Ccc 941 form 2026

The document is a form (CCC-941) from the U.S. Department of Agriculture for certifying Average Adjusted Gross Income (AGI) and consenting to the disclosure of tax information for eligibility in various agricultural program benefits. It outlines the requirements for providing personal or entity information, the calculation of AGI based on prior tax years, and the implications of failing to provide accurate information. The form also includes instructions for completion and emphasizes compliance with privacy laws.

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Click ‘Get Form’ to open the CCC-941 in the editor.
Enter the name and address of the FSA county office or USDA service center where you will submit the completed form.
In Item 2, provide your name and address as it appears on your IRS tax returns for accurate identification.
Input your Taxpayer Identification Number (TIN) in Item 3, ensuring it matches the individual or legal entity listed.
For Item 4, specify the program year for which you are requesting benefits. This determines the three-year period used for calculating average adjusted gross income (AGI).
In Item 5, select whether your average AGI is less than or equal to $900,000 or more. Choose only one option.
Review all acknowledgments and responsibilities before signing in Item 6. Ensure that you are authorized to sign on behalf of a legal entity if applicable.
Complete Items 7 and 8 by entering your title/relationship and the date of signature respectively.

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