FSA-890 Continutation form - 2017 WILDFIRES AND HURRICANES INDEM

2017 Wildfires and Hurricanes Indemnity Program (2017 WHIP) (Florida Citrus Block Grant) and Quality Loss Adjustment (QLA) Program

FSA0890 Continuation

OMB: 0560-0291

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FSA-890 Continuation U.S. DEPARTMENT OF AGRICULTURE

Farm Service Agency


WILDFIRES AND HURRICANES INDEMNITY PROGRAM (WHIP) APPLICATION

(Continuation Sheet)


1. Producer’s Name

     

2. Producer’s Address (City, State and Zip Code)

     


3A. Administrative State Name/Code

     

3B. Administrative County Name/Code

     


Each producer must apply by administrative county.

PART A – NOTICE OF LOSS


The following are 2017 and 2018 crop(s), crop type(s), and intended use(s) suffered a loss due to the disaster event cause of loss that occurred January 1, 2017 –

December 31, 2017. All Items must be completed.

4. What disaster event caused the loss?

     

5. Disaster Event Dates (Beginning and Ending):

     


6A.

Crop Year

6B.

Crop

6C.

Crop Type

6D.

Intended Use

6E.

Practice

6F.

Planting Period

7.

Insured/NAP Coverage/Uninsured

8.

Crop Loss, Prevented Planted, or

Trees, Bushes, and Vines Loss

(If prevented planted Part B must be completed)

9.

COC Approved or Disapproved

    

     

     

     

     

     

Insured

Crop Loss

Approved

Disapproved

NAP Coverage

Prevented Planting

Uninsured

Trees, Bushes and Vines Loss







Insured

Crop Loss

Approved

Disapproved

NAP Coverage

Prevented Planting

Uninsured

Trees, Bushes and Vines Loss







Insured

Crop Loss

Approved

Disapproved

NAP Coverage

Prevented Planting

Uninsured

Trees, Bushes and Vines Loss

PART B – RECORD OF MANAGEMENT FOR PREVENTED PLANTING CROPS

10A. Crop Year

    

10B. Crop

     

10C. Crop Type

     

10D. Intended Use

     

10E. Practice

     

10F. Planting Period

     

11. Purchased/delivered/arranged for. If “YES”, explain (Attach copies of receipts).

YES NO. A. Seed, Chemical, and Fertilizer

     

YES NO. B. Land Preparation Measures

     

12. What cultivation practices were employed on prevented planted acreage?

     

13A. What was done with prevented planted acreage?

     

13B. Final Planting Date

     



FSA-890 Continuation (proposal 3) Page 2 of 4

PART A – NOTICE OF LOSS


The following are 2017 and 2018 crop(s), crop type(s), and intended use(s) suffered a loss due to the disaster event cause of loss that occurred January 1, 2017 –

December 31, 2017. All Items must be completed.

4. What disaster event caused the loss?

     

5. Disaster Event Dates (Beginning and Ending):

     


6A.

Crop Year

6B.

Crop

6C.

Crop Type

6D.

Intended Use

6E.

Practice

6F.

Planting Period

7.

Insured/NAP Coverage/Uninsured

8.

Crop Loss, Prevented Planted, or

Trees, Bushes, and Vines Loss

(If prevented planted Part B must be completed)

9.

COC Approved or Disapproved

    

     

     

     

     

     

Insured

Crop Loss

Approved

Disapproved

NAP Coverage

Prevented Planting

Uninsured

Trees, Bushes and Vines Loss







Insured

Crop Loss

Approved

Disapproved

NAP Coverage

Prevented Planting

Uninsured

Trees, Bushes and Vines Loss







Insured

Crop Loss

Approved

Disapproved

NAP Coverage

Prevented Planting

Uninsured

Trees, Bushes and Vines Loss

    

     

     

     

     

     

Insured

Crop Loss

Approved

Disapproved

NAP Coverage

Prevented Planting

Uninsured

Trees, Bushes and Vines Loss



    

     

     

     

     

     

Insured

Crop Loss

Approved

Disapproved

NAP Coverage

Prevented Planting

Uninsured

Trees, Bushes and Vines Loss



PART B – RECORD OF MANAGEMENT FOR PREVENTED PLANTING CROPS

10A. Crop Year

    

10B. Crop

     

10C. Crop Type

     

10D. Intended Use

     

10E. Practice

     

10F. Planting Period

     

11. Purchased/delivered/arranged for. If “YES”, explain (Attach copies of receipts).

YES NO. A. Seed, Chemical, and Fertilizer

     

YES NO. B. Land Preparation Measures

     

12. What cultivation practices were employed on prevented planted acreage?

     

13A. What was done with prevented planted acreage?

     

13B. Final Planting Date

     



FSA-890 Continuation (proposal 3) Page 3 of 4

PART C – PAY GROUPING INFORMATION

14. Producer Name

     

15. Insured/NAP Coverage/Uninsured

Insured NAP Coverage Uninsured

16. Administrative State Name/Code

     


17. Administrative County Name/Code

     


18. Physical State Name/Code

19. Physical County Name/Code

     

Same as

Administrative

     

Same as

Administrative

20. Crop Year

    

21. Unit

     


22. Pay Crop Code

     


23. Pay Type Code

     


24. Planting Period

     

PART D – PRODUCTION INFORMATION

COC USE ONLY

25.

Crop


26.

Crop Type

27.

Crushing District


28.

Int. Use

29.

Practice


30.

Organic Status


31.

Native Sod


32.

Acres


33.

Share


34.

Stage


35.

Unit of Measure


36.

Production

To Count

37.

Yield

(FL only)

38.

Assigned or Adjusted Production

39.

Secondary Use or Salvage Value

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

PART E – VALUE LOSS CROPS

COC USE ONLY

40.

Crop

41.

Crop Type

42.

Share

43.

Dollar Value Before Disaster

44.

Dollar Value After Disaster

45.

Ineligible Dollar Value

46.

Salvage Value

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

PART F – TREES, BUSHES, & VINES

COC USE ONLY

47.

Crop

48

Crop Type

49.

Acres

50.

Share

51.

Tree Stage

52.

Number in Tree Stage

53.

Number Destroyed


54.

Number Damaged


55.

Adjusted Number in Tree Stage

56.

Adjusted Number Destroyed

57.

Adjusted Number Damaged

58.

Salvage Value

     


     

     

     

I

     

     

     

     

     

     

     

II

     

     

     

     

     

     

     

III

     

     

     

     

     

     

     

     


     

     

     

I

     

     

     

     

     

     

     

II

     

     

     

     

     

     

     

III

     

     

     

     

     

     

     

     


     

     

     

I

     

     

     

     

     

     

     

II

     

     

     

     

     

     

     

III

     

     

     

     

     

     

     

PART G - COC APPROVAL OR DISAPPROVAL OF PAY GROUPING

59. COC Action: Approved Disapproved

FSAC-890 Continuation (proposal 3) Page 4 of 4

PART C – PAY GROUPING INFORMATION

14. Producer Name

     

15. Insured/NAP Coverage/Uninsured

Insured NAP Coverage Uninsured

16. Administrative State Name/Code

     


17. Administrative County Name/Code

     


18. Physical State Name/Code

19. Physical County Name/Code

     

Same as

Administrative

     

Same as

Administrative

20. Crop Year

    

21. Unit

     


22. Pay Crop Code

     


23. Pay Type Code

     


24. Planting Period

     

PART D – PRODUCTION INFORMATION

COC USE ONLY

25.

Crop


26.

Crop Type

27.

Crushing District


28.

Int. Use

29.

Practice


30.

Organic Status


31.

Native Sod


32.

Acres


33.

Share


34.

Stage


35.

Unit of Measure


36.

Production

To Count

37.

Yield

(FL only)

38.

Assigned or Adjusted Production

39.

Secondary Use or Salvage Value

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

PART E – VALUE LOSS CROPS

COC USE ONLY

40.

Crop

41.

Crop Type

42.

Share

43.

Dollar Value Before Disaster

44.

Dollar Value After Disaster

45.

Ineligible Dollar Value

46.

Salvage Value

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

PART F – TREES, BUSHES, & VINES

COC USE ONLY

47.

Crop

48

Crop Type

49.

Acres

50.

Share

51.

Tree Stage

52.

Number in Tree Stage

53.

Number Destroyed


54.

Number Damaged


55.

Assigned or Adjusted Number in Tree Stage

56.

Assigned or Adjusted Number Destroyed

57.

Assigned or Adjusted Number Damaged

58.

Salvage Value

     


     

     

     

I

     

     

     

     

     

     

     

II

     

     

     

     

     

     

     

III

     

     

     

     

     

     

     

     


     

     

     

I

     

     

     

     

     

     

     

II

     

     

     

     

     

     

     

III

     

     

     

     

     

     

     

     


     

     

     

I

     

     

     

     

     

     

     

II

     

     

     

     

     

     

     

III

     

     

     

     

     

     

     

PART G - COC APPROVAL OR DISAPPROVAL OF PAY GROUPING

59. COC Action: Approved Disapproved


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File TitleThis form is available electronically
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