Food Safety Certification for Specialty Crops Program (FSCSC)

OMB: 0560-0311

Expiration Date: XX/XX/XXXX

Public Burden Statement (Paperwork Reduction Act): According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0560-0311. The time required to complete this information collection is estimated to average 60 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to [email protected] (OMB NO. 0560-0311).

Instructions For FSA-888

FOOD SAFETY CERTIFICATION FOR SPECIALTY CROPS (FSCSC)

Producers use this form to apply for FSCSC payments for the 2020, 2021, and 2022 program years.

Submit the original of the completed form in hard copy to any FSA county office by mail, electronically, or in person. You can find an FSA county office using the USDA Service Center Locator at http://offices.sc.egov.usda.gov/locator/app.

In addition to CCC-888, you must also submit the following to complete your application:

• SF-3881, if not previously filed with FSA.

• AD-2047, if not previously filed with FSA

• Signature authority if an entity

All documentation and required forms may be submitted in person, electronically or by mail except AD-2047, which may be submitted in person or by phone through any FSA county office.

Producers must complete Items 1 through 13.

Item 14 is for FSA use only.

Items 1-13

Fld Name / Item No.	Instruction
1 Recording State Name/Code	Enter the recording State name and code.
2 Recording County Name/Code	Enter the recording county name and code.
3 Program Year	Enter the program year for which you are applying for benefits. The 2020 program year covers expenses paid between January 1, 2020, and December 31, 2020. The 2021 program year covers expenses paid between January 1, 2021 and December 31, 2021. The 2022 program year covers expenses paid between January 1, 2022 and December 31, 2022 Note: Separate CCC-888’s must be completed for each program year.
4 Application No.	This will be automatically populated, leave blank if a manual form.
5 Applicant Name	Enter the applicant’s name. Note: The applicant’s name in Item 5 must match the person or entity listed on the applicant’s Food Safety certificate or plan.
6 Applicant’s Address	Enter the applicant’s address (including ZIP code).
7 Have you recently participated in FSA programs?	Check “YES” or “NO” to indicate whether the applicant has recently participated in FSA programs. If “NO” is selected, you must also submit completed forms AD-2047 and SF-3881 to receive payment.
8 Applicant’s Phone Number	Enter the applicant’s phone number.
9 Email Address	Enter the applicant’s Email address.
10A Category of Expenses	Check the appropriate box(es) to indicate the category of expenses for which you are applying.
10B Expenses	Enter the associated costs for each selected category. For costs that apply to more than one category, divide the amount by the number of all categories for which the cost was incurred.
10C Number of Tests	Enter the number of tests for testing for the three categories.
10D COC Adjustment of Expenses	For COC use only, leave blank
10E Other Reimbursement for Expenses Received	Enter the amount received as reimbursement from other sources for each category. If zero leave blank.
10F COC Adjustment of Other Reimbursement for Expenses Received	For COC use only, leave blank
11 Are you a small business?	Check “YES” or “NO” to indicate if you meet the definition of a small business. A small business is an average annual monetary value of specialty crops the farm sold during the 3-year period preceding the program year of more than $250,000 but not more than $500,000.
12 Are you a very small business?	Check “YES” or “NO” to indicate if you meet the definition of a very small business A very small business is an average annual monetary value of specialty crops the farm sold during the 3-year period preceding the program year of no more than $250,000.
13A Applicant’s Signature	Applicant signature. Print the form and manually enter your signature.
13B Title/ Relationship of the Individual Signing in the Representative Capacity	If you are signing on behalf of an entity or another individual, enter your representative title/relationship to the entity or individual. Note: If you are not signing in the representative capacity, this field should be left blank.
13C Date	Enter the date the form is signed. (MM-DD-YYYY)

Part D is for FSA use only.

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