CCC-37 Joint Payment Authorization

Form Approved - OMB No. 0560-0183
Expiration date (09/30/2024)
See Page 2 for Privacy Act and Public Burden Statements.

CCC-37

U.S. DEPARTMENT OF AGRICULTURE
Commodity Credit Corporation

(10-17-22)

JOINT PAYMENT AUTHORIZATION
PART A - GENERAL INFORMATION
1. Producer’s (Assignor’s) Name and Address (Including Zip Code)

2. Joint Payee’s Name and Address (Including Zip Code)

3.Producer’s (Assignor’s) Tax Identification Number (9 Digit Number)
PART B – FSA APPLICABLE PROGRAM(S)
4.
5.
Program
Program Year or
Payment Year
Agricultural Risk Coverage
(ARC)
Price Loss Coverage (PLC)
Conservation Reserve
Program Annual Rental
(CRP)
Coronavirus Food
Assistance Program
(CFAP)
Coronavirus Food
Assistance Program 2
(CFAP2)

FROM:

FROM:

FROM:

FROM:

Wildfires and Hurricanes
Indemnity Program Plus
(WHIP+)
Other (All CRP, other than
annual rental):

Other:

FROM:

FROM:
TO:

Other:

FROM:
TO:

Other:

TO:

TO:

FROM:

TO:
Other:

TO:

FROM:

FROM:

TO:
Other:

TO:

FROM:

FROM:

TO:

TO:

FROM:

FROM:

TO:
Other:

TO:

FROM:

FROM:

TO:
Other:

TO:

FROM:

FROM:

TO:
Other:

TO:

FROM:

FROM:

TO:
Other:

TO:
FROM:

5.
Program Year or
Payment Year

TO:
Other:

TO:

Livestock Forage Disaster
Program (LFP)

Noninsured Crop Disaster
Assistance Program (NAP)

Other:

TO:

FROM:

Loan Deficiency Payments
(LDP)

4.
Program

TO:

Emergency Assistance
Livestock Honeybees and
Farm-Raised Fish Program
(ELAP)

Livestock Indemnity
Program (LIP)

6.
State, County, and
Reference No.,
If Applicable

FROM:
TO:

Other:

FROM:
TO:

6.
State, County, and
Reference No.,
If Applicable

CCC-37 (10-17-22)

Page 2 of 2
PART C – JOINT PAYMENT AUTHORIZATION
The undersigned assignor and joint payee request that CCC or FSA, as applicable, make the payments specified in Item 4 payable jointly
to the specified assignor and the undersigned joint payee. Both the assignor and the joint payee agree that this authorization in no way
affects the right of offset by CCC, FSA, or any other Government agency, regardless of the date the debt was incurred. Both the assignor
and joint payee understand and agree that if the assignor files a Form CCC-36, Assignment of Payment, with CCC or FSA, for any
program covered by this joint payment authorization, regardless of the date the assignment was filed, the assignment takes precedence
and will be honored by CCC and FSA as though the assignment was filed prior to the joint payment authorization. Additional payments or
remaining amounts due after assignments have been honored will be made payable to the joint payees identified on this form, subject to
the aforementioned right of offset by Government agencies.
This authorization may be revoked at any time by the joint payee by completing Part D of this form or by submitting a written request
signed by the joint payee to the FSA County office making the payment.
7A. Producer’s Signature (By)
7B. Title/Relationship of the Individual if Signing in a
7C. Date (MM-DD-YYYY)
Representative Capacity
8A. Joint Payee’s Signature (By)

8B. Title/Relationship of the Individual if Signing in a
Representative Capacity

8C. Date (MM-DD-YYYY)

PART D - REVOCATION OF JOINT PAYMENT AUTHORIZATION
Revocation of this authorization requires the signature of the joint payee. Joint payment authorization above is hereby revoked.
9A. Joint Payee’s Signature (By)

9B. Title/Relationship of the Individual if Signing in a
Representative Capacity

FOR COUNTY OFFICE USE ONLY
10. Receiving State and County

11. Date Filed (MM-DD-YYYY)

9C. Date (MM-DD-YYYY)

12. Time Filed

SPECIAL PROVISIONS RELATING TO JOINT PAYMENT AUTHORIZATION
A.
B.
C.
D.
E.
F.

The original of this joint payment authorization, properly executed, must be filed in the FSA County office.
CCC and FSA will recognize only one joint payment authorization at any given time per assignor for each program
per program year or group of years if multi-year is selected.
Neither the United States of America, the Commodity Credit Corporation, the Secretary of Agriculture, any disbursing
officer, nor any other Government employee or official shall be subject to any suit or liable for payment of any amount
if payment is inadvertently made to the assignor without regard to this joint payment authorization.
This joint payment authorization does not extend to any successor of the joint payee.
This joint payment authorization is effective for all counties unless specify on Part B, Item 6.
This joint payment authorization is subject to offset for any delinquent Federal debt owed by the assignor

13A. FSA County Office Name and Address (Including Zip Code)
NOTE:

13B. Telephone Number (Including area code)

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 Soil Conservation and Domestic Allotment Act (16 U.S.C. 590h(g)), the Commodity Credit Corporation Charter Act (15 U.S.C.
714 et seq.), the A he Agricultural Improvement Act of 2018 (P.L.115-334) (7 U.S.C. 9094) and 7 CFR Part 1404. The information will be used to assign
payments made under applicable CCC, FSA, and/or NRCS programs to a designated assignee. The information collected on this 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) and for USDA/NRCS-1, Landowner, Operator, Producer, Cooperator, or Participant Files. Providing the requested information is
voluntary. However, failure to furnish the requested information will result in a determination that the Assignor is unable to assign applicable CCC, FSA,
and/or NRCS program payments to a designated assignee.
Public Burden Statement: Public reporting burden for this collection is estimated to average 10 minutes per response, including reviewing instructions,
gathering and maintaining the data needed, completing (providing the information), and reviewing the collection of information. This collection is
voluntary. You are not required to respond to the collection or FSA may not conduct or sponsor a collection of information unless it displays a valid OMB
control number of 0560-0183. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions
for reducing this burden by emailing to: [email protected] (OMB NO. 0560-0183).
Paperwork Reduction Act (PRA) Statement: For certain FSA, CCC programs such as ARC, PLC, CRP, ELAP, LIP, eLDP, and NRCS programs
ACEP, AMA, CSP, EQIP, GRP, RCPP the information collection is exempted from PRA as specified in 16 U.S.C. 3846(b)(1). RETURN THE
COMPLETED FORM TO THE FSA COUNTY 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.