FSA1122AeGov_ 4

Instructions For FSA-1122A
Continuation Sheet for Pandemic Assistance Revenue Program (PARP)
Adjusted Revenue
This form will be used for applicants to provide supplemental information for use on the
FSA-1122, PARP Application.
Submit the original of the completed form in hard copy, by email or facsimile to the
appropriate USDA servicing office. https://offices.sc.egov.usda.gov/locator/app
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 the following items: items 5 through 8, items 12A through 12C, if
applicable.
FSA will complete fields noted as “Agency Use Only.”

Item No. /
Field Name

Instruction

1
Recording State

Enter the producer’s recording state.

2
Program Year

The program year will be 2020.

3
Recording County

Enter the producer’s recording county.

4
Application
Number

Application Number will be assigned by the automated system.

Page 1 of 4

As of: XX-XX-2020

Item No. /
Field Name

Instruction

Part A – Producer Information
5
Producer’s Name,
Address (City,
State, and Zip
Code), and Phone
Number (Including
Area Code)

Enter the producer’s name, address, including ZIP code, and phone number,
including area code.

6
Are you a new
producer who
began farming in
2020 that doesn’t
have revenue in
2018 and 2019?
7
Are you a producer
who began farming
in 2019 that does
not have a full
year’s revenue to
report from 2018 or
2019?
8
Did your operation
have an increase in
operation capacity
in 2020 compared
to 2018 or 2019 that
impacted revenue?

Select “Yes” or “No”.
If “yes” is selected, complete Part B and Part E.

Select “Yes” or “No”.
If “yes” is selected, complete Part C and Part E.

Select “Yes” or “No”.
If “yes” is selected, complete Part D and Part E.

Part B – New Producer
9
2020 Expected
Allowable Gross
Revenue

Page 2 of 4

Enter the total Expected Allowable Gross Revenue for 2020.
Expected allowable gross revenue will be obtained from:
- Financial documents
- Sales contracts or purchase agreements
- Documentation supporting production capacity and associated alterations
- Additional documents reflecting the expected allowable gross revenue

As of: XX-XX-2020

Item No. /
Field Name
10
COC Adjusted
2020 Expected
Allowable Gross
Revenue
(COC USE
ONLY)

Instruction
COC may enter the adjusted total Expected Allowable Gross Revenue for 2020, if
applicable.
Note: An entry is only required when COC determines the total Expected
Allowable 2020 Gross Revenue is different than what is certified to by the
producer in Item 9.

Part C – New 2019 Producer Without Full Year’s Revenue
11
Basis for Increase
in Production
12
Percent of
Increased
Production for
Entire Farming
Operation
13
COC Adjusted
Percent of
Increased
Production for
Entire Farming
Operation
(COC USE
ONLY)

Enter the physical basis that is anticipated to result in an increase in production in
2020 compared to 2019.
Example: Began farming and harvested only the second crop in 2019.
Enter the percentage the change identified in Item 11 impacts the production of
the operation.
Example: Planted and harvested both initial and second crop in 2020. Initial crop
has similar value to second crop; therefore, the increase is 100% because two
crops were harvested in 2020.
COC may enter the adjusted percent for increased production for entire farming
operation, if applicable.
Note: An entry is only required when COC determines the percentage in Item 12
is not reflective of the impact of the increase in production identified in
Item 11.

Part D – 2020 Increase in Operation
14
Basis for Increase
in Production
15
Percent of
Increased
Production for
Entire Farming
Operation
16
COC Adjusted
Percent of
Increased
Production for

Page 3 of 4

Enter the physical basis that is anticipated to result in an increase in production in
2020 compared to 2018 and 2019.
Example: Increased acres from 100 acres in 2018 and 2019 to 150 acres in 2020.
Enter the percentage the change identified in Item 14 impacts the production of
the operation.
Example: Increased acres from 100 acres in 2018 and 2019 to 150 acres in 2020
resulted in a potential 50% increase in production for the entire operation.
COC may enter the adjusted percent for increased production for entire farming
operation, if applicable.
Note: An entry is only required when COC determines the percentage in Item 15
is not reflective of the impact of the increase in production identified in Item 14.

As of: XX-XX-2020

Item No. /
Field Name

Instruction

Entire Farming
Operation
(COC USE
ONLY)

Part E – Producer Certification
17
Signature (By)

Producer requesting the adjustment to 2019 allowable gross revenue for PARP
must sign.

18
Title/Relationship of
the Individual
Signing in the
Representative
Capacity
19
Date
(MM/DD/YYYY)

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-1122A is signed in Item 17.

Part D – COC Determination
20
COC or Designee
Signature
(COC USE ONLY)
21
Date
(MM/DD/YYY)
(COC USE ONLY)
22
Determination
(COC USE ONLY)

Page 4 of 4

COC or their representative will sign.

Enter the date COC or their representative signs the FSA-1122A.

COC or their representative will check () either “Approved” or “Disapproved”
Important: FSA-1122A will be approved or disapproved as certified by the
producer after applicable COC adjustment fields are completed.

As of: XX-XX-2020