CCC0910eGov_09-04-18V01

Instructions for CCC-910

2018 MARKET FACILITATION PROGRAM (MFP) APPLICATION

Producers will need to complete CCC-910 to apply for a MFP program benefits.

Producers may submit the CCC-910 by any of the following methods:

• In person

• Email

• FAX

• Mail

• Online for individuals with Level 2 eAuthentication

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. To establish online access credentials with USDA, follow the instructions provided at the USDA eForms web site.

Producers must complete Part B, items 5 through 9 in Part C, and Part D.

FSA employees will complete fields noted as “COC Use Only”.

Part A – Recording County Office (COC Use Only)

Item No./Field Name	Instruction
1A Recording State and County Office Name	Enter the Recording State and County name.
1B Recording County Office Address (Include Zip Code)	Enter the Recording County office address including the Zip Code.
1C Recording County Office Telephone Number (Include Area Code)	Enter the recording county office telephone number including the Area Code.
1D Recording County Office Fax Number (Include Area Code)	Enter the recording county office fax number including the Area Code.
Part B - Producer Contact Information
2A Producer Name	Enter your full name or the name of the business entity applying for USDA program benefits.
2B Producer Address	Enter the full address including Zip Code of the individual or business entity.
2C Contact Producer’s Name	Enter the contact producer’s name or the name of the authorized representative.
2D Contact Producer’s Telephone Number (Include Area Code)	Enter the contact producer’s telephone number including the area code.
Part C – Production Information
3 Commodity	Displays the eligible commodity.
4 Unit of Measure	Displays the unit of measure for the commodity.
5 Producer’s Share of Total Production	Enter the net quantity of the producer’s share of the total production for the selected commodity. (For example: Members of an informal joint venture have a share interest of 50 percent each on 10,000 bushels of harvested soybeans. Each member will complete a separate CCC-910 and enter 5,000 (bushels) in Item 5 to represent their share of the total production.)
6 Source of Production Evidence	Enter the source of production evidence. Certified quantities are subject to spot-check and CCC may require production evidence to support the certification. If acceptable production evidence is provided at the time of payment request, no additional documentation will be required.
7 Producer’s Signature	Enter signature on same line of the selected commodity certifying the production entered in Item 5 is accurate and represents the producer’s share of the total production of the commodity.
8 Title/Relationship of Individual Signing in the Representative Capacity	If the individual identified in item 2 A signs this document, this field should be left blank. If an authorized representative for the individual or business entity identified in Part A signs this document, use this field to show the individual’s representative capacity. (For example, “agent” or “attorney-in-fact”).
9 Date	Enter the date when Item 7 is signed.
10 Adjusted Production COC Use Only	COC representative will enter adjusted total production if the quantity is determined to be unreasonable or inaccurate, or it is adjusted to reflect the actual production based upon submitted production evidence.
Part D – Producer Certification
11A Producer’s Signature	After reading the certification statement, the producer applying for MFP benefits must sign and date items 11 A and 11 B. The signature indicates the producer has reviewed and agrees to the conditions listed. There will be one form per individual, joint operation or entity. Note: eAuthentication presently does not allow for signatures of a business entity. If you are mailing or faxing this form, print the form and manually enter your signature. If you have established credentials with USDA to submit forms electronically, your transmission is certification you have reviewed and agree to the conditions listed, use the buttons provided on the form for transmitting the form to the USDA servicing office. Presently, eForms can support only one signature per submission.
11B Title/Relationship of Individual Signing in the Representative Capacity	If the individual identified in item 2 A signs this document, this field should be left blank. If an authorized representative for the individual or business entity identified in Part A signs this document, use this field to show the individual’s representative capacity. (For example, “agent” or “attorney-in-fact”).
11C Date	Producer enters the date the CCC-910 is signed in Item 11A.
Part E – COC Determination (COC Use Only)
12 Commodity	Displays the eligible commodity
13A Signature of COC Representative	Enter the COC or designee signature next to the selected commodity designated for payment
13B Title and/or Relationship of the individual signing in a Representative capacity	Enter Title and/or Relationship of the individual signing in a COC representative capacity.
13C Date	Enter the date the COC or designee signed Item 13A.
14 Action	Check the COC determination (Approved or Disapproved) for each commodity after Part C and Part D have been completed by the producer. If a CCC-910 is postmarked or received after January 15, 2019, the COC determination must designated as Disapproved. Note: Required to be completed for each selected commodity.

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