If your application is selected for audit,
you may be requested to submit supporting documentation to prove that your
Average Adjusted Gross Income is in accordance with regulations found at 7 CFR
Part 1400-G.
Submit the
original of the completed form in hard copy or facsimile to the appropriate
USDA servicing office.
Applicants who have
established electronic access credentials with USDA may electronically transmit
this form to the USDA servicing office, provided that (1) the customer submitting
the form is the only person required to sign the transaction, or (2) the
customer has an approved Power of Attorney on file with USDA to sign for other
customers for the program and type of transaction represented by this form.
Features for transmitting
the form electronically are available to those customers with access
credentials only. If you would like to
establish online access credentials with USDA, follow the instructions provided
at the USDA eForms web site.
Producers must complete Items 1A
through 2C.
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Fld Name/ Item No. |
Instructions |
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1A Name and Address of Producer |
Enter your name and official mailing address, including
Zip code. |
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1B Telephone Number |
Enter a telephone number, including area code where you can be reached. |
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1C Producer ID or Tax ID No. |
Enter your producer ID or tax ID number. |
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1D Address |
Enter your e-mail address. (If available) |
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1E Crop Year |
Enter the crop year in which the commodity you are applying for TAA benefits was marketed. |
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1F Commodity |
Enter the name of the commodity for which you are applying for benefits and the State where the commodity was marketed. |
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1G Production |
Enter the total quantity marketed of the commodity identified in Item 1F. You must provide verifiable records to substantiate the quantity marketed. Verifiable records will indicate the commodity, year of marketing, and location where marketed. If applying for an aquaculture commodity, enter the basis of the weight such as head-on, head-off, fillet, or other basis as appropriate to the commodity. Weight conversions will be provided by FSA if needed. |
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1H Unit of Measure |
Enter the unit of measure for the production (lbs., tons, cwt., bu., etc.) entered in Item1G. |
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Items 2A - 2C
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Fld Name/ Item No. |
Instructions |
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2A Producers Signature |
Read the certification statement and enter your signature certifying that the information submitted on this application is true and that you have read, understand, and agree to the certification statement in Part B. If you are mailing or faxing this form, print the form and manually enter your signature. If this form is approved for electronic transmission and you have established credentials with USDA to submit forms electronically, use the buttons provided on the form for transmitting the form to the USDA servicing office. |
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2B Ship Captain/ Skipper |
Check yes or no indicating if you are a ship captain or skipper. |
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2C Date |
Enter the date the signature was entered in Item 2A. |
Part C, Items 3 through 9 are for FSA use only.