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Instructions For AD-1154 (Former NRCS-LTP-002, CCC-1251)

LONG-TERM AGREEMENT

Program participants use this form to enter into an agreement or contract with the Natural Resources Conservation Service (NRCS) or Commodity Credit Corporation (CCC). This form is applicable to the following programs: Emergency Watershed Program (EWP), Watershed Protection and Flood Prevention Program (WPFPP), Colorado Salinity Control Program (CRSCP), Great Plains Conservation Program (GPCP), Interim Environmental Quality Incentives Program (IEQIP), Water Bank Program (WBP), Wetlands Reserve Program (WRP), and Wildlife Habitat Incentives Program (WHIP).

Submit the original of the completed form in person, by mail or via facsimile to the appropriate NRCS servicing office. This form cannot be submitted electronically at this time.

Program participant(s) must complete Items 4 through 11d as applicable and reads the agreement terms contained on the form.

Items A-E, 1a-3b and Items 6-6b are for NRCS use only.

Items 4-11d

Fld Name / Item No. Instruction
4.

Name, Address

5-11 if applicable		 Enter the participant(s) full name(s) and address, including street, city, and zip code. If there is more than one program participant, record ALL names and entities affiliated with the contract in the spaces provided in items 5-11, if applicable.

Note: Individuals need only record their names. Persons acting on behalf of entities such as corporations or estates must indicate both the filers name and the name of the entity, such as Mary Smith of Smith Corporation or Mark Tillman of Tillman Estate.
4a.

Telephone Number

5a-11a if applicable		 Enter the daytime telephone number for contacting the participant, including area code. If there is more than one program participant or entity, enter ALL telephone numbers affiliated with the contract in 5a-11a, if applicable
4b.

SSN or Tax ID#

5b-11b if applicable		 Enter the social security number of the program participant, or tax identification number of the entity, if applicable.

If there is more than one participant or entity, enter ALL social security numbers or tax identification numbers in items 5b-11b, if applicable.
4c.

Signature

5c-11c if applicable		 Enter the signature for the participant(s). All participant(s) must sign the agreement. Enter the signature that you use when you file your tax return. Print the form and manually enter your signature after entering the date in Item 4d. If there is more than one participant, they must complete items 5c-11c, if applicable.

Note: by signing the contract, participant(s) acknowledge receipt AD-1154, Attachment A: General Provisions; Attachment B: Schedule of Operations, Attachment C: Special Provisions; and Attachment D: Location Map.
4d.

Date

5d-11d if applicable		 Enter the date that the participant(s) signs the form. Enter the date using the format of two digits for the month, day and year separated by a dash. Example: mm-dd-yy.

If there is more than one participant, they must complete items 5d-11d, if applicable.

Items 6-6b are for NRCS use only.