Assignments of Payments and Joint Payment Authorization

Assignments of Payments and Joint Payment Authorization; Request for Waiver

CCC0037eGov_05-28-21V01

Assignments of Payments and Joint Payment Authorization

OMB: 0560-0183

Document [pdf]
Download: pdf | pdf
Instructions For CCC-37
JOINT PAYMENT AUTHORIZATION
Producers use form CCC-37 to make program payments from the Commodity Credit
Corporation (CCC) or Farm Service Agency (FSA) jointly payable to multiple entities.
Submit the original completed form in hard copy or electronically to the FSA County office.
Retain copies for the producer and joint payee. DO NOT FAX.
Producers and the joint payee must complete Items 1 through 8C, Items 9A through 9C
upon revocation of joint payment authority and Items 13A and 13B at the time this form is
filed with FSA. Items 10A through 10C are for FSA County office use only.
Field Name /
Item No.

Instruction

Part A - General Information
1
Producer's Name
and Address

Enter the Producer's name and address (Including Zip Code).

2
Joint Payee's Name
and Address

Enter the joint payee’s name and address, including ZIP Code.

3
Producer's Tax ID
No. (9 Digit
Number)

Enter the producer’s Tax Identification Number (TIN) 9-digit TIN.

Part B - Applicable Program(s)
4
Program

Select the applicable program listed on the CCC-37 or add program Alpha Code in

“Other” box.

-

-

Agricultural Risk Coverage (ARC)
Price Loss Coverage (PLC)
Conservation Reserve Program Annual Rental (CRP)
Coronavirus Food Assistance Program (CFAP)
Coronavirus Food Assistance Program 2.0 (CFAP2)
Emergency Assistance Livestock Honeybees and Farm-Raised Fish (ELAP)
Livestock Forage Program (LFP)
Livestock Indemnity Program (LIP)
eLoan Deficiency Web Payment (eLPD)
Noninsured Crop Disaster Assistance Program (NAP)
Wildfires and Hurricanes Indemnity Program Plus (WHIP+)

NOTE: All CRP, other than annual rental must be indicated in the “other” block.

Page 1 of 3

As of: 05-28-2021

Field Name /
Item No.

Instruction

5
Program Year or
Payment Year

Enter the “From” and “To” years of the applicable program or payment year,
next to the program name listed in item 4.

6
State, County, and
Reference Number,
If Applicable

Enter applicable State, County, and reference number, (e.g., contract number(s),
farm number, loan number, etc.) if applicable.
Note: If the State and county is not specified, the joint payment will be
applicable
to all counties in which the producer is associated. State, County and
reference number is necessary only if multiple payments for the same
program code needs a different payee.

Part C - Joint Payment Authorization
The producer and joint payee shall read the certification statement carefully.
NOTE: By signing both parties acknowledge and agree to the terms and conditions set forth in
Part C.

7A
Producer’s
Signature (By)

Ensured that the producer, or the authorized person who is acting in a
representative capacity, signs.

7B
Title/Relationship
of the Individual if
Signing in a
Representative
Capacity
7C Date
(MM-DD-YYYY)
8A - 8C
Joint Payee’s
Signature (By)

If 7A is signed by a representative, enter title/relationship of the individual.

8B
Title/Relationship
of the Individual if
Signing in a
Representative
Capacity
8C Date
(MM-DD-YYYY)
Check applicable
box

If 8A is signed by a representative, enter title/relationship of the individual.

Page 2 of 3

Ensure that producer or representative enters the date.
Ensure that joint payee or authorized agent signs.

Ensure that producer/representative enters the date.
At the bottom of Part C check the applicable box for:
 County FSA Committee

As of: 05-28-2021

Field Name /
Item No.

Instruction
 Joint Payee, or
 Assignor

Part D - Revocation of Joint Payment Authorization
The joint payee must sign this part to revoke an existing joint payment authorization.
9A
Joint Payee’s
Signature (By)

Ensure that joint payee or authorized agent signs to revoke the existing joint
payment authority.

9B
Title/Relationship
of the Individual if
Signing in a
Representative
Capacity
9C Date
(MM-DD-YYYY)

If 9A is signed by a representative, enter title/relationship of the individual.

Ensure that producer/representative enters the date.

FOR COUNTY OFFICE USE ONLY

10 Receiving State
and County
11 Date
(MM-DD-YYYY)
12 Time Filed
Special Provisions

The receiving State and County Offices shall be entered as receiving CCC-37.

13A
FSA County Office
Name, Address,
13B Telephone
Number

Enter the County office’s name and address (Including Zip Code)

County offices shall enter the date CCC-37 was received.
County offices shall enter the time CCC-37 was filed.

Producer and the joint payee must read the Special Provisions Relating to Joint Payment
Authorization, and the Privacy Act and Public Burden Statements on Page 2 of Form
CCC-37.

Enter the County office’s telephone number (Including area code).

Additional Information
Joint Payee

A joint payee is a person or entity to whom a payment is made jointly with the producer.

Joint Payment
Authorization

A joint payment authorization is a written request to make payment to joint payees.
The joint payment authorization is executed on CCC-37 and must be filed in the FSA
office.
A check is made payable to the producer and another designated payee.
The joint payment authorization must be revoked, in writing, by the joint payee.

Page 3 of 3

As of: 05-28-2021


File Typeapplication/pdf
File TitleInstructions for CCC0037
AuthorBeverly Harold
File Modified2021-08-03
File Created2021-08-03

© 2024 OMB.report | Privacy Policy