U.S. USDA Form usda-ccc-cotton-a
U.S. DEPARTMENT OF AGRICULTURE
Commodity Credit Corporation
CCC-Cotton A
(09-02-04)
Form CCC-COTTON A Continuation is incorporated
into this Form CCC-COTTON A when this box is
marked:
COTTON PRODUCER'S NOTE AND SECURITY AGREEMENT
NOTE:
The authority for collecting the following information is Pub. L. 107-171. This authority allows for the collection of information without prior OMB approval mandated by the Paperwork Reduction Act of 1995.
The time required to complete this information collection is estimated to average 15 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.
The following statements are made in accordance with the Privacy Act of 1974 (5 USC 552a). The authority for requesting the following information is the Agricultural Act of 1949, as amended, the Federal
Agriculture Improvement and Reform Act of 1996, the Commodity Credit Corporation Charter Act, as amended, and regulations (7 CFR Part 7). The information will be used to determine eligibility for cotton
loan program benefits. Furnishing the requested information is voluntary. Failure to furnish the requested information will result in a determination if ineligibility for cotton loan program benefits. This
information may be also provided to other USDA agencies, IRS, Department of Justice, or other State and Federal law enforcement agencies, and in response to a court magistrate or administrative tribunal.
The provisions of criminal and civil fraud statutes, including 18 USC 286, 287, 371, 641, 651, 1001; 1014, 15 USC 714m; and 31 USC 3729, may be applicable to the information provided. RETURN THIS
COMPLETED FORM TO YOUR COUNTY FSA OFFICE
Name and Mailing Address of Contact Producer
Warehouse Code
St. & Cty. Codes & Farm No. Where Produced
Loan No.
:
Loan Amount
:
Crop Year
:
Clerk Fee
:
Commodity
:
Service Fee
:
Gin Code
:
Research and Promotion
:
Prep. Code
:
No. Bales
:
TOTAL DISBURSEMENT
:
Gross Loan Amount
:
Gross Loan Amount for R&P :
Loan Quantity :
Storage Deduction
:
Rec. Charge Reduction
:
PRODUCER
-A­
ID NO.
-B­
PRODUCER SHARE
-C-
The terms and conditions of the Note and Security Agreement are set forth in this Form CCC-Cotton A (''Note'') and Form CCC-601,
''Commodity Credit Corporation Note and Security Agreement Terms and Conditions,'' and any appendix thereto. By signing this Form
CCC-Cotton A, each producer agrees to all terms and conditions specified in these forms and acknowledges receipt of Form CCC-601 and any
appendix thereto. By signing this form, the producer agrees that: (1) the interest rate applicable to the loan will be determined in accordance with
7 CFR Part 1405 and will be the rate of interest charged by the U.S. Treasury, plus 1 percent, for funds borrowed by CCC on the date the loan
proceeds are disbursed to each producer, and (2) the maturity date of the loan will be the last day of the 9th calendar month following the month
in which such loan proceeds are disbursed. CCC may at any time accelerate the maturity date of this loan upon demand of payment. The loan
disbursement date, actual interest rate and maturity date for the loan may be obtained at the County FSA Office listed below. In the event that
the producer authorizes and designates an agent on form CCC-605 to redeem all or a portion of the collateral for this loan, the producer
authorizes CCC to 1) release to the provider of electronic warehouse receipts the loan number, State and County Code, electronic redemption
status, date of documents received, and date of disbursement of this loan, and 2) to accept and act upon the information contained on any copy
of the CCC-605 received by telefacsimile, mail, or other means if the producer has not submitted form FSA-237, "Facsimile Signature
Authorization and Verification".
The producer hereby sells, assigns, and mortgages, to CCC as collateral for the payment of this Note plus charges and interest, all of the
commodity described in this Note and attached Form CCC-Cotton A-1, Schedule of Pledged Cotton, and Form CCC-Cotton A Continuation, if
any, together with all authorized replacements, substitutions, additions, and accessions thereto, which is stored in this warehouse specified in
this Note.
Are you or any co-applicant delinquent on any Federal non tax debt? (If "YES", attach details to this form)
Signature
APPROVED FOR CCC BY
Date
YES
DATE
NO
Date
Signature
Name and Address of County FSA Office
TELEPHONE NO. (Including Area Code):
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, gender, religion, age, disability, political beliefs, sexual orientation, and
marital or family status. (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 USDA, Director, Office of Civil Rights, Room 326-W, Whitten Building, 1400 Independence
Avenue, SW, Washington, D.C. 20250-9410 or call (202) 720-5964 (voice or TDD). USDA is an equal opportunity provider and employer.