INSTRUCTIONS FOR FSA-211
Power of Attorney
Producers use the FSA-211, Power of Attorney, to appoint someone to act on their behalf as attorney-in-fact. This document gives another person legal authority to act on your behalf. The person receiving the power to act on your behalf may enter into binding agreements and may create liability for you. The attorney-in-fact's power and responsibilities depend on the specific powers granted in this document.
This form is valid only for certain programs and actions offered by the Commodity Credit Corporation (CCC), Farm Service Agency (FSA), and the Federal Crop Insurance Corporation (FCIC).
Producers must have their signature witnessed by a FSA employee or notarized by a Notary Public.
The completed original form must be submitted in hard copy to the appropriate FSA Service Center. FSA-211’s received through telefacsimile machines will not be accepted.
Producers complete Items 1 through 7. Notary Public must complete Item 9 when requested by the producer.
Items 1 through 7.
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Fld Name / |
Instruction |
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(1) The Undersigned does hereby appoint… |
Enter the name of the person being granted the authority to act on your behalf. |
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(2) Address of… |
Enter the address of the person being granted the authority to act on your behalf. |
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(3) County of Residence… |
Enter the county of residence of the person being granted the authority to act on your behalf. |
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(4) State of Residence… |
Enter the State of residence of the person being granted the authority to act on your behalf. |
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(5) Grantor's Name. The attorney-in-fact to act for… |
Enter your name (Grantor). If the grantor of the authority is an entity such as a corporation or partnership, enter the name of the entity. |
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Section A FSA and CCC Programs |
Check the applicable program(s) for which the appointed person will act on your behalf. If you want the appointed person to act on your behalf for ALL current and ALL future CCC and FSA programs, enter a checkmark in Item 2. Specific FSA and CCC programs not listed may be entered in Section A, Item11, Other (Specify). |
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Section B Trans- actions for FSA and CCC Programs |
Check the applicable FSA and CCC action(s) for which the appointed person will act on your behalf. If you want the appointed person to act on your behalf for ALL actions, enter a checkmark in Item 1. Specific actions not listed may be entered in Section B Item 7, Other (Specify). |
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Section C FCIC Crops |
Enter the applicable FCIC crop(s) for which the appointed person will act on your behalf. If you want the appointed person to act on your behalf for ALL FCIC crops, enter "ALL." |
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Section D Transaction Numbers Used by FCIC |
Check the applicable FCIC action(s) for which you want the appointed person to act on your behalf. If you want the appointed person to act on your behalf for ALL FCIC actions, enter a checkmark in Item 1. Specific actions not listed may be entered in Section D Item 6, Other (Specify). |
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6 A-C Signature Of Grantor (Individual), Date, Social Security Number |
If the grantor of the authority is an individual, sign your name, date, and enter your Social Security Number in Items 6A, 6B, and 6C respectively. Note: Your signature must be witnessed by a FSA employee or notarized by a Notary Public. Signatures not witnessed by a FSA employee or acknowledged by a valid Notary Public will not be accepted. See Item 7 for signature instructions if the grantor is an entity. |
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7 A-D Signature Of Grantor (Partner-ship, Trust, etc), Date, ID Number of Entity |
If the grantor of the authority is an entity, such as a corporation or partnership, a representative of the entity with signature authority for the entity must sign, enter their official title, date, and enter the entity’s Identification Number in Items 7A, 7B, 7C, and 7D respectively. Note: The signature must be witnessed by a FSA employee or notarized by a Notary Public. Signatures not witnessed by a FSA employee or acknowledged by a valid Notary Public will not be accepted. |
Item 8 is for FSA use only.
Item 9 is completed by the Notary Public when requested by the producer or entity.
Item 10 is for FSA use only.