreement in no way affects the right of offset by CCC, FSA, or any other Government agency, regardless of the date the debt was incurred. Both the producer and joint payee understand

and agree that if the producer files a Form CCC-36, Assignment of Payment, with CCC or FSA, for any program covered by this joint payment authorization, regardless of the date the assignment was filed, the assignment takes precedence and will be honored by CCC and FSA as though the assignment was filed prior to the joint payment authorization. Additional payments or remaining amounts due after assignments have been honored will be made payable to the joint payees identified on this form, subject to the aforementioned right of offset by Government agencies.


This authorization may be revoked at any time by the joint payee by completing Part D of this form or by submitting a written request signed by the joint payee to the local FSA Office making the payment.


7A. Producer's Signature (By)

7B. Title/Relationship of the Individual if Signing in a Representative Capacity


     

7C. Date

(MM-DD-YYYY)

     


8A. Joint Payee’s Signature (By)

8B. Title/Relationship of the Individual if Signing in a Representative Capacity


     

8C. Date

(MM-DD-YYYY))

     


COUNTY FSA COMMITTEE JOINT PAYEE PRODUCER



CCC-37 (06-30-15) Page 2


PART D - REVOCATION OF JOINT PAYMENT AUTHORIZATION

Revocation of this authorization requires the signature of the joint payee. Joint payment authorization above is hereby revoked.

9A. Joint Payee’s Signature (By)

9B. Title/Relationship of the Individual if Signing

in a Representative Capacity

     

9C. Date (MM-DD-YYYY)

     

FOR COUNTY OFFICE USE ONLY

10. Receiving State and County

11. Date Filed (MM-DD-YYYY)

12. Time Filed

     

     

     


SPECIAL PROVISIONS RELATING TO JOINT PAYMENT AUTHORIZATION



A. The original of this joint payment authorization, properly executed, must be filed in the Farm Service Agency office.


B. CCC and FSA will recognize only 1 joint payment authorization at any given time per producer for each program

per program year or group of years if multi-year is selected.


C. Neither the United States of America, the Commodity Credit Corporation, the Secretary of Agriculture, any disbursing

officer, nor any other Government employee or official shall be subject to any suit or liable for payment of any amount if

payment is inadvertently made to the producer without regard to this joint payment authorization.


D. This joint payment authorization does not extend to any successor of the joint payee.


E. This joint payment authorization is effective for all counties unless specify on Item 6.


F. This joint payment authorization is subject to offset for any delinquent Federal debt owed by the producer.


13A. COUNTY FSA OFFICE NAME AND ADDRESS (Including Zip Code)

     

13B. TELEPHONE NO. (Including area code):      

NOTE:

The following statement is made in accordance with the Privacy Act of 1974 (5 USC 552a – as amended).  The authority for requesting the information identified on this form is the Commodity Credit Corporation Charter Act (15 U.S.C. 714) and the Agricultural Act of 2014 (Pub. L. 113-79).  The information will be used to make payments made under applicable CCC or FSA programs jointly payable to the producer and designated joint payee.  The information collected on this form may be disclosed to other Federal, State, Local government agencies, Tribal agencies, and nongovernmental entities that have been authorized access to the information by statute or regulation and/or as described in applicable Routine Uses identified in the System of Records Notice for USDA/FSA-2, Farm Records File (Automated). Providing the requested information is voluntary.  However, failure to furnish the requested information will result in a determination of ineligibility to make applicable CCC or FSA program payments jointly payable to the producer and designated joint payee.


According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0560-0183. The time required to complete this information collection is estimated to average 10 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. For certain programs such as ARC, PLC, CRP, ELAP, LIP, and eLDP, this information collection is exempted from the Paperwork Reduction Act as specified in the Agricultural Act of 2014 (See Pub. L. 113-79, Title I, Subtitle F, Administration and Title II, Subtitle G, Funding and Administration). RETURN THIS COMPLETED FORM TO YOUR COUNTY FSA OFFICE.

The U.S. Department of Agriculture (USDA) prohibits discrimination against its customers, employees, and applicants for employment on the basis of race, color, national origin, age, disability, sex, gender identity, religion, reprisal, and where applicable, political beliefs, marital status, familial or parental status, sexual orientation, or all or part of an individual’s income is derived from any public assistance program, or protected genetic information in employment or in any program or activity conducted or funded by the Department. (Not all prohibited basis will apply to all programs and/or employment activities.) Persons with disabilities, who wish to file a program complaint, write to the address below or if you require alternative means of communication for program information (e.g., Braille, large print, audiotape, etc.) please contact USDA’s TARGET Center at (202) 720-2600 (voice and TDD). Individuals who are deaf, hard of hearing, or have speech disabilities and wish to file either an EEO or program complaint, please contact USDA through the Federal Relay Service at (800) 877-8339 or (800) 845-6136 (in Spanish).


If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, found online at http://www.ascr.usda.gov/complaint_filing_cust.html, or at any USDA office, or call (866) 632-9992 to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter by mail to U.S. Department of Agriculture, Director, Office of Adjudication, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, by fax (202) 690-7442 or email at [email protected]. USDA is an equal opportunity provider and employer.


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