Submit the original of the completed form in hard copy to the FSA county office. Retain copies for the producer and joint payee. DO NOT FAX.
| 
					Field Name / | Instruction | 
| Part A | General Information | 
| 1 Producer's Name and Address | Enter the producer's name and address (including Zip Code). | 
| 2 Joint Payee's Name and Address | Enter the name and address of the person, business, institution, etc. to be included in the payment (joint payee). | 
| 3 Producer's Tax Identification Number (9 Digit Number) | Enter the producer's social security number or tax identification number. | 
| Part B | Applicable Program(s) | 
| 4 Program | Select the applicable program as displayed or enter an applicable multi-year program name: 
 
 
 Note:? All CRP, other than annual rental must be indicated in the ?????????? ?other? block. 
 | 
| 5 Program Year or Payment Year | Enter the year of the applicable program year or payment year of the program name entered for joint payment. | 
| 6 State, County, and Reference Number, If Applicable | If Joint Payment is applicable to only one FSA county office, or a particular farm or contract, enter State, county and reference number, if applicable. | 
| Part C | Joint Payment Authorization The producer and joint payee shall read the certification statement carefully. 
 NOTE:? By signing both parties acknowledge and agree to the terms and conditions set forth in Part C. | 
| 7A-7C Producer?s Signature, Title/Relationship and Date | The producer or authorized agent shall sign and date. 
 If other authorized agent or representative signs on behalf of the entity, please enter title or nature of authority. | 
| 8A-8C Joint Payee?s Signature, Title Relationship and Date | Person, business, institution, etc. shall sign and date as joint payee.? 
 If other authorized agent or representative signs on behalf of the entity, please enter title or nature of authority. | 
| Part D | Revocation of Joint Payment Authorization The joint payee must sign this part to revoke an existing joint payment authorization. | 
| 9A-9C Joint Payee?s Signature, Title/Relationship and Date | The joint payee must sign and date this form to revoke the joint payment authorization.? If applicable, enter the title of the person representing the joint payee. | 
Items 10-12 are for FSA use only.?????
Item 13
| 
					Field Name / | Instruction | 
| Special Provisions | Producer and the joint payee must read the Special Provisions Relating to Joint Payment Authorization, and the Privacy Act and Public Burden Statements on Page 2 of Form CCC-37. | 
| 13A-13B County Office Name, Address, and Telephone Number | When CCC-37 is to be mailed or to be delivered by a carrier to the? FSA county office, the producer shall enter the FSA servicing office name and address with zip code and the telephone number with area code. | 
| 
					Field Name / | Instruction | 
| Joint Payee | A joint payee is a person or entity to whom a payment is made jointly with the producer. | 
| Joint Payment Authorization | A joint payment authorization is a written request to make payment to joint payees. 
 
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| File Type | application/msword | 
| Author | maryann.ball | 
| Last Modified By | maryann.ball | 
| File Modified | 2009-12-07 | 
| File Created | 2009-12-07 |