Submit the original of the completed form in person, by mail, fax, or e-mail attachment to the producer’s appropriate FSA Servicing Office.
Applicant must complete Items 4 through 13.
| 
					Fld Name / | Instruction | 
| 4 Name and Address of Asparagus Farm Operation… | Enter name and address of Asparagus Farm Operation, where the 2003 crop was produced. (Include Zip Code). | 
| 5 Name and Address of Asparagus Farm… | Enter name and address of Asparagus Farm Operation, where the 2007 crop was produced, if different from Item 5. (Include Zip Code). | 
| 6A Contact Producer’s Name and Address | Enter contact producer’s name and address, if different from Items 4 and 5. (Include Zip Code). | 
| 6B Contact Producer’s Telephone Number | Enter contact producer’s telephone number. (Include Area Code). | 
| 
					 Part B – Participant Certification and Signature(s) 
 
 
 
 | |
| 7 Producer’s Signature (By) | After reading the participation certification, enter your signature. 
 The form must be signed regardless of whether it is submitted by mail, fax, e-mail attachment, or delivered in person. | 
| 8 Title/ Relationship of Individual… | Enter Title/Relationship of Individual Signing in the Representative Capacity. | 
| 9 Date signed | 
					 Enter the date the producer signed the CCC-895. Enter as (MM-DD-YYYY). | 
| 10 2003 Fresh Crop Share (lbs) | Enter the quantity in pounds of the producers share of fresh-market asparagus produced during the 2003 crop year. | 
| 11 2003 Processed Market Share (lbs) | Enter the quantity in pounds of the producers share of processed- market asparagus produced during the 2003 crop year. | 
| 12 Producer of both 2003 & 2007 Crop | Check “YES” or “NO”, as applicable, to indicate whether the applicant produced both 2003 and 2007 crop asparagus. | 
| 13 Refused Payment | Check “YES” or “NO” to indicate whether the producer refuses any authorized payment. | 
Items 14 through 18 are for FSA use only.
	Page 
| File Type | application/msword | 
| File Title | Template Users: Select the text for each of the instruction components below and type over it without changing the font type, | 
| Author | Preferred Customer | 
| Last Modified By | gene.rosera | 
| File Modified | 2010-07-09 | 
| File Created | 2010-01-26 |