To the extent that the
information requested herein relates to your individual
capacity as opposed to your business capacity, the
following statements are made in accordance with the
Privacy Act of 1974, as amended (5 U.S.C. 552a). The
Federal Crop Insurance Act (7 U.S.C. 1501-1524) (Act)
and the regulations contained in 7 C.F.R. chapter IV
provides the authority to request the information on
this form..
Collection of the social security
account number (SSN) or the employer identification
number (EIN) is authorized by section 506 of the Act and
is required as a condition of eligibility for
participation in the Federal crop insurance program. The
primary use of the SSN or EIN is to correctly identify
you, and any other person with an interest in you or
your entity of 10 percent or more, as a policyholder
within the systems maintained by the Federal Crop
Insurance Corporation (FCIC). Furnishing the SSN or EIN
is voluntary. However, failure to furnish that number
will result in denial of program participation and
benefits.
Your policy also specifies other
information that must be provided. The principle
purposes of this information are to provide insurance;
reinsurance; determine eligibility; determine the
correct parties to the agreement; determine and collect
premiums or other monetary amounts (including
administrative fees and over payments); and pay
benefits. The routine uses of this information include:
(1) Referral to the appropriate agency, whether Federal,
State, local or foreign including the Department of
Justice, charged with the responsibility of
investigating or prosecuting a violation of law, or of
enforcing or implementing a statute, rule regulation or
order issued pursuant thereto, of any record within this
system when information available indicates a violation
or potential violation of law, whether civil, criminal,
or regulatory in nature, and whether arising by general
statute or particular program statute or by rule,
regulation or order issued pursuant thereto; (2)
Disclosure to a court, magistrate or administrative
tribunal, or to opposing counsel of any record within
the system that constitutes evidence in that proceeding,
or which is sought in the course of discovery, to the
extent that FCIC determines that the records sought are
relevant to the proceeding; (3)
Disclosure to a congressional office in
response to any inquiry from the congressional office
made at the request of that individual; (4) Disclosure
to Approved Insurance Providers (AIP), contractors,
cooperators, partners of FCIC, and other Federal
agencies for any purpose relating to the sale, service,
and administration of the Federal crop insurance program
and the policies insured under the authority of the Act;
(5) Disclosure to other Federal agencies and
contractors, cooperators, and partners of FCIC for the
purpose of conducting research, development, analyses,
and evaluation into all aspects relating to new and
existing crop insurance programs and other risk
management tools; (6) Disclosure to contractors or other
Federal agencies to conduct research and analysis to
identify patterns, trends, anomalies, instances and
relationships of AIP’s, agents, loss adjusters and
policyholders that may be indicative of fraud, waste, or
abuse; (7) Disclosure to AIPs, contractors, and other
applicable Federal agencies to determine whether
information has been accurately provided to FCIC and the
AIPs and to determine compliance with program
requirements; and (8) Disclosure to the Comprehensive
Information Management System (CIMS) authorized under
the Farm Security and Rural Investment Act of 2002,
Section 10706 (All information disclosed to CIMS may be
further disclosed to any contractor engaged in the
development or maintenance of CIMS, to the Farm Service
Agency (FSA) and to AIPs, their insurance agents and
loss adjusters, for information associated with their
insured producers and only with regard to such
policies); and (9) To appropriate agencies, entities,
and persons when: (a) USDA suspects or has confirmed
that the security or confidentiality of information in
the\ system of records has been compromised; (b) USDA
has determined that as a result of the suspected or
confirmed compromise there is a risk of harm to economic
or property interests, identity theft or fraud, or harm
to the security or integrity of this system or other
systems or programs (whether maintained by the
Department or another agency or entity) that rely upon
the compromised information; and (c) the disclosure made
to such agencies, entities, and persons is reasonably
necessary to assist in connection with the Department’s
efforts to respond to the suspected or confirmed
compromise and prevent, minimize, or remedy such harm.
Furnishing other information is also
voluntary. However, failure to report the information
specified in your policy may result in rejection of any
claim for indemnity, replanting payment, or other
benefit; ineligibility for insurance; a unilateral
determination of any monetary amounts due; or any remedy
provided in the policy.