Information Collection

Assignments of Payments and Joint Payment Authorization

IC 1475 under ICR 202109-0560-005 · OMB 0560-0183.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0560-0183 can be found here:

Documents and Forms

Document Name Document Type
Form CCC-251 Assignments of Payments and Joint Payment Authorization Form
CCC0036_eGov_05-28-21V01.pdf forms.sc.egov.usda.gov/eforms/mainservlet Instruction
CCC0036_eGov_05-28-21V01.pdf forms.sc.egov.usda.gov/eforms/mainservlet Instruction
CCC0037eGov_05-28-21V01.pdf forms.sc.egov.usda.gov/eforms/mainservlet Instruction
CCC0037eGov_05-28-21V01.pdf forms.sc.egov.usda.gov/eforms/mainservlet Instruction
CCC0036Spanish_eGov_06-01-21V02.pdf forms.sc.egov.usda.gov/eforms/mainservlet Instruction
CCC0036Spanish_eGov_06-01-21V02.pdf forms.sc.egov.usda.gov/eforms/mainservlet Instruction
CCC0037Spanish_eGov06-01-21V01.pdf forms.sc.egov.usda.gov/eforms/mainservlet Instruction
CCC0037Spanish_eGov06-01-21V01.pdf forms.sc.egov.usda.gov/eforms/mainservlet Instruction
FSA-252 Instruction.pdf Instruction
FSA-252 Instruction.pdf Instruction
CCC-251 Notice of Assignment CCC0251_180824V01.pdf Form
CCC-251 Notice of Assignment CCC0251_180824V01.pdf Form
CCC-252 Instrument of Assignment CCC0252_180824V01 (1).pdf Form
CCC-252 Instrument of Assignment CCC0252_180824V01 (1).pdf Form
CCC-37 Joint Payment Authorization CCC-37.pdf forms.sc.egov.usda.gov/eforms/mainservlet Form
CCC-37 Joint Payment Authorization CCC-37.pdf forms.sc.egov.usda.gov/eforms/mainservlet Form
CCC-36 (Spanish) Assignment of Payment ccc-36 Spanish.pdf forms.sc.egov.usda.gov/eforms/mainservlet Form
CCC-36 (Spanish) Assignment of Payment ccc-36 Spanish.pdf forms.sc.egov.usda.gov/eforms/mainservlet Form
CCC-37 (Spanish) Joint Payment Authorization CCC0037Spanish_210601V02 (1).pdf forms.sc.egov.usda.gov/eforms/mainservlet Form
CCC-37 (Spanish) Joint Payment Authorization CCC0037Spanish_210601V02 (1).pdf forms.sc.egov.usda.gov/eforms/mainservlet Form
FPAC-FM-12 Request for FSA AND NRCS payments of Federal benefits by FPAC-FMD0012_210614V01.pdf forms.sc.egov.usda.gov/eforms/mainservlet Form
FPAC-FM-12 Request for FSA AND NRCS payments of Federal benefits by FPAC-FMD0012_210614V01.pdf forms.sc.egov.usda.gov/eforms/mainservlet Form
CCC-36 Assignment of Payment CCC0036 (2).pdf forms.sc.egov.usda.gov/eforms/mainservlet Form
CCC-36 Assignment of Payment CCC0036 (2).pdf forms.sc.egov.usda.gov/eforms/mainservlet Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Assignments of Payments and Joint Payment Authorization	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 7 CFR 1404

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	CCC-251	Notice of Assignment	CCC0251_180824V01.pdf		No		Paper Only
Form	CCC-252	Instrument of Assignment	CCC0252_180824V01 (1).pdf		No		Paper Only
Form	CCC-37	Joint Payment Authorization	CCC-37.pdf	http://forms.sc.egov.usda.gov/eforms/mainservlet	Yes	No	Fillable Printable
Form	CCC-36 (Spanish)	Assignment of Payment	ccc-36 Spanish.pdf	http://forms.sc.egov.usda.gov/eforms/mainservlet	Yes	No	Fillable Printable
Form	CCC-37 (Spanish)	Joint Payment Authorization	CCC0037Spanish_210601V02 (1).pdf	http://forms.sc.egov.usda.gov/eforms/mainservlet	Yes	No	Fillable Printable
Instruction			CCC0036_eGov_05-28-21V01.pdf	http://forms.sc.egov.usda.gov/eforms/mainservlet	Yes	No	Printable Only
Instruction			CCC0037eGov_05-28-21V01.pdf	http://forms.sc.egov.usda.gov/eforms/mainservlet	Yes	No	Printable Only
Instruction			CCC0036Spanish_eGov_06-01-21V02.pdf	http://forms.sc.egov.usda.gov/eforms/mainservlet	Yes	No	Printable Only
Instruction			CCC0037Spanish_eGov06-01-21V01.pdf	http://forms.sc.egov.usda.gov/eforms/mainservlet	Yes	No	Printable Only
Form	FPAC-FM-12	Request for FSA AND NRCS payments of Federal benefits by check (Request for Waiver)	FPAC-FMD0012_210614V01.pdf	http://forms.sc.egov.usda.gov/eforms/mainservlet	Yes	No	Fillable Printable
Form	CCC-36	Assignment of Payment	CCC0036 (2).pdf	http://forms.sc.egov.usda.gov/eforms/mainservlet	Yes	Yes	Fillable Fileable
Instruction			FSA-252 Instruction.pdf		Yes	No	Printable Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Natural Resources

Subfunction: Agricultural Innovation and Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 700,491	Number of Respondents for Small Entity: 2,000

Affected Public: Private Sector	Private Sector: Farms

Percentage of Respondents Reporting Electronically: 5 %

	Approved	Previously Approved
Annual Number of Responses for this IC	700,491	700,491
Annual IC Time Burden (Hours)	116,687	116,687
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.