FSA-2006 Property Owned and Leased

This form is available electronically.

FSA-2006
(Proposal 8)

Form Approved - OMB No. 0560-XXXX
Position 3

U.S. DEPARTMENT OF AGRICULTURE
Farm Service Agency

PROPERTY OWNED AND LEASED
(See Page 2 for the Privacy Act and the Public Burden Statements.)
1. Name of Applicant
A. LAND. INCLUDE ALL LAND OWNED, TO BE OWNED, OR LEASED.
1A. Owner of Record

1B. Description

1C. County

1D. Farm No. 1E. Total Acres 1F. Crop Acres 1G. Oral/Written 1H. Crop Share
Lease

1I. Cash Rent

1J. Expiration Date

%$
2A. Owner of Record

2B. Description

2C. County

2D. Farm No. 2E. Total Acres 2F. Crop Acres 2G. Oral/Written 2H. Crop Share
Lease

2I. Cash Rent

2J. Expiration Date

%$
3A. Owner of Record

3C. County

3B. Description

3D. Farm No. 3E. Total Acres 3F. Crop Acres 3G. Oral/Written 3H. Crop Share
Lease

3I. Cash Rent

3J. Expiration Date

%$
4A. Owner of Record

4B. Description

4C. County

4D. Farm No. 4E. Total Acres 4F. Crop Acres 4G. Oral/Written 4H. Crop Share
Lease

4I. Cash Rent

4J. Expiration Date

%$
5A. Owner of Record

5C. County

5B. Description

4G. Oral/Written
Lease
5D. Farm No. 5E. Total Acres 5F. Crop Acres 5G. Oral/Written 5H. Crop Share
Lease

5I. Cash Rent

5J. Expiration Date

%$

The U.S. Department of Agriculture (USDA) prohibits discrimination in all 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, genetic information, political beliefs, reprisal, or because all or part of an individual's
income is derived from any public assistance program. (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, write to USDA, Director, Office of Civil Rights, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, or call (800) 795-3272 (voice) or (202)
720-6382 (TDD). USDA is an equal opportunity provider and employer.

FSA-2006 (Proposal 8) Page 2
B. EQUIPMENT/LIVESTOCK. Include only equipment/livestock to be purchased, currently leased, or to be leased.
1.
Owner of Record

2.
Description

3.
Number of
Units

4.
Rent
$

5.
Share
%

6.
7.
Type of Lease Expiration Date

C. CERTIFICATION

I certify that the information provided is true, complete, and correct to the best of my knowledge and is provided in good faith.
(Warning: Section 1001 of title 18, United States Code, provides for criminal penalties to those who provide false statements. If
any information is found to be false or incomplete, such finding may be grounds for denial of the requested action.)
1. Signature
NOTE:

2. Date

The following statements are made in accordance with the Privacy Act of 1974 (5 USC 552a), the Farm Service Agency (FSA) is authorized by the Consolidated
Farm and Rural Development Act, as amended (7 USC 1921 et seq.), or other Acts, and the regulations promulgated thereunder, to solicit the information
requested on its application forms. The information requested is necessary for FSA to determine eligibility for credit or other financial assistance, service loans,
and conduct statistical analyses. Supplied information may be furnished to other Department of Agriculture agencies, the Internal Revenue Service, the
Department of Justice or other law enforcement agencies, the Department of Defense, the Department of Housing and Urban Development, the Department of
Labor, the United States Postal Service, or other Federal, State, or local agencies as required or permitted by law. In addition, information may be referred to
interested parties under the Freedom of Information Act, to financial consultants, advisors, lending institutions, packagers, agents, and private or commercial credit
sources, to collection or servicing contractors, to credit reporting agencies, to private attorneys under contract with FSA or the Department of Justice, to business
firms in the trade area that buy chattel or crops or sell them for commission, to Members of Congress or Congressional staff members, or to courts or adjudicative
bodies. Disclosure of the information requested is voluntary. However, failure to disclose certain items of information requested, including Social Security Number
or Federal Tax Identification Number, may result in a delay in the processing of an application or its rejection.
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-XXXX. The time required to complete this
information collection is estimated to average 30 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. RETURN THIS COMPLETED FORM TO YOUR COUNTY FSA
OFFICE.