FSA-890 Continutation form - 2017 WILDFIRES AND HURRICANES INDEM

This form is available electronically. .

FSA-890 Continuation U.S. DEPARTMENT OF AGRICULTURE (proposal 3) Farm Service Agency WILDFIRES AND HURRICANES INDEMNITY PROGRAM (WHIP) APPLICATION (Continuation Sheet)

1. Producer’s Name      

2. Producer’s Address (City, State and Zip Code)      

3A. Administrative State Name/Code      

3B. Administrative County Name/Code      

Each producer must apply by administrative county.

PART A – NOTICE OF LOSS

The following are 2017 and 2018 crop(s), crop type(s), and intended use(s) suffered a loss due to the disaster event cause of loss that occurred January 1, 2017 – December 31, 2017. All Items must be completed.

4. What disaster event caused the loss?      

5. Disaster Event Dates (Beginning and Ending):      

6A. Crop Year

6B. Crop

6C. Crop Type

6D. Intended Use

6E. Practice

6F. Planting Period

7. Insured/NAP Coverage/Uninsured

8. Crop Loss, Prevented Planted, or Trees, Bushes, and Vines Loss (If prevented planted Part B must be completed)

9. COC Approved or Disapproved

    

     

     

     

     

     

Insured

Crop Loss

Approved Disapproved

NAP Coverage

Prevented Planting

Uninsured

Trees, Bushes and Vines Loss

Insured

Crop Loss

Approved Disapproved

NAP Coverage

Prevented Planting

Uninsured

Trees, Bushes and Vines Loss

Insured

Crop Loss

Approved Disapproved

NAP Coverage

Prevented Planting

Uninsured

Trees, Bushes and Vines Loss

PART B – RECORD OF MANAGEMENT FOR PREVENTED PLANTING CROPS

10A. Crop Year     

10B. Crop      

10C. Crop Type      

10D. Intended Use      

10E. Practice      

10F. Planting Period      

11. Purchased/delivered/arranged for. If “YES”, explain (Attach copies of receipts).

YES NO. A. Seed, Chemical, and Fertilizer

     

YES NO. B. Land Preparation Measures

     

12. What cultivation practices were employed on prevented planted acreage?      

13A. What was done with prevented planted acreage?      

13B. Final Planting Date      

FSA-890 Continuation (proposal 3) Page 2 of 4

PART A – NOTICE OF LOSS

The following are 2017 and 2018 crop(s), crop type(s), and intended use(s) suffered a loss due to the disaster event cause of loss that occurred January 1, 2017 – December 31, 2017. All Items must be completed.

4. What disaster event caused the loss?      

5. Disaster Event Dates (Beginning and Ending):      

6A. Crop Year

6B. Crop

6C. Crop Type

6D. Intended Use

6E. Practice

6F. Planting Period

7. Insured/NAP Coverage/Uninsured

8. Crop Loss, Prevented Planted, or Trees, Bushes, and Vines Loss (If prevented planted Part B must be completed)

9. COC Approved or Disapproved

    

     

     

     

     

     

Insured

Crop Loss

Approved Disapproved

NAP Coverage

Prevented Planting

Uninsured

Trees, Bushes and Vines Loss

Insured

Crop Loss

Approved Disapproved

NAP Coverage

Prevented Planting

Uninsured

Trees, Bushes and Vines Loss

Insured

Crop Loss

Approved Disapproved

NAP Coverage

Prevented Planting

Uninsured

Trees, Bushes and Vines Loss

    

     

     

     

     

     

Insured

Crop Loss

Approved Disapproved

NAP Coverage

Prevented Planting

Uninsured

Trees, Bushes and Vines Loss

    

     

     

     

     

     

Insured

Crop Loss

Approved Disapproved

NAP Coverage

Prevented Planting

Uninsured

Trees, Bushes and Vines Loss

PART B – RECORD OF MANAGEMENT FOR PREVENTED PLANTING CROPS

10A. Crop Year     

10B. Crop      

10C. Crop Type      

10D. Intended Use      

10E. Practice      

10F. Planting Period      

11. Purchased/delivered/arranged for. If “YES”, explain (Attach copies of receipts).

YES NO. A. Seed, Chemical, and Fertilizer

     

YES NO. B. Land Preparation Measures

     

12. What cultivation practices were employed on prevented planted acreage?      

13A. What was done with prevented planted acreage?      

13B. Final Planting Date      

FSA-890 Continuation (proposal 3) Page 3 of 4

PART C – PAY GROUPING INFORMATION

14. Producer Name      

15. Insured/NAP Coverage/Uninsured Insured NAP Coverage Uninsured

16. Administrative State Name/Code      

17. Administrative County Name/Code      

18. Physical State Name/Code

19. Physical County Name/Code

     

Same as Administrative

     

Same as Administrative

20. Crop Year     

21. Unit      

22. Pay Crop Code      

23. Pay Type Code      

24. Planting Period      

PART D – PRODUCTION INFORMATION

COC USE ONLY

25. Crop

26. Crop Type

27. Crushing District

28. Int. Use

29. Practice

30. Organic Status

31. Native Sod

32. Acres

33. Share

34. Stage

35. Unit of Measure

36. Production To Count

37. Yield (FL only)

38. Assigned or Adjusted Production

39. Secondary Use or Salvage Value

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

PART E – VALUE LOSS CROPS

COC USE ONLY

40. Crop

41. Crop Type

42. Share

43. Dollar Value Before Disaster

44. Dollar Value After Disaster

45. Ineligible Dollar Value

46. Salvage Value

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

PART F – TREES, BUSHES, & VINES

COC USE ONLY

47. Crop

48 Crop Type

49. Acres

50. Share

51. Tree Stage

52. Number in Tree Stage

53. Number Destroyed

54. Number Damaged

55. Adjusted Number in Tree Stage

56. Adjusted Number Destroyed

57. Adjusted Number Damaged

58. Salvage Value

     

     

     

     

I

     

     

     

     

     

     

     

II

     

     

     

     

     

     

     

III

     

     

     

     

     

     

     

     

     

     

     

I

     

     

     

     

     

     

     

II

     

     

     

     

     

     

     

III

     

     

     

     

     

     

     

     

     

     

     

I

     

     

     

     

     

     

     

II

     

     

     

     

     

     

     

III

     

     

     

     

     

     

     

PART G - COC APPROVAL OR DISAPPROVAL OF PAY GROUPING

59. COC Action: Approved Disapproved

FSAC-890 Continuation (proposal 3) Page 4 of 4

PART C – PAY GROUPING INFORMATION

14. Producer Name      

15. Insured/NAP Coverage/Uninsured Insured NAP Coverage Uninsured

16. Administrative State Name/Code      

17. Administrative County Name/Code      

18. Physical State Name/Code

19. Physical County Name/Code

     

Same as Administrative

     

Same as Administrative

20. Crop Year     

21. Unit      

22. Pay Crop Code      

23. Pay Type Code      

24. Planting Period      

PART D – PRODUCTION INFORMATION

COC USE ONLY

25. Crop

26. Crop Type

27. Crushing District

28. Int. Use

29. Practice

30. Organic Status

31. Native Sod

32. Acres

33. Share

34. Stage

35. Unit of Measure

36. Production To Count

37. Yield (FL only)

38. Assigned or Adjusted Production

39. Secondary Use or Salvage Value

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

PART E – VALUE LOSS CROPS

COC USE ONLY

40. Crop

41. Crop Type

42. Share

43. Dollar Value Before Disaster

44. Dollar Value After Disaster

45. Ineligible Dollar Value

46. Salvage Value

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

PART F – TREES, BUSHES, & VINES

COC USE ONLY

47. Crop

48 Crop Type

49. Acres

50. Share

51. Tree Stage

52. Number in Tree Stage

53. Number Destroyed

54. Number Damaged

55. Assigned or Adjusted Number in Tree Stage

56. Assigned or Adjusted Number Destroyed

57. Assigned or Adjusted Number Damaged

58. Salvage Value

     

     

     

     

I

     

     

     

     

     

     

     

II

     

     

     

     

     

     

     

III

     

     

     

     

     

     

     

     

     

     

     

I

     

     

     

     

     

     

     

II

     

     

     

     

     

     

     

III

     

     

     

     

     

     

     

     

     

     

     

I

     

     

     

     

     

     

     

II

     

     

     

     

     

     

     

III

     

     

     

     

     

     

     

PART G - COC APPROVAL OR DISAPPROVAL OF PAY GROUPING

59. COC Action: Approved Disapproved