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Home My WebLink About20202672.tiff Please have New Owners (all on deed ) of CRP Acres Complete and Return to FSA with Copy of Recorded Deed This form is available electronically. Forms Approved - OMB Nos . 0560-0265 and 0560-0289 AD -2047 U .S. DEPARTMENT OF AGRICULTURE (03-30- 17) Farm Service Agency Rural Development Natural Resources Conservation Service CUSTOMER DATA WORKSHEET REQUEST FOR BUSINESS PARTNER RECORD CHANGE See Pa • e 2 for Privacy Act and Paperwork Reduction Act Statements PART A - CUSTOMER INFORMATION 1A. Customer's Full Name or Business Name 1B . Customer or Business Address (Including Zip Code) band oc ('.,o OCflUi ( ssCe)tQVt O U-kid CSbL4 1150 O S#-r-et f Al it Vrn-nnav CS'4 ,- £ trak , CA) ?CAPS ! 1C . Home Telephone Number (Area Code) 1D . Business Telephone Number (Area Code) 1E . Other Telephone Number (Area Code) q70 - 35(0 -- 14 cw 2 . SSN or Tax ID Number (9 Digits) 3 . E-Mail Address gy _ 6lo0o gi e8ocerCernfracts 104,/cli v. cal , 4A. Does the customer want to receive mail by 4B . Does the customer want to receive 4C . Does the customer want to receive USPS? e-mails via GovDelivery? sensitive (but non-PII ) Producer or Farm Specific related emails? YES NO X,, YES NO YES XI NO 5 . Producer is Customer of One or More of the Following Agencies . (Check Appropriate Agency(ies) below.) FSA RD NRCS Not Participating 6. Is the Customer a Multi-County Producer? YES (If "YES, " list States and/or Counties below:) NO 7 . Reason for Request (Check appropriate box(es) below.) X New Producer Address Change Telephone Change Sale/Purchase Life Event Other (Specify) : 8 . Enter the name of the customer requesting the record change(s) . If documentation is received by Fax or from a trusted source (i .e. . USPS) . attach documentation to this form . Only Part A, Item 1A and Part B shall be completed . If the request was received by telephone . complete applicable blocks necessary to document the change(s) and enter the requestor's name in Item 8A. Requestor' s signature is not required . (The only time the customer is required to sign Item 8B is when they are physically at a Service Center and providing FSA with applicable information.) 8A. Name of Customer Requesting Change 8B . Customer Signature 8C . Date of Record Change (MM-DD- YYYY) - 26 - -2401t) PART B - SERVICE CENTER ACTION 9A. Agency Who Received Request: 9B . Initials of Employee Receiving 9C . Date Service Center Employee Received (Check one below) Request (If Different than Item 12A) the Request (MM-DD- YYYY) FSA J NRCS RD 10. How the Request for Change was Received : Office Visit Telephone FAX USPS Other (Specify) : 11 . Remarks if Applicable : Farm Service Agency 4302 West 9th Street Road Greeley , CO 80634 12A. Signature of Employee Updating Business Partner if not initialed in 12B . Date Service Center Employee Updating Business Partner Item 9B . (MM-DD-YYYY) FOR DISTRICT DIRECTOR/AREA CONSERVATIONIST USE ONLY . (OPTIONAL) 13A . I concur/do not concur the above items have been properly updated. Concur Do Not Concur 13B . Name of District Director/Area Conservationist for Spot Check 13C . Signature of District Director/Area Conservationist for Spot Check 13D . Title 13E . Date (MM-DD- YYYY) anelZ t ids bad& err) Ot 695) Vaige3G g_3(_ 20 � F.., ;.c � O AD -2047 (03-3,p- 17) Page 2 of 2 NOTE : The following statement is made in accordance with the Privacy Act of 1974 (5 USC 552a - as amended). The authority for requesting the information identified on this form is the Computer Security Act of 1987 (Pub. L. 100-235) , OMB Circular A- 123. Federal Managers ' Financial Integrity Act of 1982, and Privacy Act of 1974 (5 USC 552a - as amended) . The information will be used to document a request by the producer for changes to the business partner record. The information collected on this form may be disclosed to other Federal, State, Local government agencies, Tribal agencies, and nongovernmental entities that have been authorized access to the information by statute or regulation and/or as described in applicable Routine Uses identified in the System of Records Notices for USDA/FSA-2, Farm Records File (Automated). USDA/NRCS- 1 , Landowner, Operator, Producer, Cooperator, or Participant Files, and USDA/RD- 1 . Applicant, Borrower, Grantee, or Tenant File. Providing the requested information is voluntary. However, failure to furnish the requested information will result in a determination of ineligibility to request changes within the business partner record. According to the Paperwork Reduction Act of 1995. an agency may not conduct or sponsor. and a person is not required to respond to. a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0560-0265 and 0560-0289. The time required to complete this information collection is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources. gathering and maintaining the data needed, and completing and reviewing the collection of information. The provisions of criminal and civil fraud, privacy and other statutes may be applicable to the information provided. RETURN THIS COMPLETED FORM TO YOUR COUNTY FSA OFFICE. In accordance with Federal civil rights law and U. S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion. sex, gender identity (including gender expression) . sexual orientation, disability, age. marital status. family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all programs) . Remedies and complaint filing deadlines vary by program or incident. Persons with disabilities who require alternative means of communication for program information (e. g. , Braille, large print, audiotape. American Sign Language, etc.) should contact the responsible Agency or USDA 's TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English. To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at http://Www. ascrusda. gov/complaint filing cust. html and at any USDA office or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form. call (866) 632-9992. Submit your completed form or letter to USDA by: (1) mail: U. S. Department of Agriculture Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue, SW Washington. D. C. 20250-9410; (2) fax: (202) 690- 7442; or (3) email: program. intake@usda. gov. USDA is an equal opportunity provider, employer, and lender. This form is available electronically. CCC -931C U .S. DEPARTMENT OF AGRICULTURE 1 . Return completed form to: ( 11 -05- 12) Commodity Credit Corporation Weld County Farm Service Agency AVERAGE ADJUSTED GROSS INCOME (AGI ) CERTIFICATION 4302 West 9th Street Road AND CONSENT TO DISCLOSURE OF TAX INFORMATION Greeley , CO 80634 970 - 356 - 8097 Ext 2 For Successors to Conservation Program Contracts and Agreements Only (Name and address of FSA county office or USDA Service Center) NOTE: The following statement is made in accordance with the Privacy Act of 1974 (5 USC 552a - as amended) The authority for requesting the information identified on this form is 7 CFR Part 1400. the Commodity Credit Corporation Charter Act (15 U S C. 714 et seq.), and the Food. Conservation. and Energy Act of 2008 (Pub. L 110-246) The information will be used to determine eligibility for program benefits. The information collected on this form may be disclosed to other Federal. State. Local government agencies. Tribal agencies and nongovernmental entities that have been authonzed access to the information by statute or regulation and/or as described in applicable Routine Uses identified in the System of Records Notice for USDA/FSA-2. Farm Records File (Automated). Providing the requested information is voluntary However, failure to furnish the requested information will result in a determination of ineligibility for program benefits. This information collection is exempted from the Paperwork Reduction Act. as it is required for the administration of the Food. Conservation. and Energy Act of 2008 (Pub L 110-246. Title I. Subtitle F - Administration). The provisions of appropriate criminal and civil fraud, privacy. and other statutes may be applicable to the information provided PLEASE RETURN COMPLETED FORM TO FSA AT THE ABOVE ADDRESS. 2. Name and Address of Individual or Legal Entity (Including Zip Code) 3. Taxpayer Identification Number (TIN) (Social Security Number for Bea r� nretd Individual; or Employer Identification Number for Legal Entity) crC Mi55tvyc -s off- WCowitti Mitt, Fr a/ thotAss II so O Strad- Grion.44 Co 8olp31 24 - 60007 Use the samee and address as used for the tax return s •ecifred in Part B. PART A - CERTIFICATION OF AVERAGE ADJUSTED GROSS INCOME 4. Enter the program year for contract or agreement succession 2 O The period for calculation of the average AGI will be of the 3 taxable years preceding the most immediately preceding complete A. 20 taxable year for which benefits are requested . For example , if the year of succession entered is 2013 . the 3-year period for the calculation of the average AGI will be the taxable years of 2011 , 2010 and 2009 . 5. I certify that the average adjusted gross income (both 6. Of the average adjusted gross income (both farm farm and nonfarm income) of the individual or legal and nonfarm income) of the individual or legal NOTE : If at least 66_ 66 percent of the average adjusted gross income of the individual or legal entity in Item 2 (for the year selected in Item 4) was : entity in Item 2 (for the year selected in Item 4) , entity is derived from farming. ranching or was at least 66.66 percent from farming , forestry operation, then income from the sale A. .j Less than (or equal to) $1 , 000,000 ranching or forestry operations? of farm equipment or production inputs and services to farmers. ranchers and foresters B. More than $1 , 000, 000 A. YES B. 4 NO must be included as farm income 7. I certify that the average adjusted gross farm income of the individual or legal entity in Item 2 (for the program year selected in Item 4) was : A. Ex, Less than (or equal to) $750, 000 B. More than $750,000 8. I certify that the average adjusted gross nonfarm income of the individual or legal entity in Item 2 (for the program year selected in Item 4) was : A. X, Less than (or equal to) $500,000 B. More than $500, 000 but less than (or equal to) $1 ,000, 000 C. More than $1 , 000, 000 PART B — CONSENT TO DISCLOSURE OF TAX INFORMATION Pursuant to 26 U.S.C. §6103, I hereby authorize the Internal Revenue Service (IRS) to review the following items of " return information" (as defined in 26 U. S. C. §6103(b)(2)) from the returns (as specified below) of the individual or legal entity identified in Item 2 for the taxable years indicated in Item 4: Form 1040 and 1040NR filers; farm income or loss; adjusted gross income Form 1120, 1120A, 1120C filers: charitable contributions, taxable income Form 1041 filers; farm income or loss, charitable contributions, income distribution deductions, exemptions , adjusted total income ; total income Form 1120S filers : ordinary business income Form 1065 filers ; guaranteed payments to partners , ordinary business income Form 990T: unrelated business taxable income I understand the IRS will review these items of return information in order to perform calculations, the results of which I authorize to be disclosed to officers and employees of the United States Department of Agriculture (USDA) for use in determining the individual's or legal entity's eligibility for specified payments for various commodity and conservation programs. The calculations performed by the IRS use a methodology prescribed by the USDA _ In addition, I am aware that the USDA may use the information received for compliance purposes related to this eligibility determination , including referrals to the Department of Justice. Specially, the IRS will disclose to the USDA the individual's or legal entity's name and TIN , and inform the USDA if, pursuant to its calculations, the average Adjusted Gross Income (AGI) is above or below eligibility requirements as prescribed by the Food , Conservation and Energy Act of 2008. The IRS will also disclose to the USDA the type of return from which the information used for the calculations was obtained If the IRS is unable to locate a return that matches the taxpayer identity information provided above, or if IRS records indicate that the specified return has not been filed , for any of the taxable years indicated , the IRS may disclose that it was unable to locate a return, or that a return was not filed , for those years. whichever is applicable An approved Power of Attorney (Form FSA-211, on file with USDA cannot be used as evidence of signature authority when completing this form. By signing this form : _ I acknowledge that I have read and reviewed all definitions and requirements on Page 2 of this form ; _ I certify that all information contained within this certification is true and correct; and is consistent with the tax returns filed with the IRS ; I agree to authorize CCC to obtain tax data from the IRS for AGI compliance verification purposes by filing this form ; I am aware that without this consent to disclosure, the returns and return information of the individual or legal entity identified in Item 2 are confidential and are protected by law under the Internal Revenue Code; _ I certify that I am authorized under applicable state law to execute this consent on behalf of the legal entity identified in Item 2 (for legal entity only). 9. Signature (By) 10 . Title/Relationship of the Individual if Signing in a 11 . Date (MM-DD- YYYY) Representative Capacity for a legal entity eir(L121.4 114•01 - 2 6- 2 0 2v The U. S. Department of Agriculture (USDA) prohibits discrimination in all of its programs and activities on the basis of race. color national origin. age. disability and where applicable, sex, marital status, familial status. parental status. religion, sexual orientation. political beliefs, genetic information, reprisal, or because all or part of an individual's income is derived from any public assistance program. (Not a// prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact USDA 's TARGET Center at (202) 720-2600 (voice and TDD) . To file a complaint of discrimination. write to USDA. Assistant Secretary for Civil Rights, Office of the Assistant Secretary for Civil Rights. 1400 independence Avenue. S. W . Stop 9410. Washington. DC 20250-9410. or call toll-free at (866) 632-9992 (English) or (800) 877-8339 (TDD) or (866) 377-8642 (English Federal-relay) or (800) 845-6136 (Spanish Federal-relay). USDA is an equal opportunity provider and employer. CCC-931C (11-05-12) Page 2 of 2 GENERAL INFORMATION ON AVERAGE ADJUSTED GROSS INCOME — PART A Individuals or legal entities that receive benefits under most commodity and conservation programs administered by CCC cannot have incomes that exceed certain limits set by law For entities both the entity itself and its members cannot exceed the income limitations If a member whether an individual or an entity of an entity exceeds the limitations payments to that entity will be commensurately reduced according to that member's direct or indirect ownership share in the entity (All members of the entity must also submit this form to verify income limitations are met ) Adjusted Gross Income is the individuals or legal entity s IRS -reported adjusted gross income consisting of both farm and nonfarm income A three year average of that income will be computed for the three years of the relevant base penod identified on the first page of this form to determine eligibility for the applicable program year Individuals or legal entities with average adjusted gross income greater than $1 million shall be ineligible for direct payments under the Direct and Counter -cyclical Program Adjusted Gross Farm Income is the part of the yearly adjusted gross income that is farm income The amount is computed separately for each year and then averaged Farm income means income related to the following production of crops, livestock fish and aquaculture for food the feeding and reanng of livestock products produced or derived from livestock production of specialty crops and unfinished raw forestry products processing packing storing and transporting farm, ranch and forestry commodities including renewable energy production of farm -based renewable energy the sale of land used for agnculture sale of land or sale of easements and development nghts to agricultural land water and hunting nghts and environmental benefits rental or lease of land or equipment used in farming, ranching, forestry operation payments and benefits from risk management practices crop insurance indemnities catastrophic nsk protection plans conservation program and government farm program payments Individuals or legal entities with average adjusted gross farm income greater than $750,000 shall be ineligible for direct payments under the Direct and Counter -cyclical Program Adjusted Gross Nonfarm Income is the difference for the year between the filer's adjusted gross income and the filer's adjusted gross farm income The difference is computed separately for each year and then averaged Individuals or legal entities with average adjusted gross nonfarm income that exceeds $500,000 shall be ineligible for commodity program payments price support benefits disaster assistance programs and for the Milk Income Loss Compensation Program Additionally individuals or legal entities with average adjusted gross nonfarm income exceeding $1 million will be ineligible for new contracts or participation in conservation programs after October 1 2008 unless at least 66 66% of their total average adjusted gross income (sum of farm and nonfarm income) is generated from activities related to farming HOW TO DETERMINE ADJUSTED GROSS INCOME Individual — Internal Revenue Service (IRS) Form 1040 filers specific lines on that form represent the adjusted gross income and the income from farming ranching or forestry operations Trust or Estate — the adjusted gross income is the total income and chantable contnbutions reported to IRS Corporation — the adjusted gross income is the total of the final taxable income and any charitable contributions reported to IRS Limited Partnership (LP), Limited Liability Company (LLC), Limited Liability Partnership (LLP) or Similar Entity — the adjusted gross income is the total income from trade or business activities plus guaranteed payments to the members as reported to the IRS Tax-exempt Organization — the adjusted gross income is the unrelated business taxable income excluding any income from non-commercial activities as reported to the IRS GENERAL INFORMATION ON CONSENT TO DISCLOSURE OF TAX INFORMATION — PART B This consent allows IRS s access to and use of certain items of return information to perform calculations using a methodology prescribed by the USDA that will assist USDA in its verification of a program participants compliance with the adjusted gross income (AGI) limitations necessary for participation in, and receipt of, commodity, conservation, price support or disaster program benefits This consent also permits the USDA to receive certain items of return information for its eligibility determination This consent authorizes the disclosure of these items of return information for only the time period specified Each item of information requested on this form is needed for the IRS to (1) locate, and verify your tax information, (2) perform the requisite Average AGI calculations and (3) provide the USDA with the legal entity's name and Taxpayer Identification Number (TIN), the type of return from which the specified items were located for use in the calculation and whether or not the average AGI is above or below eligibility requirements The IRS will not provide the USDA with any of the items specified on this consent form that it uses to perform the calculations or the average AGI figure This form can only be signed by the person authorized under state law to sign this consent for the legal entity identified in Item 2 An approved Power of Attorney (Form FSA-211) on file with USDA cannot be used as evidence of signature authonty when completing this form INSTRUCTIONS FOR COMPLETION OF CCC-931C ItemlNo;IFieldiname' - • q Instr , r .• —_ 4:,. uc�i'on —} Enter the name and address of the FSA county office or USDA service center where the completed CCC-931 C will be submitted 1 Return Completed Form To 2 Person or Legal Entity's Name and Address Enter the person's or legal entity's name and address for commodity, conservation, price support or disaster program benefits Enter the name and address as it appeared on the IRS tax retums filed for the taxable years specified in Item 4 3 Taxpayer Identification Number ' In the format provided, enter the complete taxpayer identification number of the person or legal entity identified in Item 2 This will be either a Social Secunty Number or Taxpayer Identification Number 4 Program Year Enter the year for which program benefits are being requested The program year entered determines the 3 -year period used for the calculation of the average adjusted gross income (AGI) for payment eligibility and the years for which this consent allows access to tax information 5 Average Adjusted Gross Income Select the box next to the response that describes the average adjusted gross income for the applicable 3 -year period for the program year entered in Item 4 Select only one response 6 Average Adjusted Gross Income from Farming, Ranching or Forestry Select the appropriate response to indicate whether or not at least 66 66 percent of the average adjusted gross income was derived from farming, ranching, or forestry operations during the applicable 3 -year penod entered in Item 4 Select "YES" or "NO" as applicable 7 Average Adjusted Gross Farm Income Select the box next to the response that describes the average adjusted gross farm income for the applicable 3 -year period for the program year entered in Item 4 Select only one response 8 Average Adjusted Gross Nonfarm Income Select the box next to the response that describes the average adjusted gross nonfarm income for the applicable 3 -year period for the program year entered in Item 4 Select only one response 9 Signature Read the acknowledgments, responsibilities and authorizations, before affixing your signature 10 Title/Relationship Enter title or relationship to the legal entity identified in Item 2 11 Date Enter the signature date in month day and year This form must be returned to FSA within 90 days of the signature date for the consent to be valid Foy. 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C< �"'-C r +'1 PARTICIPANT Michael McCrery COUNTY AND STATE WELD, COLORADO PROGRAM AND CONTRACT NUMBER 2140E FUND CODE CRP 39 LAND UNITS OR LEGAL DESCRIPTION Tract 15334 WATERSHED ACRES 42 69 EXPIRATION DATE 9130/2020 Contract I'P.milt...'IMIrn.Miet`wiiiYi iLtt iICOr rCrci .340 Y e.a C e 1;;,,P= z sky Yap �w- a Hw b �L. jr 'k'`fa "�i1: '�'- <",<" �..'y a, .7 ri:4,ti r to P�( ��'� ;�r.�. , k�"�'�r4ti.�,.��'f1�`v.� e- �:x�'4. ii��1�,-A�� r�'��'>"t�ts�-�.��,.?��, Establish a temporary cover of milo, millet, sudangrass or sorghum to facilitate the establishment of permanent conservation cover when existing residue cover is insufficient Refer to the Cover Crop (340) Statement of Work and Conservation Practice Job Sheet for specific planning requirements if existing crop residue is sufficient and approved by NRCS, the cover will be maintained free of weeds prior to planting permanent cover Tract 15334 Contract Item PLANNED CONSERVATION TREATMENT Planned Amount Unit Cost Cost Share) Rate/ Method Completion Schedule and Estimated Cost Share or Payment by Year 2011 $ 2012 $ 2013 $ 2014 $ 2015 $ 2016 $ 2017 $ 2016 $ 2019 $ 2020 $ 1 Cover Crop (340) $1,345 000000 1a Seedbed Prep - Chemical (S1 0) 42 7 ac $6 50/Ac FR 277 0 0 0 0 0 0 0 0 l b Seedbed Prep - Mechanical (S10D) 42 7 ac $4 50/Ac FR 192 0 0 0 0 0 0 0 0 1c Seedbed Prep - Mechanical (S10D) 42 7 ac $4 50/Ac FR 192 0 0 0 0 0 0 0 0 1d Seedbed Prep - Mechanical (S10D) 42 7 ac $4 50/Ac FR 192 0 0 0 0 0 0 0 0 le Seedbed Prep - Mechanical (S10D) 42 7 ac $4 50/Ac FR 192 0 0 D 0 0 0 0 0 1 f Seed & Seeding - Cover crop (S05) 42 7 ac $7 00/Ac 50% AM 299 0 0 0 0 0 0 0 0 ContfaCt Item'2 '� K- 1 "k �`i '� Conseriation`CtiVeC 32 � '•`'»r�-l5G= 4r� y% 3a A +rte? t 44'.41 r_r. 9<<44 r :3c r �._- .cn �• ,x o a'b� �,c. t..2:`SI {_..:.: c ( 7) s �:..� � x�sr. X a�* '=�=-�Fu.y .r,F��>'�jl�f a�v'L',ti4.,��r� f -.3 ' ,�ttr�� x;'� Establish permanent vegetative cover on land retired from agricultural production Seed mixes will be selected from the applicable CRP Seeding Matrix and will meet CRP policy for the identified CP practice Refer to CO-ECS-5 for species mix guidelines Tract 15334 Contract Item PLANNED CONSERVATION TREATMENT Planned Amount Unit Cost Cost Share Rate/ Method Completion Schedule and Estimated Cost Share or Payment by Year 2011 $ 2012 $ 2013 $ 2014 $ 2015 $ 2016 $ 2017 $ 2018 $ 2019 $ 2020 $ 2 2a 2b Conservation Cover (327) Seedbed Prep - Chemical (S10) Seed & Seeding (S03) 42 7 ac 42 7 ac $6 50/Ac $45 50/Ac,_ $2,220 FR 50% AM 0 0 277 1,942 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Contract Item 3 t . r,,_, Herbaceous Weed Control (315)_ t, tA. fl , Manage infestations of weeds that may adversely impact desired vegetation All methods of pest management must comply with federal, state and local regulations Refer to Herbaceous Weed Control (315) Standard and Specification for specific planning requirements Cost share available for 12 months after grass planting Tract 15334 Contract item PLANNED CONSERVATION TREATMENT Planned Amount Unit Cost Cost Share Rate/ Method Completion -Schedule and Estimated Cost Share or Payment by Year 2011 $ 2012 $ 2013 $ 2014 $ 2015 $ 2016 $ 2017 $ 2018 $ 2019 $ 2020 $ 3 3a 3b Herbaceous Weed Control (315) Weed Control - Cover Crop - Prior to grass planting (W01A) Weed Control - Mechancial or Chemical - After grass planting (W02), 42 7 ac 42 7 ac $4 50/Ac $5 00/Ac $406 FR FR 0 0 192 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 PAGE 2 OF 3 US', E � FG#I T � i : 5,comS5 . O� its ®Rest► ouL" PIERA':IO1)S Mr.:..- x�^- ,4� `e-` '',.�, L - NRC5;CP 1155Y ,, AT RA 'RES©U CES CO ER RITo �'SERV Gaz1,:;w� 5 ' r 'S 4c,:t` . ;�' `- -t�,, `d _`-:et ,r'. r.'.y -pia- -1?-01, t'",-.:• r, -`l_ PARTICIPANT Michael McCrary COUNTY AND STATE WELD COLORADO PROGRAM AND CONTRACT NUMBER 2140E FUND CODE CRP 39 LAND UNITS OR LEGAL DESCRIPTION Tract 15334 WATERSHED ACRES 42 89 EXPIRATION DATE 9/30/2018 Contract item444v-f.7: F All haying and livestock grazing will be excluded from the designated area for the life of the CRP contract, unless authorized by the FSA County Committee for Emergency or Managed Grazing or Managed Haying Refer to Access Control (472) Job Sheet for more specifications i ram 17'.34 Cost Share Corn letlon Schedule and Estimated Cost Share or Payment b Year Contract Planned Unit Rate! 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 Item PLANNED CONSERVATION TREATMENT Amount Cost Method $ $ $ $ $ $ $ $ $ $ 4 Access Control (472) 42 7 ac $0 427ac NC NC 427ac 427ac 427ac 427ac 427ac 427ac 427ac 427ac 00ac 00ac Contract Item 5';,wUpla`rid Wildlife Habitat Management Land enrolled in CRP will be managed to maintain or improve desired habitat values for grassland birds and other identified wildlife species No maintenance practices shall be applied after vegetation establishment during the nesting period of March 15th — July 15th Refer to Upland Wildlife Habitat Management (646) Standard and job sheet for additional guidelines on wildlife habitat quality criteria and assessment IraCI 17334 Cost Share Corn lotion Schedule and Estimated Cost Share or Payment b Year Contract Planned Unit Rate/ 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 Item PLANNED CONSERVATION TREATMENT Amount Cost Method $ $ $ $ $ $ $ $ $ $ 5 Upland Wildlife Habitat Management (645) 42 7 ac $0 427ac NC NC 427ac 427ac 427ac 427ac 427ac 427ac 427ac 427ac 00ac 00ac Contract Item 6 N - x s" r -g; - •Early Successional Habitat Development/Management (647)"s or - M f .rf i•W All CRP contracts in sign-up 26 and later are required to perform a minimum of one mid -contract management activity during years 4-6 of the contract to ensure plant diversity and wildlife benefits Mid -contract management activities include disking, Interseeding, prescribed burning, managed grazing and managed haying Refer to Early Successional Wildlife Habitat Management (647) Mid -Contract Management Job sheet or Worksheet for practice planning documentation iracl Contract Item 1oaa% PLANNED CONSERVATION TREATMENT Planned Amount Unit Cost Cost Share Rate! Method Completion Schedule and Estimated Cost Share or Payment by Year 2011 $ 2012 $ 2013 $ 2014 $ 2015 $ 2016 $ 2017 $ 2018 $ 2019 $ 2020 $ 6 Early Successional Habitat Development 42 7 ac $3,415 6a Mid -contract Management - Routine Grazing 42 7 ac NC NC 0 0 0 0 42 7 ac 0 0 0 0 0 6b Mid -contract Management - Managed Harvesting 42 7 ac NC NC 0 0 0 0 42 7 ac 0 0 0 0 0 6c Mid -contract Management - Interseeding (S07) 42 7 ac $45 50/Ac 50% AM 0 0 0 0 1,942 0 0 0 0 0 6d Mid -contract Management - Prescribed Burning (M01) 42 7 ac $30 00/Ac FR 0 0 0 0 1,281 0 0 0 0 0 6e Mid -contract Management - Light Tillage (M02) _ 42 7 ac $4 50/Ac FR 0 0 0 0 192 0 0 0 0 0 tilRATURAL'ffithil U talE -45%11411"4 E l ltdt aEs -4! ,-.-' ;,,' Al 0 S7 I t I?! 1Q rG - : ' ,' 1953 .PARROIP-AFIT Daft3° ND- STATE _ _ i i.arm16tr.Dtery _ 1 t ,,OOL(76JAIlO - P $4Gfi t D �4� �GrN 9 3 FUiCR ly fl DRP,38 rAlta(AMOR LEGAL DESCRIPTION r . Ti - 1I_ W1�TERSI1EL A '1EdIll CTTQe DATE 'efJG2JJ1S = �, ik -. n o - Tol7J1_COBt Eater Teratily � ` ' 201112i19 ' 202O 1 Yam. Arn 2011 '1.345 2092 201 S' - 1414 I Ibig 2b118' 241? '_ 2,025 .,aunlit” _ G 0 ,G41S 0 ' 0 4 cr, ti 1,3115 NOTES- A,AiNeinsnurnbelatntram FfRC5CPA-t15 be Igirtletkaufatpartofhe=nilactfhprotect ablation. B.1061lillgill1W6d, the s>pftsa tlon# cdeltlJEIttanl p toi* Iliknkiffell+lemAmtlKbairt2mEabnledItytfla artl4antetnacusltolhepavEvnmead CAI oestfkflatilliteateltaltOSell orr e'lt Be_ l $C} with tha killo•Wttraexoppltvnv • AA'mAtuat tg1 o'eoacearlavotata;Ot. ERoR iar€ PR liicagaeittalm polklon t's11are AM =AMAcost riptioera' th etjfadaflaxiimum D lay*Wpm lea Paatatanlar5{pbU+todoeere allo �bflhis nsereattdn Ptah Incglt€1fngYfifatarm NRCS•CPA-11.55'dredbsgt s egmplywill Ma Wins ltandrfsnnsllera of Pattlel 41,V-. ' i iis w 4ratiiacLhte' Y r„f v o SIgnahare Vedp Sragattire D z Dal SltpratIlral of Reelavilnft =Walls NIRMAppre APpf4wNy try rJ4rrSJbrvaitori DialrtriRdpreseritatlye prrattlfft Date' SJ�eattare / bale 7?/, Pt10LIC URN 8TA1ERtert - - Aessureint; rataa-Paparvaqt,reatiOian Acts 194 43.n t•maya *o¢rtdadorap04? andaperealAri<ntrocjulratl- MAI collEpdon.atinimrmBrddvnlewtd layd a utid-contonatindrrihar The gua.OMB mrthflmadlortogiiiainror n-coug 8onarsb57 14 Thviffne refidirecuaciamigatelnylat61 a, t afedfa,a a475arencitertpet hi.4Ronte,Brcludantne.tmefdt laut rar grncbActeat araeablarretestafalialatteurcecgathalto endirnainlahno datamaded, andpantOllna and telihNolng SieCdUeottoilint agean, P�N+Ac9� a11G�lt -the alMmIslam.gramltdein ;cord3 1164 Gdir: c, k�LLillt4fir fS. } FaavaNngIV-th rornandanisidirritimhoweverregurClodndstreartedoa IntaytabatayAresatiMf allairkedg prwithdaaaal awl: W.4)Oer fin@lialatatgratatter511110Jhlonaartallptio tle.e. mrtheli alhirlsst3A.Vadtta, IlItanfarrial ReVedde Beano , mBDap dinar l3br.9rtaceo rdteratale-arlederatizte eararnelnada99nrles, Gal raapentarel rdets a -Court r6.30486d1T,*WAdritestairiittlobilla WMIONYISIAIMINMA0Il,IgThrIEVate 'THID. . inontaikAMIlfterr (U.SakiaretlfilasilikairplialktOktaiLfod tDadAcVVr Dnlp@ sitgrace.,cater,negian At0.ttaaRe bje ,81#Q @dabkac,marital slaJr, ,thmrlysfa n, Odtarr I0gtpa,Tellan;sexualarsttf h'6ii,*naltirrra+radranmastrat6afiefe,reotetar eatiforapartafantadh is 'radkrivetllea r rowiarallitaa,,taicoaproyarT4N tdllprei�rrbitee ' ePpJy a�lg4 aAIP lnsst ballet autaait'alveterdeirDetrialttrl♦1� ntlenleaianibr:rmgtamDearauttlbaOralta, tlM,;�.�JR,Jshouw r MD Mkt au<d_ , TofiIF n Jt tr,a00T+2{ir-`FTd0rat fi�gn72� !��'�!�n�brn,+��st�,olraain�o��t�J��m.weed+esar>te�wru��,w,.t�satfnpt�at�Jfl�6P�1rsa�D.nr�alLi�stsd}7>35.s4zf++06tarfn2}xtB- ttgegt0h1 iikVeep uif irGh': 6smA PAS !CPS This form is available electronically CRP -1 (Appendix) (05-01-03) See CRP -1 for Privacy Act and Public Burden Statements U S DEPARTMENT OF AGRICULTURE Commodity Credit Corporation APPENDIX TO FORM CRP -1, CONSERVATION RESERVE PROGRAM CONTRACT NOTE The authonty for collecting the following information is Pub L 107-171 This authonty allows for the collection of information without pnor OMB approval mandated by the Paperwork Reduction Act of 1995 The time required to complete this information collection is estimated to average 3 minutes per response including the time for reviewing instructions searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information 1 DEFINITIONS The following definitions are applicable to the Conservation Reserve Program (CRP) Contract A CRP contract or CRP -1 means the program documents including form CRP -1, the applicable contract appendix, conservation plan and the terms of any required easement, if applicable, entered into between CCC and the participant Such contract shall set forth the terms and conditions for participation in the CRP and receipt of CRP payments B Current agricultural market value for offer evaluation purposes means the amount in dollars per acre as determined by CCC to be the adjusted price at which the land placed in the CRP could be rented based on the average cash rental rate, or equivalent, per acre, and which is paid for dryland cropland at the time at which this contract is signed by the participant C Vegetative cover means perennial or permanent grasses, legumes, forbs, and shrubs with a life span of 10 years or more, or trees D All other words and phrases, unless the context of subject matter otherwise requires, shall have the meanings assigned to them in the regulations governing the Conservation Reserve Program which are found at 7 CFR Part 1410 2 ELIGIBILITY REQUIREMENTS FOR CONSERVATION RESERVE PROGRAM A By signing the CRP contract, the participant, except in the case of persons qualifying solely as a tenant, certifies that such participant will control the land subject to the contract for the contract period and, if applicable, any easement period and shall, upon demand, provide evidence to CCC demonstrating that such participant will control the land for that period B Land otherwise eligible for the CRP shall not be eligible, except as agreed otherwise, in writing, by CCC, if the land is subject to a deed or other restriction prohibiting the production of agricultural commodities or where a benefit has or will be obtained from a Federal agency in return for the participant's agreement not to produce such commodities on the land during the same time as the land would be enrolled in the CRP By offering land for enrollment, the participant certifies as a condition for payment that no such restrictions apply to such land 3 RESTRICTIONS ON PAYMENTS TO FOREIGN PERSONS A Any person who enters into this CRP contract or participates in such contract at any time who is not a citizen of the United States or an alien lawfully admitted into the United States for permanent residence under the Immigration and Nationality Act (8 U S C 1101 et seq ) shall be ineligible to receive annual rental payments under this contract unless such person meets the requirements of 7 CFR Part 1400 which shall be applicable to this contract B Persons succeeding to a CRP contract subject to a reduction in payment under this paragraph 3 for any preceding party shall not be eligible for payments during the contract period greater than those that could have been received by such preceding party CRP -1 (Appendix) (05-01-03) 4 AGREEMENT A The participant agrees Page 2 of 7 (1) That the applicable CRP -2 and CRP -1 and its addenda shall be considered an offer to enter into the Conservation Reserve Program on the terms specified on Form CRP -1 and its addenda The offer, until revoked, may be accepted by CCC provided further, that liquidated damages may apply in the case of a revocation as specified elsewhere in this Appendix, (2) To place eligible land into the CRP for a period of 10 years, or as agreed to by CCC for a longer period not to exceed 15 years, from the effective date of the CRP contract executed by CCC, (3) To comply with the terms and conditions of the Conservation Plan, (4) To establish, maintain, and replace, as specified in the CRP contract, the practices agreed to in the Conservation Plan, (5) Not to harvest or sell, nor otherwise make commercial use of, trees or forage or other cover on the CRP land including the shearing or shaping of trees for future use as Christmas trees (the participants may conduct pruning, thinning, stand improvement, or other activities consistent with customary forestry practices on land that is planted to trees), provided further, however, that CCC may, in its discretion and only in writing or by publication intended for a general allowance for CRP lands in particular States or regions, permit, in certain emergencies, certain commercial uses, as specified by CCC, which may be conditioned on a reduction in CRP payments otherwise payable under this contract, (6) Not to undertake any action on land under the participant's control which tends to defeat the purposes of this contract, as determined by CCC, (7) (8) (9) To annually certify crop and land use for the farm with the CCC on the appropriate form, accurately listing all land enrolled in CRP on the farm, not later than the final reporting date determined and announced by the Farm Service Agency, or successor agency, To control on land subject to a CRP contract all weeds, insects, pests and other undesirable species to the extent necessary to ensure that the establishment and maintenance of the approved cover is adequately protected and to provide such maintenance as necessary to avoid an adverse impact on surrounding land, taking into consideration water quality, wildlife and other factors, Not to disturb the acreage under contract during the primary nesting and brood rearing season for wildlife, except as approved by CCC, (10) To annually file required forms as requested by CCC for payment limitation determinations, (11) To file applicable forms required by CCC for Adjusted Gross Income (AGI) determinations, (12) That it is understood any payment or portion thereof due any participant will be made by CCC without regard to any question of title under State law, and without regard to any claim or lien which may be asserted by a creditor, except agencies of the U S Government Offsets for debts owed to agencies of the U S Government shall be made prior to making any payments to participants or their assignees (13) To perform certain periodic management activities described in the conservation plan to maintain the approved cover such as light discing, burning, etc CRP -1 (Appendix) (05-01-03) Page 3 of 7 B CCC agrees, subject to the availability of funds (1) To share the cost with owners and operators of establishing an eligible practice, or an identified unit thereof, agreed to in the Conservation Plan as described herein, except that, in no case may the share of CCC exceed an amount equal to 50 percent of the price at which the land placed in the CRP could be sold for use as farmland at the time at which this contract is signed by the participant, unless the CCC otherwise approves such amount, provided further, that such approval must specifically reference the particular land placed in the CRP under this contract, (2) To pay the agreed -upon annual rental payment, including any incentive payment, based upon the shares to which the parties have agreed as set forth on Form CRP -1 for a period of years not in excess of the contract period, (3) To pay to the participant, to the extent required by CCC regulations, an interest penalty on cost- share payments, incentive payments, and all annual rental payments not made by the date, as determined by CCC, that the payment is due, (4) To make annual rental payments after October 1 of each year of the contract period 5 CONSERVATION PLAN A Subject to the approval of CCC, the Conservation Plan will include some or all of the following information and requirements (1) The vegetative or water cover to be established on the CRP land, (2) A tree planting plan, developed in cooperation with the Forest Service, if trees are to be established as the vegetative cover on the CRP land, A schedule of completion dates for establishment of the cover on the CRP land, (3) (4) The level of environmental benefits which must be attained on the CRP land, (5) Any other practices required for the establishment or maintenance of the cover on the CRP land including weed, insect, pest, and other controls of undesirable species, and such maintenance as necessary to avoid an adverse impact on surrounding land as determined appropriate by CCC, taking into consideration the needs of water quality, wildlife concerns, and other factors (6) The acreage will not be disturbed during the primary nesting season for wildlife as determined by CCC (7) Management activities authorized by paragraph 6 B By signing the Conservation Plan, the participant agrees to implement the practices specified in such Conservation Plan on the CRP land even if such practices differ from those listed on Form CRP -1 6 MANAGEMENT ACTIVITIES Subject to the approval of CCC, the Conservation Plan may include managed grazing or harvesting of the cover on the CRP land, including biomass, as necessary to avoid an adverse impact on surrounding land, as determined appropriate by CCC, taking into consideration the needs of the vegetative cover, wildlife concerns, and other factors Managed grazing or harvesting may be conditioned on a reduction in CRP payments otherwise payable under this contract, as determined by CCC CRP -1 (Appendix) (05-01-03) Page 4 of 7 7 COST -SHARE PAYMENTS A Subject to the availability of funds, cost -share payments shall be made available upon a determination by CCC that an eligible practice, or an identifiable unit thereof, has been established in compliance with the conservation plan and with appropriate standards and specifications B CCC will not make cost -share payments in excess of 50 percent of the actual or average cost of establishing the eligible practice specified in the Conservation Plan as determined by CCC It is understood that all cost -shares from all sources must be reported to CCC and that a reduction in the CCC cost -share may be made if there are other cost -shares received Such reductions will be made to the extent required or allowed by the program regulations C Except as otherwise provided for in program regulations, cost -share assistance may be made available under the CRP only for the establishment or installation of an eligible practice In order to receive cost -share assistance, the participant, upon completion of the practice, must file Form AD -245 or similar form approved by CCC, for approval by CCC 8 PROVISIONS RELATING TO TENANTS AND LANDLORDS A Payments shall not be paid under this CRP contract if CCC determines that (1) The landlord or operator has (a) when the acreage offered is not enrolled in the CRP at the time of signup (i) not provided tenants who have an Interest in the acreage being offered at the time of stgnup an opportunity to participate in the benefits of the program, (ii) reduced the number of tenants on the farm as a result of or in anticipation of enrollment in the CRP (b) when the acreage offered is enrolled in the CRP at the time of signup, not provided tenants with an Interest in the CRP contract acreage an opportunity to participate in the benefits of the program if (i) the tenants are otherwise involved in farming other acreage, as determined by CCC, on the farm at the time of signup, or (ii) the tenants have an Interest in the acreage being offered on the effective date of the new CRP -1 (2) The landlord or operator has deprived any tenant of any benefits to which such tenant would otherwise be entitled (3) If any such conditions as Identified in (1) and (2) occur or are discovered after payments have been made, all or any part of the payments, as determined by CCC, must be refunded with interest and no further payments shall be made B After this CRP contract is approved, the operator or tenant may, with the approval of CCC, be replaced for purposes of the CRP contract and for payments to be made under the contract if such tenant or operator, as determined by CCC (1) terminates their tenancy voluntarily or for some reason other than being forced to terminate their tenancy by the landowner or operator in anticipation as, or because of, participation in the program, (2) fails to maintain tenancy, as determined by CCC, throughout the CRP contract period, (3) files for bankruptcy and the trustee or debtor in possession fails to affirm this CRP contract, (4) dies during the term of this CRP contract and the administrator of the operator or tenant's estate (or a similar person with authority to administer the affairs of the operator or tenant) fails to succeed to this contract within the time required by CCC, or (5) was removed for cause, as determined by CCC CRP -1 (Appendix) (05-01-03) Page 5 of 7 C The removal of an operator or tenant from the agreement shall not release the operator or tenant from liabilities for actions arising before such removal 9 ERRONEOUS REPRESENTATION AND SCHEME AND DEVICE A A participant who is determined to have erroneously represented any fact affecting a determination with respect to this CRP contract and the regulations applicable to this CRP contract, adopted any scheme or device which tends to defeat the purposes of this CRP contract, or made any fraudulent representation with respect to this contract will not be entitled to payments or any other benefits made in accordance with this CRP contract and the participant must refund to CCC all payments received by such participant, plus interest and liquidated damages thereon, with respect to the CRP contract Such liquidated damages will be determined in accordance with paragraph 10 of this Appendix B Unless CCC regulations provide otherwise, refunds determined to be due and owing to CCC in accordance with this CRP contract will bear interest at the rate which CCC was required to pay for its borrowings from the United States Treasury on the date of the disbursement by CCC of the monies to be refunded Interest will accrue from the date of such disbursement by CCC C. The remedies provided under paragraph 9A of this Appendix shall be applicable in addition to any remedies under criminal and civil fraud statutes, including 18 U S C 268, 287, 371, 641, 1001, 15 U S C 714m, and 31 U S C 3729, or any other remedy available under law 10 LIQUIDATED DAMAGES 11 It is mutually agreed that in the event the CRP contract is breached by the participant, the CCC will suffer substantial damages which may not be possible to quantify with certainty Therefore, in addition to the refund of payments received plus interest due, for breach of contract prescribed in this contract, the participant agrees to pay an amount equal to the product obtained by multiplying (1) 25 percent of the rental payment rate per acre on Form CRP -1 by, (2) the number of acres that are the subject of the CRP contract Such amount shall be due as liquidated damages in addition to such other damages or amounts as may be due, and not as a penalty NOTIFICATION OF CHANGES TO TERMS AND CONDITIONS OF THE CONTRACT CCC agrees that, if any changes of any terms and conditions of this CRP contract, including changes necessary to reconcile the practices listed on the CRP -1 to those specified in the conservation plan, become necessary prior to the date that this contract is approved on behalf of CCC, CCC will notify the persons signing the CRP -1 of such change and such person will be given 10 days from the date of notification in which to agree to the revised terms and conditions or to withdraw from the offer The participant agrees to notify the CCC of an intention to withdraw from the offer within 10 days from the date of the issuance of such notice and further agrees that failure to notify the CCC will constitute agreement to the revised terms and conditions 12 CORRECTIONS CCC reserves the right to correct all errors arising from entering data or computations in the contract 13 TERMINATION OF CONTRACT, JOINT LIABILITY If a participant fails to carry out the terms and conditions of this CRP contract but CCC determines that such failure does not warrant termination of this CRP contract, CCC may require such participant to refund, with interest, payments received under this CRP contract, or require the participant to accept such adjustments in the subsequent payment as are determined to be appropriate by CCC Participants that sign the CRP -1 with zero percent interest in the annual rental payment shall not be held responsible for contract compliance CRP -1 (Appendix) (05-01-03) Page 6 of 7 14 CONTRACT MODIFICATIONS A CCC may modify this contract to add, or substitute certain practices when (1) The Installed practice failed to adequately control erosion through no fault of the participants, (2) The installed measure has deteriorated because of conditions beyond the control of the participants, or (3) Another practice will achieve at least the same level of environmental benefits B Concurrence of NRCS and the conservation district may be obtained by CCC when modifications to this contract involve a technical aspect of a participant's Conservation Plan 15 EFFECTIVE DATE AND CHANGES TO CONTRACT A The CRP contract is effective when, as determined by CCC, it has been signed by the participants and an authorized representative of CCC Except as otherwise determined by CCC, as permitted by regulations or other law, the CRP contract may not be revoked or revised unless by mutual agreement between the parties If, after the effective date of this contract, CCC determines that the offered acreage was erroneously enrolled or otherwise ineligible for enrollment, CCC may terminate the contract Such termination shall not effect payments already made to the participants as of the time of termination Within the dates established by CCC, the CRP contract must be signed by all required participants B In the event that a statute is enacted during the period of this CRP contract which would materially change the terms and conditions of this CRP contract, the CCC may require the participants to elect between acceptance of modifications in this CRP contract consistent with the provisions of such statute or termination of this CRP contract 16 TRANSFER OF LAND A If a new owner or operator purchases or obtains the right and interest in, or right to occupancy of, the land subject to this contract, such new owner or operator, upon the approval of CCC, may become a participant to a new CRP contract under the same terms and conditions with CCC covering such transferred land, B With respect to the transferred land, if the new owner or operator becomes a successor to the existing CRP contract, the new owner or operator shall assume all obligations under such contract of the previous participant, C If the new owner or operator becomes a successor to a CRP contract with CCC (I) Cost -share payments shall be made to the participant who established the practice, and (2) Annual rental payments to be paid during the fiscal year when the land was transferred shall be divided in an equitable manner, as determined by CCC CRP -1 (Appendix) (05-01-03) Page 7 of 7 D A new owner or operator will not be eligible to succeed to the CRP contract or receive payments under the contract if a previous participant in the contract maintains or acquires any interest of any kind in the property including, but not limited to, present, future, or conditional interests, or reversionary interests, or any option with respect to the property In addition, unless otherwise approved in writing by CCC for the particular contract, a new owner or operator will not be eligible to succeed to the CRP contract, if a lender has or will obtain an option to purchase the property, any other right of occupancy, or share in the equity in the property which is not conditional on a foreclosure or other remedy for nonpayment of debt or on a voluntary transfer by the person seeking to succeed to the CRP contract E The participant certifies that no person has, or will, obtain an interest in the property that would render the new owner or operator to be ineligible to succeed to the CRP contract under the provisions of this paragraph The existence or acquisition of such an interest by another person shall be considered a breach of the contract for which the CCC may terminate the contract and enforce the remedies provided in this Appendix F If a participant transfers all or part of the right and interest in, or right to occupancy of, the CRP land and the new owner or operator does not become a successor to such contract within 60 days, or such other time as determined appropriate by CCC, of such transfer, such contract will be terminated with respect to the affected portion of such land and the original participant must (1) Forfeit all rights to any future payments with respect to such acreage, (2) Refund all or part of the payments made with respect to such contract plus interest thereon, as determined by CCC, and (3) Pay liquidated damages to CCC as specified in paragraph 10 of this Appendix 17 REGULATIONS TO PREVAIL The regulations in 7 CFR Part 1410 for the CRP are incorporated herein In the event of a conflict between these regulations and the terms of this Appendix, the provisions of the regulations will prevail The U S Department of Agnculture (USDA) prohibits discnmination in all its programs and activities on the basis of race, color, national origin, gender, religion, age, disability, political beliefs, sexual onentation, and mantal or family status (Not all prohibited bases apply to all programs) Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc) should contact USDA's TARGET Center at (202) 720-2600 (voice and TDD) To file a complaint of discrimination, wnte USDA, Director, Office of Civil Rights, Room 326-W, Whitten Building, 1400 Independence Avenue, SW, Washington, D C 20250-9410 or call (202) 720-5964 (voice or TDD) USDA is an equal opportunity provider and employer Map of Farm 14024 in Weld County , Colorado Page 1 of 1 ____LH% r, Weld County , Colc Jo - + ` [ Non-Cropland Acres W; HEL I __ __ _ ____- _ -_ -.___ ._ � -- __ -- � `. ra • g,. • • A , • } 1 >: f 4— ti i . i . . .. - .� • a • ' rr ♦ .� - .. 42 69) H E t r gill i . X pilee5 , I'. 7/ 42. 4) 2'3 ,r _ . . . . 4 . _. , auLA . .i , 1► - $ _ 67.11. . __. . ;� ey - ' : , 4- 4/6412‘/1 /171s . •. ., ' , it r _ _- _a" - - , � • } 94 I ' _ ,. I 1 i \ 1 , Y lir f 1 , . * . . se- z. . -- -, • - * Nill ‘ ! - - . i - - . _ . . . ,: ._ _ at- - Leaflet I Powered by Esn Common Land Unit 2018 Crop Year Cropland Non-cropland CRP Wetland Determination Identifiers Farm 14024 (; Restricted Use N Tract 15334 Limited Restrictions W ± E S C Exempt from Conservation Compliance Provisions Tract Page: 1 of 1 United States Department of Agriculture (USDA) Farm Service Agency (FSA) maps are for FSA Program administration only This map does not represent a legal survey or reflect actual ownership, rather rt depicts the information provided directly from the producer and/or National Agricultural Imagery Program (NAIP) imagery The producer accepts the data 'as is' and assumes all risks associated with its use USDA-FSA assumes no responsibility for actual or consequential damage incurred as a result of any users reliance on this data outside FSA Programs Wetland identifiers do not represent the size shape, or specific determination of the area Refer to your anginal determination (CPA-026 and attached maps) for exact boundaries and determinations or contact USDA Natural Resources Conservation Service (NRCS) https ://intranet-apps . fsa. usda. gov/cars/setUpReports. do?dispatchTo- report&report=fsa578Map& farmNu. . . 4/ 10/2018 iv pire9E- USDA United States All producer shares 100 % ..---us--iiiii Department of Weld County, Coloradole, unless otherwise indicated Agriculture s, _, A„,. ,, aL4 4 L.�� c 0 • ‘, 010N67W v , . 910N (NJ _. � _ _ - -County Raab - Air ii4!G y .ht r c1 1 11. .��! . . : •.. — �. !:a w .. . mow • R,._IW yoy*.i tT-+1. .. . . .. . .-.... . .'77: '4 `� a , -:gam- ��-litx 7 v .y / U .. . :, 42 _ . - ..5. 1tip •_ .et sa f RP - ✓ .: . • • ti i s ., ' 115334 . •t 4 S. i \ 1 i I - y ei - CRP ` _. r`w 92 .40 :.y , _ HEL # ik - .t, .ti ' 10N 67W - .4 '$ _ .. i 1 t :4 ' X11 •: iN 1 1 , - . .. e • ‘ ;4 irt4 . . * ' . . Yr T 15334 , 9310N67W ,* ' • 4 ; di i (If it k - .. - 0 — S' 1 - Pk / . 4- Illrilit, I 2 7 i. . f 0 3. fi,1 0 1 , 220 14 10N 67W li6 t Feet - - Program Year Common Land Unit „ CRP 2020 Pro g / / Non-Cropland M Tract Boundary Map Created April 01 , 2020 Cropland PLSS Farm 14024 Wetland Determination Identifiers ® Restricted Use Tract 15334 - Limited Restrictions Exempt from Conservation Tract Cropland Total : 193. 90 acres • Compliance Provisions United States Department of Agriculture (USDA) Farm Service Agency (FSA) maps are for FSA Program administration only. This map does not represent a legal survey or reflect actual ownership, rather it depicts the information provided directly from the producer and/or National Agrcu -tural Imagery Program (NAIP) imagery. The producer accepts the data 'as is' and assumes all risks associated with its use USDA-FSA assumes no responsibility for actual or consequential damage incurred as a result of any user's reliance on this data outside FSA Programs. Wetland identifiers do not represent the size, shape , or specific determination of the area Refer to your original determination (CPA-026 and attached maps ) for exact boundaries and determinations or contact USDA Natural Resources Conservation Service (NRCS ) Cheryl Hoffman From : Esther Gesick Sent: Friday, August 28, 2020 8 :47 AM To: Cheryl Hoffman Subject: FW: Purchased CRP land Attachments: USDA CRP Forms - McCrery. pdf; USDA CRP Forms - Petersheim . pdf FYI . . . Esther E. Gesick Clerk to the Board 1150 O Street / P. O. Box 758 / Greeley, CO 80632 tel: (970) 400-4226 , I • • -- % rI Confidentiality Notice : This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication . Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited . From : Esther Gesick < egesick@weldgov . com > Sent : Wednesday, August 26, 2020 12 : 13 PM To : Lacy, Susan - FSA, Greeley, CO < susan . lacy@usda . gov>; Rasmussen , Jeff - FSA, Greeley, CO <jeff. rasmussen@usda . gov> Cc : Toby Taylor <ttaylor@weldgov . com >; Esther Gesick <egesick@weldgov . com >; Bruce Barker < bbarker@weldgov . com > Subject : RE : Purchased CRP land Hello Lacy, The completed CRP Forms for the McCrery and Petersheim properties are attached for your review . Please let Toby or me know if you need anything further . Toby — I will list the original packets on the Commissioners' Consent Agenda on Monday, August 31 , 2020 to get them added to the file . Regards, Esther E. Gesick Clerk to the Board 1150 O Street / P. O. Box 758 / Greeley, CO 80632 tel: (970) 400-4226 •1 ti � p Confidentiality Notice : This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e- mail and destroy the communication . Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited . 1 From : Lacy, Susan - FSA, Greeley, CO < susan . Iacy@usda .gov> Sent : Tuesday, August 25, 2020 3 : 23 PM To : Esther Gesick < egesick@weldgov . com > Cc : Rasmussen , Jeff - FSA, Greeley, CO <jeff. rasmussen@usda .gov> Subject : RE : Purchased CRP land Caution : This email originated from outside of Weld County Government . Do not click links or open attachments unless you recognize the sender and know the content is safe . Esther, You are correct, the forms are not interactive and will require a wet ink signature . However, we can accepted them by email or fax after they are signed . Thank you for attaching the forms showing that Mr . Freeman has signature authority . Once I receive the completed AD-2047 from you , I will prepare all the other required documents for him to sign , date and return . Let me know if I can be of any further assistance . Svsa vu & L RCH Key Conservation Program Technician 4302 West 9th Street Road Greeley, CO 80634 Phone: 97O-534-23O1 FAX: 844-332-7505 susan. lacy@usda.gov From : Esther Gesick < egesick@weldgov . com > Sent : Tuesday, August 25 , 2020 3 : 16 PM To : Rasmussen , Jeff - FSA, Greeley, CO < aeff. rasmussen@usda .gov >; Lacy, Susan - FSA, Greeley, CO < susan . lacy@ usda .gov> Cc : Esther Gesick < egesick@weldgov . com >; Toby Taylor <ttaylor@weldgov . com > Subject : FW : Purchased CRP land Hello Jeff and Susan , In reading through the email string below, I ' ve attached this year' s Resolution appointing Mike Freeman as Chair and delegating authority to him to sign items presented for approval by the Board ( See attached 20200003 ) . Additionally, the Resolutions approving the purchase contracts authorizing the Chair to sign all necessary documents are attached for your reference . I ' m assisting with completion of the requested forms; however, they do not appear to be interactive , so I just want to confirm that it is acceptable to either print or type the necessary information and obtain a wet ink signature from the Chair . 2 Please advise . Esther E. Gesick Clerk to the Board 1150 O Street / P. O. Box 7581 Greeley, CO 80632 tel: (970) 400-4226 11 raj mg tie . . W;. % Confidentiality Notice : This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e- mail and destroy the communication . Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited . From : Toby Taylor <ttaylor@weldgov . com > Sent : Monday, August 24, 2020 4 : 18 PM To : Esther Gesick < egesick@weldgov . com > Subject : FW : Purchased CRP land Esther, How would you like to capture this and/or fill our before taking to Mike to sign ? Toby Taylor, Director Weld County Department of Buildings & Grounds Weld County Veterans Services 1105 H Street P . O . Box 758 Greeley, CO 80632 P : 970 . 400 . 2023 F : 970 . 304 . 6532 ttaylor@weldgov . com From : Bruce Barker < bbarker@weldgov . com > Sent : Monday, August 24, 2020 3 :40 PM To : Toby Taylor < ttaylor@weldgov . com > Subject : RE : Purchased CRP land Yes . Mike can sign . Bruce T. Barker, Esq . Weld County Attorney P . O . Box 758 1150 " O " Street Greeley, CO 80632 ( 970 ) 400-4390 Fax : ( 970 ) 352 -0242 I , r � - 1 N ` ' P 3 Confidentiality Notice : This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is attorney privileged and confidential , or otherwise protected from disclosure . If you have received this communication in error, please immediately notify sender by return e - mail and destroy the communication . Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited . From : Toby Taylor <ttaylor@weldgov . com > Sent : Monday, August 24, 2020 3 : 38 PM To : Bruce Barker < bbarker@weldgov . com > Subject : FW : Purchased CRP land Is this something that Mike can sign since all documents for the land purchases were approved . Or does this need to placed as a new item of business . Toby Taylor, Director Weld County Department of Buildings & Grounds Weld County Veterans Services 1105 H Street P . O . Box 758 Greeley, CO 80632 P : 970 . 400 . 2023 F : 970 . 304 . 6532 ttaylor@weldgov . com From : Rasmussen , Jeff - FSA, Greeley, CO < jeff. rasmussen@usda . gov> Sent : Monday, August 17 , 2020 4 : 50 PM To : Toby Taylor < ttaylor@weldgov . com > Cc : Lacy, Susan - FSA, Greeley, CO < susan . lacy@usda . gov>; Rasmussen , Jeff - FSA, Greeley, CO <jeff. rasmussen@usda . gov> Subject : FW : Purchased CRP land Caution : This email originated from outside of Weld County Government . Do not click links or open attachments unless you recognize the sender and know the content is safe . Toby, Attached is paperwork involving CRP Property that Weld County purchased that needs to be filled out so the office can revise the CRP contracts can be revised and a farm division completed involving other parties . Susan and I visited about this and concluded the simplest way to complete the process is to have you send us a statement on Weld County Letterhead stating who has signature authority and to have that person fill out the attached CCC-931C form . The urgency we have with this is that it involves other CRP participants that will not get paid until we receive the information back from Weld county . On another note CRP contract # 10430H does not expire until September 30, 2023 . If the county has any plans of disturbing the land is before the expiration date then the contract should be bought . Thank you for your promptness on these issues . If you have any questions please call 970-356 -8097 x 2 and ask for Susan or myself. 4 Jeff From : Lacy, Susan - FSA, Greeley, CO Sent : Thursday, April 23 , 2020 6 : 40 AM To : Toby Taylor <ttaylor@weldgov . com > Subject : Purchased CRP land Toby, Attached are the two contracts for the Conservation Reserve Program that Weld County purchased from Petersheim and McCreery along with the appendix to the contracts . I have also attached an AD- 2047 form which is how our office collects information on the new landowners for our Federal Programs within USDA . I will need to have this form completed by the entity that purchased the property so I can start the contract revision process . When I spoke with you yesterday on the phone , I mentioned the Adjusted Gross Income statement that is part of the e ligibility process that is required have a CRP contract . It would have to be completed by the entity that owns the land also . If you could complete the AD2047 and return to our office , I would be glad to revise the contracts into the correct entity n ame and have the documents ready for you to present at your meeting . Our procedure is to have this process completed within a 60 day period . cS tA.sa tA, & La c � Key Conservation Program Technician 4302 West 9th Street Road Greeley, CO 80634 Phone: 970-534-2301 FAX: 844-332-7505 susan. lacy@usda.gov This electronic message contains information generated by the USDA solely for the intended recipients . Any u nauthorized interception of this message or the use or disclosure of the information it contains may violate the law and subject the violator to civil or criminal penalties . If you believe you have received this message in error, please notify the sender and delete the email immediately . 5 Hello