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\nowidctlpar\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\cgrid \snext0 Normal;}{\*\cs10 \additive Default Paragraph Font;}}{\info{\title Farm Contracts / CRP Payments Submission Worksheet}{\author Karen Knott}{\operator George Karl}
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\qc\nowidctlpar\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\cgrid {\b\f1\fs24 Farm Contracts / CRP Payments Submission Worksheet}{\f1\fs24 
\par }{\b\f1\fs24 
\par }{\f1\fs24 
\par }\pard \nowidctlpar\tldot\tx4680\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\b\f1\fs24 CCFC/Referral Representative Information
\par }\pard \sl360\slmult0\nowidctlpar\tldot\tx4680\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\b\f1\fs24 
\par }\pard \sl360\slmult0\nowidctlpar\tlul\tx6930\tlul\tx9187\faauto\adjustright\rin0\lin0\itap0 {\f1\fs24 Name\tab Date\tab 
\par }\pard \sl360\slmult0\nowidctlpar\tlul\tx9187\faauto\adjustright\rin0\lin0\itap0 {\f1\fs24 Company\tab \tab 
\par Address \tab \tab 
\par }\pard \sl360\slmult0\nowidctlpar\tlul\tx4680\tx5040\tlul\tx9187\faauto\adjustright\rin0\lin0\itap0 {\f1\fs24 City\tab  State  ___________ ZIP\tab 
\par Phone \tab  Fax\tab }{\b\f1\fs24 
\par }\pard \sl360\slmult0\nowidctlpar\tldot\tx4680\tx5040\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f1\fs24 
\par }{\b\f1\fs24 Client Information
\par }\pard \sl360\slmult0\nowidctlpar\tlul\tx4680\tlul\tx9187\faauto\adjustright\rin0\lin0\itap0 {\f1\fs24 Name \tab  Date\tab 
\par }\pard \sl360\slmult0\nowidctlpar\tlul\tx9187\faauto\adjustright\rin0\lin0\itap0 {\f1\fs24 Address \tab 
\par }\pard \sl360\slmult0\nowidctlpar\tlul\tx4680\tlul\tx9187\faauto\adjustright\rin0\lin0\itap0 {\f1\fs24 City \tab  }{\f1\fs24 State  ___________ }{\f1\fs24 ZIP\tab 
\par }\pard \sl360\slmult0\nowidctlpar\tlul\tx9187\faauto\adjustright\rin0\lin0\itap0 {\f1\fs24 Home Phone \tab 
\par }\pard \sl360\slmult0\nowidctlpar\tlul\tx4680\tlul\tx9187\faauto\adjustright\rin0\lin0\itap0 {\f1\fs24 
\par }\pard \sl360\slmult0\nowidctlpar\tldot\tx4680\tx5040\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\b\f1\fs24 Payments due to client as listed on Form CCC\_478P
\par  }{\f1\fs24 
\par }\pard \nowidctlpar\tx720\tx1440\tx1980\tqr\tx10080\faauto\adjustright\rin0\lin0\itap0 {\b\f1\fs24 Year \tab \tab Payment Amount}{\f1\fs24 
\par 
\par 1998\tab  \tab __________________________
\par 
\par 1999\tab  \tab __________________________
\par 
\par 2000\tab \tab __________________________
\par 
\par 2001\tab \tab __________________________
\par 
\par 2002 \tab \tab __________________________
\par 
\par 
\par Client has elected to receive payments:
\par 
\par  \tab }{\f1 {\field{\*\fldinst SYMBOL 111 \\f "Wingdings" \\s 10}{\fldrslt\f14\fs20}}}{\f1   }{\f1\fs24 September only
\par 
\par  \tab }{\f1 {\field{\*\fldinst SYMBOL 111 \\f "Wingdings" \\s 10}{\fldrslt\f14\fs20}}}{\f1   }{\f1\fs24 September and December
\par 
\par  \tab }{\f1 {\field{\*\fldinst SYMBOL 111 \\f "Wingdings" \\s 10}{\fldrslt\f14\fs20}}}{\f1   }{\f1\fs24 September and January
\par 
\par 
\par }{\i\f1\fs24 Attach copy of Form CCC-478P and/or Forms CRP-1 and CRP-2}{\f1\fs24 
\par 
\par }{\f1 /farmpymt}{
\par }}