|
U.S. Department of Agriculture NRCS-CPA-41
<br />Natural Resources Conservation Service 12/2016
<br />NONDISCRIMINATION STATEMENT
<br />The U.S. Department of Agriculture (USDA) prohibits discrimination against its customers. If you believe you
<br />experienced discrimination when obtaining services 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 discrimination complaint is available from the Office of the Assistant Secretary
<br />for Civil Rights.
<br />USDA prohibits discrimination in all its programs and activities on the basis of race, color, national origin,
<br />age, disability, and where applicable, sex (including gender identity and expression), marital status, familial
<br />status, parental status, religion, sexual orientation, political beliefs, genetic information, reprisal, or because
<br />all or part of an individual's income is derived from any public assistance program. (Not all prohibited bases
<br />apply to all programs.)
<br />To file a complaint of discrimination, complete, sign and mail a program discrimination complaint form,
<br />available at any USDA office location or online at www.ascr.usda.. ov, or write to:
<br />USDA
<br />Office of the Assistant Secretary for Civil Rights
<br />1400 Independence Avenue, S.W.
<br />Washington, D.C. 20250-9410
<br />Or call toll free at (866) 632-9992 (voice) to obtain additional information, the appropriate office or to request
<br />documents. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through
<br />the Federal Relay service at (800) 877-8339 or (800) 845-6136 (in Spanish). USDA is an equal opportunity
<br />provider, employer, and lender.
<br />Persons with disabilities who require alternative means for communication of program information (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 Privacy Act of 1974 (U.S.C. 522a). Furnishing
<br />this information is voluntary; however, failure to furnish correct, complete information will result in the
<br />withholding or withdrawal of such technical or financial assistance. The information may be fumished to
<br />other USDA agencies, the Internal Revenue Service, the Department of Justice, or other State or Federal
<br />law enforcement agencies, or in response to orders of a court, magistrate, or administrative tribunal.
<br />This information collection 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 as an Eligible Entity under ACEP-ALE a non-governmental organization must be:
<br />(1) organized for, and at all times since the formation of the organization been operated principally for, 1 or
<br />more of the conservation purposes specified in clause (i), (ii), (iii), or (iv) of section 170(h)(4)(A) of the
<br />Internal Revenue Code of 1986;
<br />(2) an organization described in section 501(c)(3) of that Code that is exempt from taxation under section
<br />501(a) of that Code; or
<br />(3) described in "(1) section 509(a) (1) and.(2) of that Code; or (II) section 509(a)(3) of that Code and is
<br />controlled by an organization described in section 509(a)(2) of that Code.
<br />ii Select only one. ACEPALE applications are organized by Eligible Land type; ACEP ALE agreements are
<br />specific to the Eligible Land type. The Eligible Land type will affect minimum deed terms and ALE Plan .
<br />requirements. Applications with more than one selection may be deferred until corrected.
<br />iii Historical and archaeological resources mean resources that are:
<br />(1) Listed in the National Register of Historic Places (established under the National Historic Preservation
<br />Act (NHPA), 16 U.S.C. 470, et seq.);
<br />(2) Formally determined eligible for listing in the National Register of Historic Places (by the State historic
<br />preservation officer (SHPO) or Tribal historic preservation officer (THPO) and the Keeper of the National
<br />Register in accordance with section 106 of the NHPA);
<br />PAGE 4 of 5
<br />
|