Fillable CORONAVIRUS FOOD ASSISTANCE PROGRAM (CFAP) APPLICATION (USDA, Office of Communications)

Fill Online, Printable, Fillable, Blank CORONAVIRUS FOOD ASSISTANCE PROGRAM (CFAP) APPLICATION (USDA, Office of Communications) Form

Use Fill to complete blank online USDA, OFFICE OF COMMUNICATIONS (DC) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

CORONAVIRUS FOOD ASSISTANCE PROGRAM (CFAP) APPLICATION (USDA, Office of Communications)

On average this form takes 35 minutes to complete

The CORONAVIRUS FOOD ASSISTANCE PROGRAM (CFAP) APPLICATION (USDA, Office of Communications) form is 2 pages long and contains:

  • 0 signatures
  • 0 check-boxes
  • 140 other fields

Country of origin: US
File type: PDF

U.S.A. forms for USDA, Office of Communications

BROWSE USDA, OFFICE OF COMMUNICATIONS (DC) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Form Approved - OMB No. 0560-0295
This form is available electronically.
OMB Expiration Date: 11/30/2020
AD-3114-A U.S. DEPARTMENT OF AGRICULTURE
(06-26-20)
CORONAVIRUS FOOD ASSISTANCE
PROGRAM (CFAP) APPLICATION
(Continuation Sheet)
1. Recording State
2. Program Year
3. Recording County
4. Application Number
NOTE:
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 7 CFR
Part
9, the CARES Act (Pub. L. 116-136), and 15 U.S.C. 714b and 714c. The information will be used to determine eligibility for program benefits. The information collected on this
form may be disclosed to other Federal, State,
and 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/F
SA-2, Farm Records File (Automated). Providing the
requested information is voluntary.
However, failure to furnish the requested information will result in a determination of ineligibility for program benefits. Payments may be made
under the program to which the form applies only to the extent permitted by applicable authorities.
Public Burden Statement (
Paperwork Reduction Act): Public reporting burden for this collection is estimated to average 60 minutes per response, including reviewing
instructions, gathering and maintaining the data needed, completing (providing the information), and
reviewing the collection of information. You are not required to respond to the
collection
, or USDA may not conduct or sponsor a collection of information unless it displays a valid OMB control number. RETURN THIS COMPLETED FORM TO YOUR COUNTY
FSA OFFICE.
PART B – PRODUCER INFORMATION
5. Producer’s Name, Address
(City, State and Zip Code)
and Phone Number (Include Area Code)
PART D – NON-SPECIALTY CROP AND WOOL INFORMATION
13.
Commodity
14.
Unit of Measure
15.
2019 Total
Production
16.
2019
Production Not Sold
(as of Jan 15, 2020)
17.
COC Adjusted 2019
Total Production
18.
COC Adjusted 2019
Production Not Sold
(as of Jan 15, 2020)
PART E – LIVESTOCK INFORMATION COC USE ONLY
19.
Livestock
20.
Unit of Measure
21.
Sales
(Between Jan 15, 2020 –
April 15, 2020)
of Inventory Owned as of
Jan 15, 2020
22.
Inventory
(Highest Between
April 16, 2020 - May
14, 2020)
23.
COC Adjusted Sales
(
Between Jan 15, 2020 -
April 15, 2020)
of Inventory Owned as
of Jan. 15, 2020
24.
COC Adjusted
Inventory
(Highest
Between
April 16, 2020 - May
14, 2020)
PART F - VALUE LOSS INFORMATION
25.
Commodity
26.
Value of Sales
(Jan 15, 2020 –
April 15, 2020)
27.
Value of Inventory
(as of April 15, 2020)
28.
COC Adjusted Value of
Sales
(Jan 15, 2020 –
April 15, 2020)
29.
COC Adjusted
Value of Inventory
(as of April 15, 2020)
AD-3114-A Continuation Sheet (06-26-20) Page 2 of 2
PART G - SPECIALTY CROP INFORMATION (COC DETERMINATION NOT REQUIRED) AMS USE ONLY
30.
Crop
31.
Unit of
Measure
32.
Volume of
Production Sold
(Jan 15, 2020 -
April 15, 2020)
33.
Volume of
Production
Shipped but Not
Sold and Unpaid
(Jan 15, 2020 -April
15, 2020)
34.
Acres with
Production Not
Shipped or Sold
(Jan 15, 2020 -April
15, 2020)
35.
AMS Adjusted
Volume of
Production
Sold
(Jan 15, 2020 -
April 15, 2020)
36.
AMS Adjusted
Volume of
Production
Shipped but Not
Sold and Unpaid
(Jan 15, 2020 -
April 15, 2020)
37.
AMS Adjusted
Acres with
Production Not
Shipped or Sold
(Jan 15, 2020 -
April 15, 2020)
In accordance with Federal civil rights law and USDA civil rights regulations and policies, the USDA, its agencies, offices, and employees 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: program.intake@usda.gov. USDA is an equal opportunity provider, employer, and lender.
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

CORONAVIRUS FOOD ASSISTANCE PROGRAM (CFAP) APPLICATION (USDA, Office of Communications)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 11 August 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document