Get Started – Crop Disaster Recovery

PRODUCER APPLICATION

Part One

Company Name *

Individual Name *

Email Address *

Office Phone *

Cell

Street Address *

City *

State/Province *

ZIP / Postal Code *

Part Two

Crops or Commodities *

Acres in Production *

Gross Yearly Revenue

List States and Counties of Operation: *

What year did you start farming? *

What year did you start your company? *

How do you market your crops or commodities? *

What financial hardships do you need help with in your operations? *

Part Three

Check all that apply:I have suffered from a natural disaster (hurricane, drought, fire, tornado, etc.).I am currently participating in ongoing USDA programs.I have applied to USDA agencies for relief (FSA, NRCS, RD, RMA, crop insurance claim).I have filed a claim that was paid/approved.I have filed a claim that is under determination.I have filed a claim that was denied with right to appeal.

Date of Denial Letter:

Date Denial Letter Received:

How did you hear about us?0 / 180