# Instructions for form [NRCS-CPA-09]{.underline}

# POWER OF ATTORNEY

### The Power of Attorney is the document that is used by a program participant in a conservation program administered by the Natural Resources Conservation Service (NRCS) to authorize a different individual to act on behalf of the program participant. The program participant provides to NRCS the signed document prior to NRCS accepting any program action by someone other than the program participant. The program participant identifies the name of the "Attorney-in-Fact" and the programs for which that person is authorized to conduct business on behalf of the program participant. The program participant signs the Power of Attorney and has the signature witnessed by a public notary. Once the Power of Attorney is signed, notarized, and delivered to an NRCS representative, the "Attorney-in-Fact" is authorized to conduct business with NRCS related to the identified conservation programs. The program participant is responsible for completing items 1-7 on the Power of Attorney, and the program participant's public notary is responsible for completing items 8-16. 

### Items 1-7 are for completed by the program participant.

+-----------+-----------------------------------------------------------+
| ##        | ### Instruction {#instruction .unnumbered}                |
| # Fld Nam |                                                           |
| e / Item  |                                                           |
| No. {#fld |                                                           |
| -name-ite |                                                           |
| m-no. .un |                                                           |
| numbered} |                                                           |
+===========+===========================================================+
| Item No.  | Enter your name identically to how it appears in the deed |
| 1         | or lease by which you obtained control of the property    |
|           | affected by program participation.                        |
+-----------+-----------------------------------------------------------+
| Item No.  | Enter the name of the individual you wish to designate as |
| 2         | authorized to conduct business with NRCS on your behalf.  |
+-----------+-----------------------------------------------------------+
| Item No.  | Check the name of the program(s) for which you wish the   |
| 3         | Power of Attorney to apply. If the name of the program is |
|           | not identified in the list, check the blank next to the   |
|           | item "Other", and enter the name of the program.          |
+-----------+-----------------------------------------------------------+
| Item No.  | Enter the day of the month on which you are signing the   |
| 4         | Power of Attorney                                         |
+-----------+-----------------------------------------------------------+
| Item No.  | Enter the month of the year in which you are signing the  |
| 5         | Power of Attorney                                         |
+-----------+-----------------------------------------------------------+
| Item No.  | Enter the year in which you are signing the Power of      |
| 6         | Attorney                                                  |
+-----------+-----------------------------------------------------------+
| Item No.  | Sign your name as it appears in Item 1.                   |
| 7         |                                                           |
+-----------+-----------------------------------------------------------+

### 

### Items 8-16 are to be completed by the public notary witnessing the program participant signature.

+-----------+-----------------------------------------------------------+
| ###       | ### Instruction {#instruction-1 .unnumbered}              |
| Fld Name  |                                                           |
| / Item No |                                                           |
| . {#fld-n |                                                           |
| ame-item- |                                                           |
| no.-1 .un |                                                           |
| numbered} |                                                           |
+===========+===========================================================+
| Item No.  | Enter the name of the State in which you are witnessing   |
| 8         | the program participant's signature.                      |
+-----------+-----------------------------------------------------------+
| Item No.  | Enter the name of the County in which you are witnessing  |
| 9         | the program participant's signature.                      |
+-----------+-----------------------------------------------------------+
| Item No.  | Enter the day of the month in which you are witnessing    |
| 10        | the program participant's signature.                      |
+-----------+-----------------------------------------------------------+
| Item No.  | Enter the month in which you are witnessing the program   |
| 11        | participant's signature.                                  |
+-----------+-----------------------------------------------------------+
| Item No.  | Enter the year in which you are witnessing the program    |
| 12        | participant's signature.                                  |
+-----------+-----------------------------------------------------------+
| Item No.  | Enter the name of the program participant.                |
| 13        |                                                           |
+-----------+-----------------------------------------------------------+
| Item No.  | Enter the appropriate masculine or feminine form of the   |
| 14        | pronoun (i.e. he/she) for the program participant.        |
+-----------+-----------------------------------------------------------+
| Item No.  | Enter the appropriate masculine or feminine form of the   |
| 15        | adjective (i.e. his/her) for the program participant.     |
+-----------+-----------------------------------------------------------+
| Item No.  | Sign your name.                                           |
| 16        |                                                           |
+-----------+-----------------------------------------------------------+