Ccc-505 Voluntary Permanent Base Acres Reduction

This form is available electronically.

CCC-505 U.S. DEPARTMENT OF AGRICULTURE (04-22-15) Commodity Credit Corporation VOLUNTARY PERMANENT BASE ACRE REDUCTION

1. STATE AND COUNTY CODE

2. FARM NO.

3. PROGRAM YEAR

     

     

    

4. REASON FOR REDUCTION OF BASE ACRES CRP Enrollment

Other

     

NOTE:

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 7 CFR Part 1412, the Commodity Credit Corporation Charter Act (15 U.S.C. 714 et seq.), and the Agriculture Act of 2014 (Pub. L. 113-79).  The information will be used to process a request for a permanent reduction of the base acres established for identified crops.  The information collected on the form may be disclosed to other Federal, State, 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 an inability to process a request for a permanent reduction of the base acres established for identified crops. This information collection is exempted from the Paperwork Reduction Act, as it is required for administration of the Agriculture Act of 2012 (Pub. L. 113-79), Title 1, Subtitle F – Administration.    The provisions of appropriate criminal and civil fraud, privacy, and other statutes may be applicable to the information provided. RETURN THIS COMPLETED FORM TO YOUR COUNTY FSA OFFICE.

PART A - REQUEST

The undersigned requests a permanent reduction of the base acres established for the following crop(s) for the farm identified in Item 2 above.

5. TRACT NO.

6. COMMODITY

7. YIELD

8. BASE ACRES ON TRACT BEFORE REDUCTION

9. BASE ACRES ON TRACT TO BE REDUCED

10. BASE ACRES ON TRACT AFTER REDUCTION (Column 8 MINUS Column 9)

     

     

     

     

-

     

=

     

     

     

     

     

-

     

=

     

     

     

     

     

-

     

=

     

     

     

     

     

-

     

=

     

11. Total Base Acres to be Reduced (Total of Column 9)

     

12. Total Base Acres on Farm Before Reduction      

13. Total Base Acres on Farm After Reduction (Item 12 minus Item 11)      

14A. Requestor’s Signature (By)

14B. Title/Relationship (of the individual signing in the Representative Capacity)      

14C. Date (MM-DD-YYYY)      

15A. Owner’s Signature (By)

15B. Title/Relationship (of the individual signing in the Representative Capacity)      

15C. Date (MM-DD-YYYY)      

16A. Owner’s Signature (By)

16B. Title/Relationship (of the individual signing in the Representative Capacity)      

16C. Date (MM-DD-YYYY)      

17. REMARKS (If the base acres are being reduced because of cropland enrollment into CRP, enter the CRP-1 number and the effective date of CRP-1).      

PART B- APPROVAL (COUNTY OFFICE USE ONLY)

18. REDUCTION IS: APPROVED DISAPPROVED

19. COUNTY FSA OFFICE NAME AND ADDRESS (Including Zip Code)      

20. COC'S SIGNATURE

DATE (MM-DD-YYYY)

TELEPHONE NUMBER (Area Code):

     

     

The U.S. Department of Agriculture (USDA) prohibits discrimination against its customers, employees, and applicants for employment on the bases of race, color, national origin, age, disability, sex, gender identity, religion, reprisal, and where applicable, political beliefs, marital status, familial or parental status, sexual orientation, or all or part of an individual’s income is derived from any public assistance program, or protected genetic information in employment or in any program or activity conducted or funded by the Department. (Not all prohibited bases will apply to all programs and/or employment activities.) Persons with disabilities, who wish to file a program complaint, write to the address below or if you require alternative means of communication for program information (e.g., Braille, large print, audiotape, etc.) please contact USDA’s TARGET Center at (202) 720-2600 (voice and TDD). Individuals who are deaf, hard of hearing, or have speech disabilities and wish to file either an EEO or program complaint, please contact USDA through the Federal Relay Service at (800) 877-8339 or (800) 845-6136 (in Spanish).

If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, found online at http://www.ascr.usda.gov/complaint_filing_cust.html, or at any USDA office, or call (866) 632-9992 to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter by mail to U.S. Department of Agriculture, Director, Office of Adjudication, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, by fax (202) 690-7442 or email at [email protected]. USDA is an equal opportunity provider and employer.