Form FSA-174 Rice Production (RPP) Application

FSA-174
(xx-xx-23)

U.S. DEPARTMENT OF AGRICULTURE
Farm Service Agency

OMB Control No. 0560-NEW
OMB Expiration Date: xx/xx/20xx
(See Page 2 for Privacy Act and Paperwork Reduction Act Statements)
1. Program Year
2. Application Number

3. Recording State Name/Code

4. Recording County Name/Code

5A. Name and Address of Recording
County FSA Office (Include City,
State and Zip Code)

5B. Recording County FSA Office
Telephone No. (Include Area Code)

RICE PRODUCTION PROGRAM (RPP) APPLICATION

PART A – PRODUCER AGREEMENT
The Farm Service Agency (FSA) will make payments under RPP to eligible producers who meet the requirements of the program. The following information is needed for FSA to
determine the applicant is eligible to receive RPP assistance. By submitting this application, and upon approval by FSA, the applicant agrees:
1.

To comply with RPP eligibility requirements, payment eligibility and limitation, including all terms and conditions associated with RPP as stated in the notice of funds availability issued
for RPP.
2. To provide FSA all information that is necessary to verify the information provided on this form is accurate. Producer is required to retain documentation in support of their application
for 3 years after the date of approval. All information provided to FSA for program eligibility and payment calculation purposes, including certification that a producer planted the crop,
is subject to spot check.
3. To comply with payment attribution and payment eligibility provisions by submitting the following forms within 60 days from the date the applicant signs this application, if not already
on file with FSA for the applicable crop year:
• CCC-902, Farm Operating Plan for Payment Eligibility
• CCC-901, Member Information for Legal Entities, if applicable
• FSA-510, Request for an Exception to the $125,000 Payment Limitation for Certain Programs, optional
• AD-1026, Highly Erodible Land Conservation (HELC) and Wetland Conservation (WC) Certification
• AD-2047, Customer Data Worksheet
4. This application will be considered incomplete until the applicant has signed Item 11.
5. The payment will be subject to a pro-rated adjustment if total claims for RPP payments exceed the funds available for RPP, and the payment data reflected on this form is the result of
the RPP payment calculation process which is subject to payment eligibility and payment limitation requirements and may be reduced.
6. This application form must be submitted to FSA by [INSERT SIGNUP DEADLINE DATE] to be considered for a RPP payment, and if the form is submitted after [INSERT SIGNUP
DEADLINE DATE] this application for payment will be disapproved. Failure of an individual, entity, or member of an entity to timely submit all eligibility documents required may result in no
payment or a reduced payment.
PART B - PRODUCER INFORMATION
6A. Producer/Entity Name
6B. Producer/Entity Address (City, State, and Zip Code)
6C. Contact Producer’s Name
6D. Contact Producer’s Telephone Number (include Area Code)

DATE STAMPED

FSA-174 (XX-XX-23)

Page 2 of 3

PART C - CROP INFORMATION
7.
Physical
Location
State Code

8.
Physical
Location County
Code

9.
Crop Type

10.
Intended Use

11.
Crop Status

12.
Eligible Acres
(Reported acres x
producer share)

13.
Actual Production History or
DAFP Established Yield
(Based on Items 7, 8, 9, and
10)

15. TOTAL ESTIMATED RPP PAYMENT BY CROP TYPE (Payment amounts are subject to payment eligibility and payment limitation
requirements and may be reduced.)
Note: Temperate Japonica is included with Medium Grain and Sweet rice is included with Short Grain.

14.
Estimated RPP Payment
(Item 12 x Item 13 x payment
rate; Prevented Planted Acres
will be paid at 60% of the
payment rate)

Short Grain

$

Medium Grain

$

Long Grain

$

PART D – PRODUCER CERTIFICATION
I hereby sign and acknowledge under penalty of perjury in accordance with 28 U.S.C. § 1746 and 18 U.S.C. § 1621 that all information on this application, whether entered by me
or by someone else on my behalf, is true and correct. I understand that if any information is determined to be in error, the application may be denied, and such errors may result
in a determination of ineligibility in whole or in part.
16A. Producer Signature (By)

16B. Title/Relationship of the Individual Signing in the Representative Capacity

16C. Date (MM/DD/YYYY)

PART E – COUNTY COMMITTEE (COC) DETERMINATION
17A. COC or Designee Signature

17B. Date (MM/DD/YYYY)

17C. Determination

Approved

Disapproved

FSA-174 (XX-XX-23)
NOTE:

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The following statement is made in accordance with the Privacy Act of 1974 (5 USC 552a - as amended). The authority for requesting the information identified
on this form is the Extending Government Funding and Delivering Emergency Assistance Act (Pub. L. 117-43). The information will be used to determine
eligibility for program benefits. The information collected on this form may be disclosed to other Federal, State, and Local government agencies, Tribal
agencies, and nongovernmental entities that have been authorized access to the information by statute or regulation and/or as described in applicable Routine
Uses identified in the System of Records Notice for USDA/FSA-2, Farm Records File (Automated). Providing the requested information is voluntary; however,
failure to furnish the requested information will result in a determination of ineligibility for program benefits. Payments may be made under the program to
which the form applies only to the extent permitted by applicable authorities.
Public Burden Statement (Paperwork Reduction Act): Public reporting burden for this collection is estimated to average 60 minutes per response, including
reviewing instructions, gathering, and maintaining the data needed, completing (providing the information), and reviewing the collection of information. You
are not required to respond to the collection of information, unless it displays a valid OMB control number. RETURN THIS COMPLETED FORM TO YOUR
RECORDING COUNTY FSA OFFICE.

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or
administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex, gender identity (including gender expression), sexual orientation, disability, age, marital status,
family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not all
bases apply to all programs). Remedies and complaint filing deadlines vary by program or incident.
Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.) should contact the responsible Agency or
USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other
than English.
To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at http://www.ascr.usda.gov/complaint_filing_cust.html and at any USDA office or
write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA
by: (1) mail: U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue, SW Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email:
[email protected]. USDA is an equal opportunity provider, employer, and lender.