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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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Versions	Form popularity	Fillable & printable
2020	4.9 Satisfied (22 Votes)
2019	4.8 Satisfied (40 Votes)
2014	4.3 Satisfied (48 Votes)

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