Subject: Instructions For CCC-901
From: <Saved by Windows Internet Explorer 7>
Date: Mon, 20 Dec 2010 16:49:52 -0500

Instructions For CCC-901

MEMBER'S INFORMATION

Producers are required to complete this form to report information about
their farming operation. This information is used by FSA to determine the
ownership interest of entities for payment limitation purposes.

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.  To establish online access credentials
with USDA, follow the instructions provided at the USDA eForms web
site.

All items applicable to the payment entity must be completed by following
the instructions provided below.

Items 1-3

Fld Name /
Item No.

Instruction

1 and 2

County and State Name

Enter the name of the county and State where the
farming operation is located.
If in more than one county, enter the name of the county that has
been designated as the administrative county.

3

Program Year

Enter the current program year, or the year for which
this information is applicable.

Part A, Items 1-5

Fld Name /
Item No.

Instruction

Part A

Legal Entity Name

Enter the name of the legal entity earning the
payment.

1

Member’s Name

Enter the names of the members making up the legal
entity listed in Part A. (This
could be a person or a legal entity.)

2

Social Security Number/ Tax ID Number

Enter the social security number or tax identification
number of the members.

3

Address

Enter the address of each member of the legal
entity.

4

Percent Share

Enter the percent share of the legal entity that each
member owns.

5

Signature Authority

Check “YES” if the member has signature authority for
this entity.

Check “NO” if the member does not have signature
authority for       this
entity.

Part B

Embedded Legal Entities – If any member listed in Part A, Item 3 is a legal
entity (i.e., part of another partnership, corporation, etc.) list the members
of that legal entity in this item.  (If more than one member is a legal
entity, use a separate, supplemental sheet to provide the requested information
for each embedded legal entity.)

Part B, Items 1-5

Fld Name /
Item No.

Instruction

Part B

Embedded Legal Entity Name

Enter the name of the embedded legal entity that is a
member of the legal entity entered in Part A.

1

Member’s Name

Enter the names of the members making up the legal
entity listed in  Part B. (This could be a person or a legal
entity.)

2

Social Security/Tax ID Number

Enter the social security number or tax identification
number of the members.

3

Address

Enter the address of each member of the
entity.

4

Percent Share

Enter the percent share of the legal entity that each
member owns.

5

Signature Authority

Check “YES” if the member has signature authority for
this entity.

Check “NO” if the member does not have signature
authority for
this entity.

Part C

Embedded Legal Entities – If any member listed in Part B, Item 7 is a legal
entity (i.e., part of another partnership, corporation, etc.) lists the members
of that legal entity in this item.  (If more than one member is a legal
entity, use a separate, supplemental sheet to provide the requested information
for each embedded legal entity.)

Part C, Items 1-5

Field Name /
Item No.

Instruction

Part C

Embedded Legal Entity Name

Enter the name of the embedded legal entity that is a
member of the legal entity entered in Part B.

1

Member’s Name

Enter the names of the members making up the legal
entity listed in  Part C. (This could be a person or  legal
entity.)

2

Social Security/Tax ID Number

Enter the social security number or tax identification
number of the members.

3

Address

Enter the address of each member(s).

4

Percent Share

Enter the percent share of the legal entity that each
member owns.

5

Signature Authority

Check “YES” if the member has signature authority for
this entity.

Check “NO” if the member does not have signature
authority for
this entity.

Part D

Embedded Legal Entities – If any member listed in Part C, Item 11 is a legal
entity (i.e., part of another partnership, corporation, etc.) list the members
of that legal entity in this item.
(If more than one member is a legal entity, use a separate, supplemental
sheet to provide the requested information for each embedded legal entity.)

Part D, Items 1-5

Fld Name /
Item No.

Instruction

Part D

Embedded Legal Entity Name

Enter the name of the embedded legal entity that is a
member of the legal entity entered in Part C.

1

Member’s Name

Enter the names of the members making up the legal
entity listed in Part D. (This
could be a person or a legal entity.)

2

Social Security/ Tax ID Number

Enter the social security number or tax identification
number of the member(s).

3

Address

Enter the address of each member(s).

4

Percent Share

Enter the percent share of the entity that each member
owns.

5

Signature Authority

Check “YES” if the member has signature authority for
this entity.

Check “NO” if the member does not have signature
authority for
this entity.

Part E, Items 1-6  Minor Members or
Shareholders

Fld Name / Item
No.

Instruction

Minor
members

If none of the members listed Parts A-D is a minor,
check “N/A” (not applicable), then GO TO Part F.

1 – 5

Minor Members or Shareholders

If any member listed in Parts A-D is a minor, provide
the following information about that member:

1)   Minor’s name

2)   Minor’s date of birth

3)
Name
of the minor’s parent or guardian

4)
Address of the parent or
guardian

5)
Taxpayer ID number of the parent or guardian

Note: If the complete taxpayer ID
number is already on file at

FSA, only the last 4 digits are required.

6(a) – 6(d)

Separate Status of Minors …

a)
Check “YES” if any minor listed in Part E is a
producer on a farm and the parent or guardian has no interest.  Check “NO” if the minor is a
producer on a farm and the parent or guardian has an interest in the
farming operation.

b)  Check
“YES” if the minor listed in Part E maintains a separate

household
from the parent or guardian and personally carries out all

farming
activities with respect to the minor’s own farming

operation,
including maintaining separate accounting.  Check “NO”

if the
minor does not maintain a separate household from the parent

or
guardian and does not personally carry out all farming activities

with
respect to the minor’s own farming operation, including

maintaining separate accounting

c)  Check
“YES” if the minor listed in Part E who is represented by a

court-appointed
guardian or conservator, live in a household other

than the
parents’ household(s), and have a vested ownership in the

farm.  Check “NO” if the minor, who is
represented by a court-

appointed
guardian or conservator, does not live in a separate

household other
than the parents’ household(s), and does not have a

vested ownership
in the farm.

d)
If “YES” is checked for all Items 6(a) through
6(c), write the name of the minor in the space provided at 6(d).

Part F, Items 1-3 Certification

Field Name/ Item
No.

Instruction

1

Signature (By)

An individual member, or an authorized representative
of the entity identified in Part A, shall sign the
certification.

2

Title/

Relationship

If an authorized representative for the entity
identified in Part A signs this document, use this field to show the
individual’s representative capacity.  (For example, “agent” or
“attorney-in-fact.”)

3

Date

Enter the date the form was
signed.