CONSERVATION PROGRAM APPLICATION
Name:
Application Number:
Address:
Application Date:
County and State:
Telephone:
Watershed:
Subaccount:
Location (Legal Description or Farm and Tract Number):
(Please note that not all questions apply to all Programs)
1. This is an application to participate in the:
❑ Agricultural Management Assistance (AMA) ✔ Environmental Quality Incentives Program (EQIP)
❑ Conservation Security Program (CSP)
❑ Wildlife Habitat Incentives Program (WHIP)
2. ❑ Yes
❑ No
If applying for the EQIP or CSP, are you either a Limited Resource
Farmer or Rancher or a Beginning Farmer or Rancher?
If you wish to apply in either of these categories, you must complete certification requirements.
For more information please go to the following url: http://www.lrftool.sc.egov.usda.gov/
3. ❑ Yes ❑ No
Do you have farm records established with the appropriate USDA
Service Center Agency?
If no, you must establish them with the appropriate USDA Service Center Agency prior to
submitting this application.
4. Are you applying for a conservation program contract as an (check one of the following):
❑ Individual
❑ Entity (Corporation, Limited Partnership, Trust, Estate, etc...)
a) Please enter entity name and tax identification number:
Name:
Tax Number:
b) ❑ Yes ❑ No
Do you have appropriate documents including proof to sign for the entity?
❑ Joint Operation (General Partnership, Joint Venture)
a) Please enter entity name and tax identification number:
Name:
Tax Number:
b) ❑ Yes ❑ No
Do you have appropriate documents including proof to sign for the entity?
5. ❑ Yes
❑ No
If applying for the EQIP, are you engaged in livestock or agricultural
production, and have you produced at least $1000 of agricultural products in a year?
6.
Is the land being offered for enrollment used for agricultural or livestock production?
❑ Agriculture
Crop Type:
❑ Livestock Production
Livestock Type:
US DEPARTMENT OF AGRICULTURE
NATURAL RESOURCES CONSERVATION SERVICE
NRCS-CPA-1200
OMB 0578-0013 Expires 9/30/09
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7. ❑ Yes
❑ No
If applying f