540062_leaseagreement_20140613

FSA-211 U. S. DEPARTMENT OF AGRICULTURE
Farm Service Agency - Natural Resources Conservation Service -
(92-97 8) Commodity Credit Corporation - Federal Crop Insurance Corporation - Risk Management Agency L
POWER OF ATTORNEY
THE frD KI NF.D does heRby appoint the following grantee:
(I) 1 D G of the following address: R)
in the county of (3) L e ,1 D , r in the State of:
(4) /y (' the attorney -in -fact for (S) k ;ny it ('yG„t •f � � 1 �'�^ LL L
(insert grantor's name) in connection with the Farm Service Agency, Natural Resources Conservation Service Agency, or Commodity Credit Corporation
Programs checked below. NOTE: This power of attorney form is not valid for FSA Farm Loan Program purposes.
A. FSA, NRCS and CCC PROGRAMS
(Check applicable programs)
1. All current programs. ❑ 10. Noninsrucd Crop Disaster
2. All current and all future programs. Assistance Proms.
❑ ❑ 11. Marketing Assistance Loans and
3. Direct and Counter-GYclical Pr
ogram Loan Deficiency Payments.
❑ 4. Average Crop Revenue Election
Program.
® 5. Supplemental Revemie Assistance
PaymcM Program (SURE).
6. Tree Assistance Program (TAP).
7. Livestock Indemnity Program (LIP).
[] S. Livestock Forage Disaster
Program (LFP).
® 9. Emergency Assistance for
Livestock, honey Bees, and
Farm -Raised Fish (FLAP).
❑ 12, Milk Income Loss Cormact
Program.
❑
13. Farm Storage Facility Loan
Program.
❑
14. FSA Conservation Programs.
❑
15. NRCS Conservation Programs.
❑
16. Tobacco Programs.
®
17. Other (Spec):
B. TRANSACTIONS for FSA, NRCS and CCC PROGRAMS
(Check applicable actions)
.All actions.
® 2 Signing applications, agreements, and
contracts.
❑ 3. Making reports ❑ 4. Conducting all marketing assistance R E C E N E D
loan and LDP transactions.
❑ 5. AGI Certification
❑ 6. Routing Banking Accounts
❑ 7. Other (Spec):
JUN `',
LENOIR COUNTY FARM,
SERVICE AGENCY
This form may also be used to grant authority to an attorney -in -fact to act on the grantor's behalf with respect to FCIC crop insurance policies.
Checking any of the FCIC transactions does not have any impact as to the FSA, NRCS or CCC transactions checked above:
C. INSURED CROPS/STATE/COUNT V
(Enter "All" or specify each crop, state, county and year(s)
1. A 1.1
2.
3.
4.
D. CROP INSURANCE TRANSACTIONS
(Check applicable actions)
o i. All actions. ❑ 5. Making transfers and cancellations.
❑ 2. Making application for insurance. ❑ 6. Making contract changes.
❑ 7. Other act&)'
L_] 3. Reporting crop acreage and P-11 on
reports.
❑ 4.
a notice of damage or loss
This Power of Attorney is valid in all counties in the United States unless otherwise noted. This power of attorney shall remain in full force and effect ulltltl (I) written notice
of its revocation has been duly served upon FSA, NRCS or CCC as appropriate; (2) death of the undersigned grantor, or (3) incompetence or incapacitation of tbe undersigned
grantor. The undersigned grantor shall provide separate written notice of revocation to the applicable crop insurance agent. This power of attorney shall not be effective
rmrit rm,nerty executed and served to a USDA Service Center.
Trust, etc.) (By)
Notary Public (this, fV be
Signature (a)
Witness Signature (FSA Employee Only)
N2 - 13 - 2011
TiddRelationship of Individual Signing
in the Representative Capacity
rotary Public unless witnessed by a FSA employee or a e
the State of (b) /kS the County o
9B. Signature Date
10. This power of rorney was served to (a) `14��! Qt -
Of /V (---- _ and became effective this
day of
Continuation, check here
if FSA-21LA-is attached.
Signature Date (MM DD-YYY7
DINA G
ommission Expires
USDA Service Center, (b) State
(e) �)( .
NOTF- The primary authority for requesting and safeguarding the k9bymaftn described on this form is the Food Conser egm, and Energy Act of ZQ08 (Pub L 11D-246errd any
anwdnarrts to such act as may fbf w). The infarmaflon requested is necessary far the auf o&ed attomePW4bd to act in a repr96elrtaffue pparxty for rite undersigned
torn
grantor Famishing the requested Information is volLu f y. FWlu►a to furnish the requested kdbrrnaffon wl7i rosuk in a deftww i�im of krer &* for P►Og
benefrts and other flhanciai assistance administered by USDA. The inrormako colleted as a result of this farm may be released to USDA employee% USDA contractors,
or authorized USDA cooperators who are band to safeguard the information under Section 1619 of the Food, Conselvateon and EneW A4 the R*M7 Act of 1974' the
E-GavemmentActof 2002, and related ougmrfUem The information coihctk- is exempted from the Paperwork Rkdueffon Act as it is requked far the adrnbfTshaffm Of"
Food Conservation, and Energy Act of 2008 (see Pub. L 110-244 Ti fe i, Subtiffe F Adminics mWn slid Trde ii. SOW J -A&*W atlon). The Provisions of taiminal,
civ,7 ad privacy statutes may be appheabie to fhe imfomra w pmvfdeol REiUM THIS COMPLETED FORM TO THE APPLICABLE USDA SERVICE CEN7M
The US Depmtmerrt ofAg=ft- (USDA) prohrlds d »n in M its mvn msard acihdBas on the basis of race cOIan neftW origin. age tHsab W. and w/M appticRW am madfe(Sfa&A iandW
ata ^ pew sbiva, refigbn, mualartwW,4 genetic edmutbn, po&21 be&ft remiw arbecause ag or part of an kdvldrmis henna is de*W fiom any xmk ass oe program M017preaw
bases aFW t4 asPm9n ms.) Persons we cambmes who reglwe alternative means foreommunwahm OfPWM irdammfio n l! fa►p Aft ai dolaae etc) tiro M wntO USDA's TARGET Camera
= 72o.2m Note and TDD). To file a eamp wm of tffsW MWw, write to USDA, Maxtor, 0r=&0flaRWft t4W bdeperWWw Avenue, S.W., wadrngton, D.C. 20250-ga10, orcO MOD) 79-1-VM
"ft) cr (=) r2awa2 (GOD). USDA is an equal oppomuriry prawi W -d emPloYer.