CCAP provides assistance to eligible owners or designated marketing agents of U.S. agricultural products for eligible shipping containers from the Port of Oakland and designated ports associated with the Northwest Seaport Alliance (NWSA).
Submit the completed form including signature no later than the 15 days after the end of the month to USDA Farm Service Agency Price Support Division by email to [email protected] Examples: Submit number of containers for March and April no later than May 15, 2022, and submit number of containers for May no later than June 15, 2022.
Applicants may electronically transmit this form to the USDA FSA Price Support Division, provided that (1) the applicant submitting the form is the only person required to sign the transaction, or (2) the applicant has power of attorney or signature authority if representing an individual or entity.
Applicants must complete Part A Items 3 through 10, Part B items 11, 12, and enter the number of containers under the applicable month, and Part C Items 13A through 13C.
Fld Name /
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Instruction |
1 Program Year (Preprinted)
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The program year 2022 |
2 Application No.
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The application number will be assigned by FSA.
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PART A – APPLICANT INFORMATION |
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3 Applicant’s Name |
Enter name of applicant. |
4 Applicants Address |
Enter applicant’s address (City and State, Include Zip Code). |
5 Applicants Phone Number (Include Area Code) |
Enter applicant’s phone number (Include Area Code). |
6 Unique Entity ID |
Enter Unique Entity ID (12 alphanumeric characters assigned by SAM.gov).
Important Note: Applicants that wish to receive payment by direct deposit must complete SAM.gov registration online and provide bank account information . https://sam.gov/content/home |
7 Contact Name |
Enter point of contact name. |
8 Contact Address |
Enter point of contact address (City and State, Include Zip Code). |
9 Contact Phone Number (Include Area Code) |
Enter point of contact phone number (Include Area Code). |
10 Contact Email Address |
Enter point of contact email address. |
PART B – NUMBER OF CONTAINERS PICKED UP OR FILLED (Enter the port of origin of the containers and the number of containers picked up or filled for the month) |
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11 Designate Port of Origin |
Click on ‘Choose and item’ and use the drop-down menu to select either:
Submit only one application per Port per month or Calendar Year (CY) 2022. A separate form must be used if applicant is reporting containers picked up or filled with an agricultural commodity at different Port locations.
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12 Enter Yes or No |
Enter “Yes” or “No”, in each row to indicate which type(s) of containers have or have not been picked-up or filled with an agricultural commodity for the previous month or CY 2022.
Important Note: When completing a subsequent application, do not resubmit the total number of containers submitted for previous month(s).
Example: On May 1, 2022, an application was submitted reporting number of containers for March and April. When submitting a subsequent application for May, the number of containers for March and April on the application must be blank. |
March |
Enter the total number of containers for March 1 – March 31. |
April |
Enter the total number of containers for April 1 – April 30. |
May |
Enter the total number of containers for May 1 – May 31. |
June |
Enter the total number of containers for June 1 – June 30. |
July |
Enter the total number of containers for July 1 – July 31. |
August |
Enter the total number of containers for Aug. 1 – Aug. 31. |
September |
Enter the total number of containers for Sept. 1 – Sept. 30. |
October |
Enter the total number of containers for Oct. 1 – Oct. 31. |
November |
Enter the total number of containers for Nov. 1 – Nov. 30. |
December |
Enter the total number of containers for Dec. 1 – Dec. 31. |
All applicants must certify, by signing the application, that all of the information entered on this form, whether personally entered by the undersigned or not, or by someone else, is true and correct. The undersigned certifies and acknowledges that the information entered on the form is needed in order for USDA to make a determination that the applicant is eligible to receive a Commodity Container Assistance Program payment and is subject to verification by USDA. Failure to certify any of the information on this form accurately may result in a loss of program benefits. Additionally, by signing this form, the undersigned authorizes the owner of the containers to provide records of such containers listed on the form to USDA representatives for the purpose of verification. The undersigned (1) agrees to comply with all terms and conditions associated with Commodity Container Assistance Program as stated in the Notice of Funds Availability published in the Federal Register; (2) will maintain and provide verifiable and reliable records upon request; (3) payment is subject to the availability of funds (4) and understands the applicant must have a Unique Entity ID registration on SAMS.gov in order to receive a payment. |
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13A Applicants Signature (By) |
Applicant applying for a CCAP payment must sign. |
13B Title/ Relationship of the Individual Signing in the Representative Capacity |
Enter title and/or relationship of the individual to the entity when signing in a representative capacity.
Note: If the applicant signing is not signing in a representative capacity, this field should be left blank. |
13C Date Signed (MM-DD-YYYY) |
Enter the date FSA-862 is signed in Item 13A. |
PART D – DAFP APPROVAL (For FSA Use Only) |
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14A DAFP or Designee Signature |
Enter DAFP or Designee signature. |
14B Title of Designee (If Applicable) |
Enter title of designee, if applicable. |
14C Date Signed (MM-DD-YYYY) |
Enter date signed. |
14D Determination |
Check applicable box. |
Page
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | Template Users: Select the text for each of the instruction components below and type over it without changing the font type, |
Author | Preferred Customer |
File Modified | 0000-00-00 |
File Created | 2022-05-05 |