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Field Name / |
Instruction |
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Part A |
General Information |
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1 Producer (Assignor's) Name and Address |
Enter the name and address (including Zip Code) of the producer (assignor) making the assignment. |
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2 Assignee’s Name and Address |
Enter the name and address (including Zip Code) of the assignee. |
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3 Producer (Assignor’s) Tax Identification Number (9 Digit Number) |
Enter the producer’s (assignor's) social security number or tax identification number. |
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4 Assignee’s Tax Identification Number (9 Digit Number) |
Enter the social security number when the assignee is an individual or enter the employer tax ID when the assignee is a company or a financial institution. NOTES: - Assignee must provide Tax ID information to the FSA office. - The ID type of a financial institution is "E". - If the assignee wishes to receive payment by EFT, the assignee must sign up for this service on line or submit a completed SF-1199A or SF-3881 to an FSA office. |
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Part B |
Applicable
Program(s) |
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5 Program |
Select the applicable program as displayed or enter an applicable multi-year program name: - Conservation Reserve Program (CRP) - Milk Income Loss Contract (MILC) - Direct and or Counter Cyclical Payment (DCP) - Loan Deficiency Payment (LDP) Note: All CRP, other than annual rental must be entered in Item 8. |
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6 Assigned Amount of Each Applicable Year |
Enter the year and amount of payment benefits to be assigned from the applicable program listed under Item 5. |
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7 State, County, and Reference Number, If Applicable |
If Assignment is applicable to only one FSA county office, or a particular farm or contract, enter the State, county and reference number, if applicable. |
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8 Other Program Name |
Enter the names of any other program(s) not listed under Item 5. |
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9 Program Year or Payment Year |
Enter the year of the applicable program year or payment year of the assigned program name entered. |
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10 Assigned Amount |
Enter the amount of payment benefits to be assigned. |
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11 State, County, and Reference Number, If Applicable |
If assignment is applicable to only one FSA county office, or a particular farm or contract, enter the State, county and reference number, if applicable. |
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Part C |
Representation of
Assignor and Assignee The producer and assignee shall read the certification statement carefully. NOTE: By
signing both parties acknowledge and agree to the terms and conditions set
forth in Part C. |
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12A Producer’s (Assignor's) Signature (By) |
Ensure that the producer's (assignor's) signature is completed. |
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12B Title/Relationship of the Individual if Signing in a Representative Capacity |
If the signature is not the Producer’s, enter the Representative’s information. |
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12C Date |
Enter date the producer (assignor) signs the form. |
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13A Assignee’s Signature (By) |
Ensure that the assignee's signature is completed. |
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13B Title/Relationship of the Individual if Signing in a Representative Capacity |
If the signature is not the Assignee’s, enter the Representative’s information. |
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13C Date |
Enter date the assignee signs the form. |
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Part D |
Revocation of
Assignment The assignee must complete Part D to revoke an existing
Assignment of Payment. |
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14A-14B Assignee's Signature and Date |
Ensure that the assignee's signature and date to revoke the existing assignment are completed. |
Item 18
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Field Name / |
Instruction |
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Page 2, Special Provisions |
Assignor and assignee must read the Special Provisions Relating to Assignments, and Privacy Act and Public Burden Statements on Page 2 of Form CCC-36. |
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18 |
If CCC-36 is mailed or delivered by a carrier to the FSA county office, the assignee shall make sure the FSA county office name and address with zip code and the telephone number are entered. |
Additional Information
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Item |
Instruction |
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Assignee |
An assignee is a person or entity to which the assignment of a payment is made. |
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Assignment |
An assignment is the transfer of the right to receive a cash payment from a producer (assignor) who is participating in FSA or CCC farm programs to an assignee. · An assignment of payment is executed on CCC-36 and must be filed in the County FSA Office. · Payment is made payable to assignee. |
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Assignor |
An assignor is any person (the producer) who: · Is eligible to receive a payment · Assigns the payment to another party. |