FSA-578 Acreage Rept (Exempt)

This form is available electronically.

FSA-578 Manual
(proposal 1)

REPORT OF ACREAGE
See Page 2 for Privacy Act and Paperwork Reduction Act Statements.
1.
2.
3.
FARM NO.
FARMLAND
CROPLAND

KEY

5. OPERATOR NAME AND ADDRESS

4.
PROGRAM YR.

7.
KEY

OMB Control No. 0581-XXXX
OMB Expiration Date: 05/2020
U.S. Department of Agriculture
PAGE
Farm Service Agency
OF
8.
NAMES OF OTHER PRODUCERS

9.
ID NUMBER

10.
OTHER FARMS

6. OTHER FARMS

1
11. PHOTO NO. - LEGAL DESCRIPTION

12
TRACT
NO.

13.

14.

FIELD
NO.

CROP OR LAND USE

15.
PRACTICE 1/

16.
CROP
STATUS
2/

17. CROP OR LAND USE SUMMARY (Maple trees, after number enter "T"; Honey, after number enter "H")

18.
KEY

19.
SHARE

20. TOTAL OPERATOR REPORT
21. TOTAL DETERMINED ACREAGE
22. CERTIFICATION - I certify to the best of my knowledge and belief that the acreage of crops/commodities and land uses listed herein are true and correct and that all required crops/commodities and
land uses have been reported for the farms as applicable. Absent any different or contrary prior subsequent certification filed by any producer for any crop for which NAP coverage has been purchased, I
certify that the applicable crop, type, practice, and intended use is not planted if it is not included on the Report of Commodities for this crop year. The signing of this form gives FSA representatives
authorization to enter and inspect crops/commodities and land uses on the above identified land. A signature date (the date the producer signs the FSA-578) will also be captured.
A. CERTIFIER'S SIGNATURE
B. DATE
A. CERTIFIER'S SIGNATURE (BY)
B. DATE
A. CERTIFIER'S SIGNATURE (BY)
B. DATE
(MM-DD-YYYY)

(MM-DD-YYYY)

(MM-DD-YYYY)

1/ l = Irrigated
N=
Nonirrigated
O = Other (Honey or Maple Sap)
2/ I = Initial
P = Prevented
F = Failed
S = Subsequent Crop
D = Double Crop
R = Repeat
V = Volunteer

E = Experimental
IF = Initial Failed
IP = Initial Prevented
SF = Subsequent
Failed
DF = Double-cropped
Failed
DP = Double-cropped
Prevented

FSA-578 Manual (proposal 1)

Page 2

23. REMARKS/SKETCHES

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 Farm Security
and Rural Investment Act of 2002 (Pub L. 107-171), the Agricultural Act of 2014 (7 U.S.C. 9018), 7 CFR Part 718 and 7 CFR Part 1437. The information will be used to collect producer certification
of the report of acreage of crops/commodities and land use data which is needed in order to determine producer eligibility to participate in and receive benefits under FSA programs. The
information collected on the 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) and USDA/FSA-14,
Applicant/Borrower. Providing the requested information is voluntary. However, failure to furnish the requested information may result in a denial of the producer’s request to participate in and
receive benefits under FSA programs.
Public Burden Statement (Paperwork Reduction Act): In general, the information collection is exempted from PRA as specified in 7 U.S.C. 9091(2)(c)(B). For only AMS participants reporting
acreage, public reporting burden for this collection is estimated to average 30 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 AMS may not conduct or sponsor a collection of information unless it
displays a valid OMB control number; the OMB control number for the AMS use of this form is 0581-XXXX.
The provisions of criminal and civil fraud, privacy, and other statutes may be applicable to the information provided. RETURN THIS COMPLETED FORM TO YOUR COUNTY FSA OFFICE.

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are
prohibited from discriminating based on race, color, national origin, religion, sex, gender identity (including gender expression), sexual orientation, disability, age, marital status, family/parental status, income derived from a public assistance
program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all programs). Remedies and complaint filing deadlines vary by program or incident.
Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.) should contact the responsible Agency or USDA’s TARGET Center at
(202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.
To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at http://www.ascr.usda.gov/complaint_filing_cust.html and at any USDA office or write a letter addressed to
USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: (1) mail: U.S. Department of Agriculture Office of the
Assistant Secretary for Civil Rights 1400 Independence Avenue, SW Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email: [email protected]. USDA is an equal opportunity provider, employer, and lender.