2017 WHIP and QLA

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Instructions For FSA-899
Historical Nutritional Value Weighted Average Worksheet
This form will be used for applicants applying for QLA Program Benefits who suffered an eligible
forage crop quality losses.
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 1 through 23C
FSA employees will complete fields noted as �CCC Use Only�.

Fld Name /
Item No.

Instruction

Part A � General Information
1
State

Enter the physical State where the forage crop suffered a quality loss.

2
County

Enter the physical county where the forage crop suffered a quality loss.

3
Producer�s
Name

Enter the producer�s name that suffered a quality loss on their forage crop.

4
Crop Year

Enter the crop year for the forage crop that suffered a quality loss.

Part B � Crop Information
The crop information part of the FSA-899 allows for producer to complete 3 historic years of forage
crop data with 6 rows.
�
Note: At the top of each section you will see Crop Year 20__, complete the blank with the

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applicable year.�
5
Enter the eligible forage crop that suffered a quality loss.
Crop Name
6
Crop Type

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

7
Intended Use

Enter the intended use for the crop entered in item 5 at the time of planting
indicated on the FSA-578.

8
Organic Status
(O/C)

Enter the organic status code according to the below.
- �C�, Conventional and Transitional
- �O�, USDA Certified Organic
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
This item will be entered in item 16 on the FSA-898.
Enter the unit of measure for the crop (such as pounds, bushels, or tons), crop
type, and intended use.�
Enter the production of the forage crop in items 5 through 10 during the
applicable crop year entered in the blank above.

9
Nutritional
Category
10
Unit of Measure
11
Production
12
Nutritional Value
13
Production Times
Nutritional Value
14
Production

Enter the nutritional value of item 11.

15
Nutritional Value
16
Production Times
Nutritional Value

Enter the nutritional value of item 14.

17
Production
18
Nutritional Value

Enter the production of the forage crop in items 5 through 10 during the
applicable crop year entered in the blank above.
Enter the nutritional value of item 17.

19
Production Times
Nutritional Value
20
Sum of
Production

Enter the answer from calculating item 17 times item 18.

(All Applicable Items
11, 14, 17 &
Continuation if

Enter the answer from calculating item 11 times item 13.
Enter the production of the forage crop in items 5 through 10 during the
applicable crop year entered in the blank above.

Enter the answer from calculating item 14 times item 15.

Enter the sum of production.� The sum of all production entered in items 11,
14, and 17.�
Note: If a continuation was necessary for additional line, add those applicable
lines in as well.

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needed)

21
Sum of All
Production Times
Nutritional Value

Enter the sum of all production times nutritional values, as calculated in items
13, 16, and 19.�

22
Historical
Average
Nutritional Value
(Item 21 divided
by item 20)

Calculate the historical average nutritional value by dividing item 21 by item 20.

(All applicable items
13, 16, 19 &
Continuation if
needed)

Note: If a continuation was necessary for additional line, add those applicable
lines in as well.

Part C � Production Certification
23A
Signature of
Producer (By)
23B
Title/Relationship
of the Individual
Signing in a
Representative
Capacity
23C
Date (MM-DD-YY)

Producer with a forage crop that suffered a quality loss and has historical
nutritional value records must sign.
Enter title and/or relationship to the individual when signing in a representative
capacity.
Note: If the producer signing is not signing in a representative capacity, this
field should be left blank
Enter the date the FSA-899 is signed in item 23A.

Part D � CCC Signature
24A
Signature of CCC
Representative
24B
Date
(MM-DDYYYY)

CCC representative must sign.
Enter the date the CCC representative signs the FSA-899 in item 24A.

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