Bcap- 20 Biomass Crop Assistance Program (bcap)

Form Approved – OMB No. 0560-0082

This form is available electronically.

BCAP-20

U.S. DEPARTMENT OF AGRICULTURE
Commodity Credit Corporation

(08-04-15)

BIOMASS CROP ASSISTANCE PROGRAM (BCAP)
PROJECT AREA PROPOSAL SUBMISSION
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 1450, the Commodity Credit Corporation Charter Act (15 U.S.C. 714 et seq.), and the Agricultural Act of 2014 (Pub. L. 113-79). The information will be
used to determine eligibility to participate in and receive benefits under the Biomass Crop Assistance Program through documentation of the project sponsor’s project area
proposal submission. 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
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 to participate in and receive benefits under the Biomass Crop Assistance Program.
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 0560-0082. The time required to complete this information collection
is estimated to average 10 hours 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 appropriate criminal and civil fraud, privacy, and other statutes may be applicable to the
information provided. RETURN THIS COMPLETED FORM WITH YOUR PROJECT AREA PROPOSAL.

1. Full Name of Project Area Proposal:
A. USPS State Code
B. Proposed Project Area Name

3. Name of Project Sponsor

5A. Street Address (Number and Name)

For CCC Use Only
2A. Approved Project
2B. Date Assigned
(MM-DD-YYYY)
Area ID Number

4. Proposed Acreage Limitation

5B. City

6. Telephone Number (Include Area Code)

5C. State

5D. Zip Code

5E. Mailing Address (Include Zip Code)

7. Email Address

PART A - FACILITY OVERVIEW (Project Area Sponsor Facility/Operation Status)(If more space is needed, see Page 4)
8A. Name of the Facility Project Area

8B. Location of Facility Project Area

8C. As appropriate, please complete:
Facility Operation Status (Check Only One):
(1) Operational Biomass Conversion Facility
(2) Not Currently Operational Biomass Conversion Facility
Qualified Biomass Conversion Facility (BCF) Status (Check Only One):
(3) Currently a Qualified Biomass Conversion Facility for Matching Payments
BCAP Qualified Biomass Conversion Facility ID Number:

Prepare and attach copy of Applicable
Documents:
• New completed for BCAP-1
• New completed Qualified BCF
Agreement
• New Additional Forms/Documents
for BCAP-1
• Existing Professional engineering
design plan
• Existing Business/financial
operations plan.
• New completed form BCAP-22
• New completed form AD-1047

(4) Not Currently a Qualified Biomass Conversion Facility for Matching Payments
(5) Not Currently a Qualified Biomass Conversion Facility, but intend to become qualified.
8D. If facility is not operational for the conversion of biomass, what is the projected date it will become operational
for the conversion of biomass?

DATE (MM-DD-YYYY)

The U.S. Department of Agriculture (USDA) prohibits discrimination against its customers, employees, and applicants for employment on the basis of race, color, national origin, age,
disability, sex, gender identity, religion, reprisal, and where applicable, political beliefs, marital status, familial or parental status, sexual orientation, or all or part of an individual’s
income is derived from any public assistance program, or protected genetic information in employment or in any program or activity conducted or funded by the Department. (Not all
prohibited bases will apply to all programs and/or employment activities.) Persons with disabilities, who wish to file a program complaint, write to the address below or if you require
alternative means of communication for program information (e.g., Braille, large print, audiotape, etc.) please contact USDA’s TARGET Center at (202) 720-2600 (voice and TDD).
Individuals who are deaf, hard of hearing, or have speech disabilities and wish to file either an EEO or program complaint, please contact USDA through the Federal Relay Service at
(800) 877-8339 or (800) 845-6136 (in Spanish).
If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, found online at
http://www.ascr.usda.gov/complaint_filing_cust.html , or at any USDA office, or call (866) 632-9992 to request the form. You may also write a letter containing all of the
information requested in the form. Send your completed complaint form or letter by mail to U.S. Department of Agriculture, Director, Office of Adjudication, 1400 Independence
Avenue, S.W., Washington, D.C. 20250-9410, by fax (202) 690-7442 or email at program.intake@usda.gov. USDA is an equal opportunity provider and employer.

BCAP-20 (08-04-15)

Page 2 of 5

9. List All Crops/Acreage Proposed for Establishment. (If more space is needed, see Page 5):
Crops To
Be
Established
On

(1)
Crops Proposed for Establishment
(List Common Name and Scientific Name)
Scientific

(2)
Crop Type

Common

A.
Cropland

(6) Totals

B.
Non-Crop
Agland

(6) Totals

C.
NonIndustrial
Private
Forest Land

(6) Totals

(3)
Number of
Acres

(4)
Estimated
Annual
Productivity
(Dry Tons
Per Acre)

(5)
Perennial Crops
(a)
(b)
To Be
Previously
Established
Established
Acreage

BCAP-20 (08-04-15)

Page 3 of 5

10. Proposed Biomass Production/Utilization Schedule by Year (Record Total Dry Tons for Each Year Planned from All Sources). Enter Tonnage Estimates
for each Applicable Calendar Year Beginning after the Proposal is Approved:

(1)
Total Tons for
Annual Crop

A.
Contract Acreage
(2)
Total Tons for Woody
Perennial

(3)
Total Tons for NonWoody Perennial

B.
Non-Contract Acreage

(1)
Total Dry Tons Other
Sources for Biomass

(2)
Crop Type(s)

Year 1
Year 2
Year 3
Year 4
Year 5
Year 6
Year 7
Year 8
Year 9
Year 10
Year 11
Year 12
Year 13
Year 14
Year 15

PART B - CERTIFICATION

I certify that: 1) I am the project sponsor for this project proposal, 2) the above information and supporting documents are true
and complete to my knowledge and comply with 7 CFR Part 1450, and 3) I have provided this form for the purpose of proposing
the geographic project area delineated in the proposal. This application is for purposes of the consideration by the CCC of special
BCAP projects and not for the BCAP matching payment program. A separate application is required for the matching payment
With respect to the attachments hereto, I am aware that any requested future changes to the proposed project area geographic
boundaries may require a new or amended environmental screening and/or assessment. I am aware that all information provided
and activities conducted are subject to compliance review and that misinformation is subject to sanctions and other remedies under
program authorities in addition to any liability which may be incurred under various criminal and civil fraud statutes, including, but
not limited to, 18 U.S.C. 1001 and 15 U.S.C. 714m.

11. Authorized Representative for Project Sponsor
Signature (By)

12. Title/Relationship of the Individual if Signing in a
Representative Capacity

13. Date (MM-DD-YYYY)

BCAP-20 (08-04-15)
PART A - FACILITY OVERVIEW

Page 4 of 5

CONTINUATION FOR ITEM 8

8A. Name of the Facility Project Area

8B. Location of Facility Project Area

8C. As appropriate, please complete:
Facility Operation Status (Check Only One):
(1) Operational Biomass Conversion Facility
(2) Not Currently Operational Biomass Conversion Facility
Qualified Biomass Conversion Facility (BCF) Status (Check Only One):
(3) Currently a Qualified Biomass Conversion Facility for Matching Payments
BCAP Qualified Biomass Conversion Facility ID Number: __________________________
(4) Not Currently a Qualified Biomass Conversion Facility for Matching Payments

Prepare and attach copy of Applicable
Documents:
• New completed for BCAP-1
• New completed Qualified BCF
Agreement
• New Additional Forms/Documents
for BCAP-1
• Existing Professional engineering
design plan
• Existing Business/financial
operations plan.
• New completed form BCAP-22
• New completed form AD-1047

(5) Not Currently a Qualified Biomass Conversion Facility, but intend to become qualified.
8D. If facility is not operational for the conversion of biomass, what is the projected date it will become operational
for the conversion of biomass?

DATE (MM-DD-YYYY)

8C. As appropriate, please complete:
Facility Operation Status (Check Only One):
(1) Operational Biomass Conversion Facility
(2) Not Currently Operational Biomass Conversion Facility
Qualified Biomass Conversion Facility (BCF) Status (Check Only One):
(3) Currently a Qualified Biomass Conversion Facility for Matching Payments
BCAP Qualified Biomass Conversion Facility ID Number: __________________________
(4) Not Currently a Qualified Biomass Conversion Facility for Matching Payments

Prepare and attach copy of Applicable
Documents:
• New completed for BCAP-1
• New completed Qualified BCF
Agreement
• New Additional Forms/Documents
for BCAP-1
• Existing Professional engineering
design plan
• Existing Business/financial
operations plan.
• New completed form BCAP-22
• New completed form AD-1047

(5) Not Currently a Qualified Biomass Conversion Facility, but intend to become qualified.
8D. If facility is not operational for the conversion of biomass, what is the projected date it will become operational
for the conversion of biomass?

DATE (MM-DD-YYYY)

8C. As appropriate, please complete:
Facility Operation Status (Check Only One):
(1) Operational Biomass Conversion Facility
(2) Not Currently Operational Biomass Conversion Facility
Qualified Biomass Conversion Facility (BCF) Status (Check Only One):
(3) Currently a Qualified Biomass Conversion Facility for Matching Payments
BCAP Qualified Biomass Conversion Facility ID Number: __________________________
(4) Not Currently a Qualified Biomass Conversion Facility for Matching Payments

Prepare and attach copy of Applicable
Documents:
• New completed for BCAP-1
• New completed Qualified BCF
Agreement
• New Additional Forms/Documents
for BCAP-1
• Existing Professional engineering
design plan
• Existing Business/financial
operations plan.
• New completed form BCAP-22
• New completed form AD-1047

(5) Not Currently a Qualified Biomass Conversion Facility, but intend to become qualified.
8D. If facility is not operational for the conversion of biomass, what is the projected date it will become operational
for the conversion of biomass?

DATE (MM-DD-YYYY)

BCAP-20 (08-04-15)

Page 5 of 5

CONTINUATION FOR ITEM 9

9. List All Crops/Acreage Proposed for Establishment:
(1)
Crops Proposed for Establishment
Crops To
(List Common Name and Scientific Name)
Be
Established
On
Scientific
Common

(2)
Crop Type

A.
Cropland

(6) Totals

B.
Non-Crop
Agland

(6) Totals

C.
NonIndustrial
Private
Forest Land

(6) Totals

(3)
Number of
Acres

(4)
Estimated
Annual
Productivity
(Per Acre)

(5)
Perennial Crops
(a)
(b)
To Be
Previously
Established
Established
Acreage