RELIEF 
FOR UNDUE ECONOMIC HARDSHIP REQUEST HIGHLY ERODIBLE 
Producers use this form to 
request an exemption for highly erodible land conservation provisions under USDA 
programs because of undue economic hardship. 
Submit the original of the 
completed form in hard copy or facsimile to the appropriate FSA servicing 
office.  
Customers 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 (Form FSA-211) 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 1 through 8.
Items 1 - 8 
| Fld. Name/ Item 
      No. | Instruction | 
| 1 State and  | Enter the State and 
      County name (address not required). | 
| 2A Landlord Information 
       | Enter the landlord or 
      landowners name and address including Zip code. | 
| 2B Telephone  Number | Enter the landlord or 
      landowners phone number including area code. | 
| 3 Identification Number | Enter the landlord or 
      landowners social security number or tax ID 
    number. | 
| 4 Farm 
      Number | Enter the farm number 
      on which the exemption request is being made. | 
| 5A Tract 
      Number | Enter the tract number 
      on which the highly erodible land is located. | 
| 5B Field 
      Number | Enter the field number 
      on which the highly erodible land is located. | 
| 6 Crop 
      Year | Enter the crop year 
      for which the exemption request is being made. | 
| 7 Reason for 
      Request | Enter the reason for 
      the request.  Describe in 
      detail how the conservation system would impose an undue economic 
      hardship.  Include any 
      supporting documentation. | 
| 8 Producers Signature 
      and Date | Enter the producers 
      signature and date. 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. | 
Items 9 - 22 are for FSA's use only.
| File Type | text/html | 
| File Modified | 0000-00-00 | 
| File Created | 0000-00-00 |