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U.S . Department.of AQrlc&ilture
<br />Natu,-1 Re1MUce1 ConeetVatton Service
<br />NONDISCRIMINATION STATEMENT
<br />NRCS-CPM1
<br />12/2018
<br />The U.S. Department of Agriculture (USDA) prohibits discrimination againet i:tl customers. If you belleve you
<br />experienced diacrlmlnatlon when obtaining seNlcea from USDA, participating In a USDA program , or
<br />participating In a program that receives financial assistance from USDA, you may file a complaint with USDA.
<br />Information about how to file a dlacrimination complaint Is available from the Office of the Assistant Secretary
<br />for CMI Rights.
<br />USDA prohibits dlacrfminatlon in all Ill programa and actlvttles on the basis of race . color, national ortgln ,
<br />age, dlsablllty , and where appll~ble, sex (Including gender Identity and expreHion), marital status , familial
<br />statue, parental statua, rel!glon 1 aexual orientation, political bellefa, ganettc Information, repriaal , or because
<br />all or part of an lndilrlduara Income 11 derived from any public aasistance program . (Not all prohibited bales
<br />apply to all programs.)
<br />To file a complaint of discrimination, complete, sign and mail a program discrimination complaint form,
<br />avallable at any USDA office location or online at www .ascr.usdagov, or write to:
<br />USDA
<br />Office of the Assistant Secretary for CMI Rlghta
<br />1400 Independence Avenue, S.W.
<br />Washington, D.C. 20250-9410
<br />Or can toll free at (866) 632-9992 (voice) to obtain additional information, the appropriate office or to request
<br />documenta. Individuals who are deaf, hard of hearing or have speech disabllitiaa may contact USDA through
<br />the Federal Relay service at (800) an-8339 or (800) 84~138 (in Spanish). USDA is an equal opportunity
<br />provider, employer, and lender.
<br />Persona with disabHltiee who require alternative means for communication of program infonnation (e.g.,
<br />Braille, large print, audiotape, etc.) should contact USDA's TARGET Center at (202) 720-2600 (voice and
<br />TDD).
<br />PRIVACY ACT STATEMENT
<br />The following statements are made In accordance With the Prtvacy Act of 1974 (U.S.C. 522a). Furnishing
<br />this Information ia voluntary; however, fallure to furnish correct, complete infQnnation will result in the
<br />withholding or wlthdrawal of such technical or flnanclal aaalatance . The Information may be rumlished to
<br />other USDA agenc~, the Internal Revenue Service, the Oep•-rtment of Jultice, or other State or Federal
<br />law enforcement agencies, or In response to orders of a court , magistrate , or adminlatrative btbunaL
<br />Thia information colectlon is exempted from the Paperwork Reduction Act under 16 U.S.C. 3801 note and
<br />16 u.s.c. 3846.
<br />I To be considered •• an Ellglble Entity under ACEP-ALE a non-governmental organization must be:
<br />(1) organized for, and at au times since the fonnation of the organization been operated princ ipally for, 1 or
<br />more of the conservation purposes specified In clause (l), (II), (Iii), or (iv) of section 170(h)(4)(A) of the
<br />Internal Revenue Code of 1988;
<br />(2) an organization daacrlbed In section 501 (c)(3) of that Code that ia exempt from taxation under section
<br />501 (a) of that Code; or
<br />(3) described In "(I) aection 509(a) (1) and (2) of that Code; or (II) section 509(a)(3) of that Code, and ia
<br />controlled by an org~nizallon described In section 509(a)(2) of that Code.
<br />II Select onfy one. ACEP-ALE applications are organl2ed by EHglble Land type; ACEP-ALE qreements are
<br />specific to the Eligible Land type. The Eligible Land type wtH affect minimum deed tenns and ALE Plan .
<br />requirement,. Applications with more than one selection may be defeffed until corrected.
<br />Ill Historical and archHologlcal rasources mean resources that are:
<br />(1) Listed in the National Regiater of Historic Places (established under the National Historic Preservation
<br />Act (NHPA), 18 U.S.C. 470, et seq.);
<br />(2) Fonnally determined eligible for listing in the National Register of Historic Places (by the State historic
<br />preservation officer (SHPO) or Tribal hletorlc preservation officer (THPO) and the Keeper of the National
<br />RegJater In accordance with section 106 of the NHPA);
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