2017 WHIP and QLA

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Instructions For FSA-898
Quality Loss Adjustment Program Application
This form will be used for applicants to apply for QLA Program Benefits.
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.� If you would like to establish online access credentials with USDA, follow the
instructions provided at the USDA eForms website
https://forms.sc.egov.usda.gov/eForms/welcomeAction.do?Home.

Producers must complete Items 5 through 17B, items 22 through 34, items
38 through 48, items 52A through 52C,
FSA employees will complete fields noted as �COC Use Only�.

Fld Name /
Item No.

Instruction

1
Recording State
Name/Code
(COC Use Only)
2
Recording County
Name/Code
(COC Use Only)
3
Crop Year
(COC Use Only)

Enter the producer�s recording state.

4
Application No.
(COC Use Only)

Application Number will be assigned by the automated system.

Part A
Producer Agreement

For Informational Purposes

Enter the producer�s recording county.

Enter the applicable crop year that suffered a quality loss.

Applicants who are an individual person must complete automated CCC902 or manual
CCC-902I or CCC-902 Short Form,

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Applicants who are a legal entity, including General Partnership or Joint
Venture, must complete automated CCC-902 or manual CCC-902E and
CCC-901 (if applicable).

Part B � Producer Information
5
Producer�s Name and
Address (City, State,
and Zip Code) and
Phone Number (Include
Area Code)
Part C � Forage
6
State/County

Enter the producer�s name and address, including the zip code and
phone number including area code.

Enter the physical state and county were the quality loss occurred.

7
Crop

Enter the eligible crop that suffered a quality loss.

8
Crop Type
9
Intended Use
10
Organic Status (O/C)

Enter the crop type or variety indicated on the FSA-578 that suffered a
quality loss.
Enter the intended use for the crop entered in item 7 at the time of
planting indicated on the FSA-578.
Enter the organic status code according to the below.
- �C�, Conventional and Transitional
- �O�, USDA Certified Organic
Enter the disaster event that caused the quality loss (for example,
wildfire, hurricane, tornado).
Enter the beginning date of the disaster event specified in item 11.

11
Disaster Event
12
Disaster Event
Beginning Date
(MM/DD/YYYY)
13
Disaster Event Ending
Date
(MM/DD/YYYY)
14
Unit of Measure
15
Total Affected
Production

16
Nutritional Category

Enter the ending date of the disaster event specified in item 11.

Enter the unit of measure for the crop (such as pounds, bushels, or
tons), crop type, and intended use.
Enter the total affected production of item 7 through item 10.�
Note:� Only report the producers share of total affected production.�
For additional information on total affected production contact
county FSA office.
Enter one of the following applicable nutritional categories, based on
the expected quality for the timing of harvest within the crop year
- High Tier
- Low Tier
Note: For additional information on Nutritional Categories contact

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17A
Current Verifiable
Nutritional Value
17B
Historical Verifiable
Nutritional Value
(Item 23 on FSA-899)

18
COC Adjusted Total
Affected Production
(COC Use Only)
19
COC Adjusted Current
Verifiable Nutritional
Value
(COC Use Only)
20
COC Adjusted
Historical Verifiable
Nutritional Value
(COC USE ONLY)

21
COC Determined
Average Percentage of
Loss
(COC USE ONY)

county FSA office.
Enter the current verifiable nutritional value, if the producer does not
have at least the current nutritional value, the forage crop is ineligible.
Note: For additional information on current verifiable nutritional value
contact county FSA office.
Enter the historical verifiable nutritional value from the FSA-899, item
23.
Note: For additional information on Historical Verifiable Nutritional
Value contact county FSA office.
COC may enter the adjusted total affected production, if applicable.
Note: An entry is only required when COC determines the total
affected production is different than what is certified to by the
producer in item 15.
COC may enter the adjusted current verifiable nutritional value, if
applicable.
Note: An entry is only required when COC determines the current
nutritional value is different than what is provided by the
producer in item 17A.
COC may enter the adjusted historical verifiable nutritional value, if
applicable.
Note: An entry is only required when COC determines the historical
nutritional value is different than what is provided by the
producer in item 17B and on the FSA-899.
System will display the average percentage of loss.
Note:� This will only display for forage crops without a historical
verifiable nutritional value

Part D � Crops Other Than Forage with Total Dollar Value Loss
22
State/County

Enter the physical state and county were the quality loss occurred.

23
Crop

Enter the eligible crop that suffered a quality loss.

24
Crop Type

Enter the crop type or variety indicated on the FSA-578 that suffered a
quality loss.

25
Intended Use

Enter the intended use for the crop entered in item 23 at the time of
planting indicated on the FSA-578.

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26
Organic Status
27
Disaster Event

Enter the organic status code according to the below.
-���� �C�, Conventional and Transitional
-���� �O�, USDA Certified Organic
Enter the disaster event that caused the quality loss (for example,
wildfire, hurricane, tornado).

28
Disaster Event
Beginning Date
(MM/DD/YYYY)
29
Disaster Event Ending
Date
(MM/DD/YYYY)
30
Unit of Measure

Enter the beginning date of the disaster event specified in item 27.

31
Total Affected
Production

Enter the total affected production of item 23 through item 26.�

32
Type of Quality Loss
Discount
33
Total Dollar Value Loss
on Affected Production

34
Price Before Discount

Enter the ending date of the disaster event specified in item 27.

Enter the unit of measure for the crop (such as pounds, bushels, or
tons), crop type, and intended use.�

Note:� Only report the producer�s share; . For additional information
on total affected production contact County FSA office.
Enter the type of quality loss discount; this is the condition that caused
the quality loss. (for example, low test weight, falling numbers, nutrient
values)
Enter the total dollar value loss on the affected production in item 31.�
Note: Only report the producer�s share; For additional information on
Total Dollar Value Loss on Affected Production contact County
FSA office.
Enter the price of the crop entered in item 23, before the quality loss
discount occurred.

35
COC Adjusted Total
Affected Production
(COC Use Only)

COC may enter the adjusted total affected production, if applicable.

36
COC Adjusted Total
Dollar Value Loss on
Affected Production
(COC Use Only)

COC may enter the adjusted total dollar value loss on affected
production, if applicable.

37
COC Adjusted Price

COC may enter the adjusted price before discount, if applicable.

Note:� An entry is only required when COC determines the total
affected production is different than what is certified to by the
producer in item 31.

Note: An entry is only required when COC determines the total dollar
value loss on affected production is different than what is provided
the producer in item 33.

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Before Discount
(COC Use Only)

Note: An entry is only required when COC determines the price before
discount is different than what is provided by the producer in item
34.

Part E � Crops Other Than Forage without Total Dollar Value Loss
38
State/County

Enter the physical state and county were the quality loss occurred.

39
Crop

Enter the eligible crop that suffered a quality loss.

40
Crop Type

Enter the crop type or variety indicated on the FSA-578 that suffered a
quality loss.

41
Intended Use

Enter the intended use for the crop entered in item 39 at the time of
planting indicated on the FSA-578.

42
Organic Status

Enter the organic status code according to the below.
- �C�, Conventional and Transitional
- �O�, USDA Certified Organic
Enter the disaster event that caused the quality loss (for example,
wildfire, hurricane, tornado).

43
Disaster Event
44
Disaster Event
Beginning Date
(MM/DD/YYYY)
45
Disaster Event Ending
Date
(MM/DD/YYYY)
46
Unit of Measure

Enter the beginning date of the disaster event specified in item 43.

47
Total Affected
Production

Enter the total affected production of item 39 through item 42.�

48
Type of Quality Loss
Discount
49
COC Adjusted Total
Affected Production
(COC Use Only)
50
COC Determined
County Average Loss
Per Unit of Measure

Enter the ending date of the disaster event specified in item 43.

Enter the unit of measure for the crop (such as pounds, bushels, or
tons), crop type, and intended use.

Note:� Only report the producers share, For additional information on
total affected production contact county FSA office.
Enter the type of quality loss discount, this is the condition that caused
the quality loss. (Ex. Low test weight, falling numbers, nutrient values)
COC may enter the adjusted total affected production, if applicable.
Note:� An entry is only required when COC determines the total
affected production is different than what is certified to by the
producer in item 47.
System will generate the COC determined county average loss per unit
of measure.

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(COC Use Only)
51
COC Determined
County Average Priced
Before Discount
(COC Use Only)

System will generate the COC determined county average price before
discount.

Part F � Producer Certification
52A
Signature (By)
52B
Title/Relationship of the
Individual Signing in
the Representative
Capacity
52C
Date
(MM/DD/YYYY)

Producer applying for QLA Program benefits must sign.
Enter title and/or relationship to the individual when signing in a
representative capacity.
Note: If the producer signing is signing representative capacity, this field
should be left blank
Enter the date the FSA-898 is signed in item 52A.

Part G � COC Review
53
COC or Designee
Signature
(COC Use Only)
54
Date
(MM/DD/YYYY)
(COC Use Only)

COC or their designee will sign when the review has been completed.

Enter the date the COC or their designee signs the FSA-898 in item 53.

Part H � COC Determination
55
COC or Designee
Signature
(COC Use Only)
56
Date
(MM/DD/YYYY)
(COC Use Only)
57
Determination
(COC Use� Only)

COC or their designee will sign.

Enter the date the COC or their designee signs the FSA-898 in item 55.

COC or their representative will check (✓) either �Approved� or
�Disapproved�.
Important: FSA-898 will be approved or disapproved after
applicable COC adjustment fields are completed.

�����������

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