CCC0860eGov_08-05-19V01

Food Safety Certification for Specialty Crops Program (FSCSC)

CCC0860eGov_08-05-19V01

OMB: 0560-0311

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Instructions for CCC-860
SOCIALLY DISADVANTAGED, LIMITED RESOURCE,
BEGINNING, AND VETERAN FARMER OR RANCHER
CERTIFICATION
This form is to be used by FSA customers to certify that they or the entity or joint
operation:
•

are a member (or if applicable members) of a socially disadvantaged group

•

qualify as limited resource FSA producer(s)

•

are beginning farmer(s) or rancher(s)

•

are veterans

Submit the original of the completed form in hard copy or facsimile to the
appropriate USDA Farm Service Agency servicing office.
Producers must complete all Items as applicable.
Item
No./Field
Name
1A
County FSA
Office
Name and
Address
1B
Telephone
Number
1C
Program
Year

2
Applicant’s
Name and
Address

Page 1 of 2

Instruction
Enter the name and address (including Zip Code) of the servicing
County FSA Office.

Enter the telephone number (including Area Code) of the servicing
County FSA Office.
Enter the program year for which the certification is being filed.
Note: Socially disadvantaged certification is valid indefinitely. Limited
resource certification must be filed annually. Beginning farmer or
rancher and veteran farmer or rancher certifications are valid until
applicable 10-year periods have expired.
Enter the name and address of applicant.

(As of: 08-05-2019)

Item
No./Field
Name

Instruction

3
Certification of
Socially…..
4
Certification of
Limited……
5
Certification of
Beginning
Farmer or
Rancher
6
Certification of
Veteran
Farmer
7A
Applicant’s
Signature
7B
Title/
Relationship of
the Individual
Signing in a
Representative
capacity

Applicant shall check the appropriate check boxes in Item 3 to certify
that they or the entity or joint operation they represent qualify as
“Socially Disadvantaged Farmer or Rancher.”
Applicant shall check the box in Item 4 to certify that they or the
entity or joint operation they represent qualify as a “Limited
Resource Farmer or Rancher” as defined on the back of this form.
Applicant shall check the box in Item 5 to certify that they or the
entity or joint operation they represent qualify as a “Beginning
Farmer or Rancher” as defined on the back of this form. Applicant
shall also enter month and year they or the entity or joint operation
they represent began farming.
Applicant shall check the appropriate check boxes in Item 6 to certify
that they or the entity or joint operation they represent qualify as a
“Veteran Farmer or Rancher” as defined on the back of this form.
Applicant shall sign to validate certification.
Person signing Item 7A must complete this item if one of the
following applies:
•

they are someone other than the individual identified in Item 2

•

the member is a legal entity or joint operation

the title must show that the person signing has signature authority
to bind the entity.
Applicant shall enter date (MM-DD-YYYY) the form was signed in
Item 7A.
•

7C
Date Signed

Page 2 of 2

(As of: 08-05-2019)


File Typeapplication/pdf
File TitleTemplate Users: Select the text for each of the instruction components below and type over it without changing the font type,
AuthorPreferred Customer
File Modified2022:06:01 15:28:59-04:00
File Created2022:06:01 15:28:58-04:00

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