United States

Department of

Agriculture

Federal Crop

Insurance

Corporation 

FCIC-20660U 

(01-2022) 

POSTAPPLICATION 

COVERAGE 

ENDORSEMENT 

INSURANCE

STANDARDS 

HANDBOOK 

2022 and Succeeding Crop 

Years

December 2021 FCIC-20660U TP 1 

RISK MANAGEMENT AGENCY

KANSAS CITY, MO 64133

TITLE: POST-APPLICATION 

COVERAGE ENDORSEMENT CROP 

INSURANCE STANDARDS HANDBOOK

NUMBER: FCIC-20660U

EFFECTIVE DATE: 

2022 and Succeeding Crop Years

ISSUE DATE: January 5, 2022

SUBJECT:

Provides the procedures and instructions 

for administering the Post-Application 

Coverage Endorsement crop insurance 

program. 

OPI: Product Administration and Standards 

Division

APPROVED: 

/s/ Richard Flournoy

Deputy Administrator for Product Management 

REASON FOR ISSUANCE

This handbook is being issued to provide procedures and instructions for administering the PostApplication Coverage Endorsement for the 2022 and succeeding crop years.
December 2021 FCIC-20660U TP 2

INSURANCE STANDARDS HANDBOOK

CONTROL CHART

Post Application Coverage Application Insurance Standards Handbook

TP

Page(s)

TC

Page(s)

Text

Page(s)

Exhibit 

Number 

Exhibit 

Page(s) 

Date FCIC

Number

Current 

Index 1-2 1 1-12 1-7 13-34 12-2021 FCIC-20660L

FILING INSTRUCTIONS:

This handbook is effective for the 2022 and succeeding crop years.
December 2021 FCIC 20660U TC1

POST-APPLICATION COVERAGE ENDORSEMENT CROP INSURANCE STANDARDS 

HANDBOOK --TABLE OF CONTENTS

PAGE NO.

PART 1 GENERAL INFORMATION AND RESPONSIBILITIES

1 General Information................................................................................................................... 1

2 Responsibilities.......................................................................................................................... 1

3-10 (Reserved)

PART 2 STANDARDS AND INSTRUCTIONS

11 General Rules............................................................................................................................. 3

12-20 (Reserved)

PART 3 INSURABILITY

21 Insurable Practice....................................................................................................................... 4

22 Insurance Dates.......................................................................................................................... 4

23 Insurance Period ........................................................................................................................ 4

24 Coverage Level.......................................................................................................................... 4

25 Causes of Loss........................................................................................................................... 4

26 Units........................................................................................................................................... 5

27 Application and Reporting Instructions..................................................................................... 6

28 Written Agreements................................................................................................................... 7

29-30 (Reserved)

PART 4 GUARANTEES, PREMIUMS, AND INDEMNITIES

31 The PACE Guarantee ................................................................................................................ 8

32 Premium Calculation ................................................................................................................. 8

33 Indemnity................................................................................................................................. 10

34-40 (Reserved)

EXHIBITS

1 Acronyms and Abbreviations.................................................................................................. 13

2 Definitions ............................................................................................................................... 14

3 Post-Application Coverage Endorsement Application............................................................ 15

4 Post-Application Coverage Endorsement Acreage Report...................................................... 21

5 Post-Application Coverage Endorsement Nitrogen Report..................................................... 27

6 Notice of Probable Loss........................................................................................................... 30

7 Production Report.................................................................................................................... 32
December 2021 FCIC 20660U 1

PART 1 GENERAL INFORMATION AND RESPONSIBILITIES

1 General Information

A. Purpose 

The purpose of this handbook is to provide supplementary instructions for 

establishing Post-Application Coverage Endorsement (PACE) crop insurance 

coverage in accordance with the PACE Endorsement (22-PACE-20660), PACE 

LASH (FCIC-20660L), CIH (FCIC-20660U), DSSH (FCIC-24040), and GSH 

(GSH-18190). The supplemental RMA-issued standards for this crop and crop year 

are in effect as of the signature date for this crop handbook 

https://www.rma.usda.gov/en/Policy-and-Procedure/Privately-Developed-Products--

-20000.

This handbook remains in effect until superseded by reissuance of either the entire 

handbook or selected portions (through amendments, bulletins, or Final Agency 

Determinations). If amendments are issued for a handbook, the original handbook 

as amended shall constitute the handbook. A bulletin or Final Agency 

Determination can supersede either the original handbook or subsequent 

amendments.

B. Source of Authority 

The PACE is approved by the Federal Crop Insurance Corporation (FCIC) Board of

Directors under Section 508(h) of the Federal Crop Insurance Act.

C. Program Duration

PACE is available beginning with the 2022 crop year and continues until terminated by 

FCIC.

D. Approved Insurance Provider (AIP) Option to Offer

In accordance with Section II. (a) (3) of the Standard Reinsurance Agreement (SRA), AIPs 

are not required to offer PACE to insureds. Accordingly, each AIP must determine whether 

it will offer the PACE. AIPs that elect to offer the PACE must offer it to all eligible 

insureds everywhere it is available and must administer the program according to the 

policies and procedures approved by FCIC.

2 Responsibilities

A. AIP’s Responsibilities

AIPs must use standards, procedures, methods, and instructions, as authorized by

FCIC, in the sale and service of PACE. Each AIP is responsible for using RMA

approved procedures. AIPs should report any program issues or concerns to the

Product Administration and Standards Division (PASD) of RMA.
December 2021 FCIC 20660U 2

2 Responsibilities (continued)

B. Agent’s Responsibilities

PACE requires additional records regarding nitrogen practices and applications to be 

submitted in the event of an insurable cause of loss. It is recommended that the agent 

review the applicant’s records at the time of completing the application to assure the correct 

entity and other application determinations can be verified.

C. Insured’s Responsibilities

(1) PACE Eligibility – To be eligible for PACE: 

(a) The insured must have an underlying insurance policy in force (YP, RP, or RPHPE) for non-irrigated corn.

(b) Coverage for the underlying insurance policy must be at the additional coverage 

level.

(c) The insured must use a split application of nitrogen practice.

(d) The insured must comply with all terms and conditions of the underlying 

insurance policy.

(e) The insured must have documentation supporting the purchase of nitrogen for 

the split-application of nitrogen practice.

(f) The insured must have been physically prevented from applying the postapplication of nitrogen during the insurance period by an insurable cause of loss 

stated in the underlying insurance policy.

(g) The acreage on which a split application of nitrogen practice was intended, and 

the pre-application of nitrogen was applied must be listed on the insured’s 

timely submitted PACE acreage report.

3-10 (Reserved)
December 2021 FCIC 20660U 4

PART 2 STANDARDS AND INSTRUCTIONS

11 General Rules

A. This part identifies information specific to the applicability of the CIH, GSH, DSSH, LAM, 

LASH and any other procedural issuance that may require supplemental information 

regarding a crop insured under the Post-Application Coverage Endorsement.

B. Related Handbooks

The following table provides handbooks closely related to this handbook. However, other 

RMA approved handbooks may refer to this handbook and be applicable.

Handbook Relation/Purpose

CIH Provides overall general underwriting (not crop specific) procedures.

DSSH Provides general document standards.

GSH Provides general administrative procedures.

LAM Provides general loss adjustment procedures.

PACE LASH Provides loss adjustment procedures.

(1) General procedures, terms, abbreviations, and definitions (not crop specific) are 

identified in the CIH, GSH, and LAM.

(2) Procedures, terms, abbreviations, and definitions specific to PACE are identified as

additions or exceptions in this handbook.
December 2021 FCIC 20660U 4

PART 3 INSURABILITY

21 Insurable Practice

The only practice insurable under PACE is a split application of nitrogen on eligible nonirrigated corn acres. PACE only provides an indemnity for those acres for which the postapplication of nitrogen was prevented.

22 Insurance Dates

(1) The insured must apply for PACE on or before sales closing date for the underlying 

insurance policy for the first year it is to be effective.

(2) PACE is a continuous endorsement and will remain in effect for each crop year following 

the acceptance of the original application until cancelled by the insured or AIP in 

accordance with the terms of the underlying insurance policy. If the underlying insurance

policy is cancelled or terminated, PACE will automatically terminate or be cancelled as of 

the same date.

(3) The cancellation date and termination date are the same as that of the underlying insurance

policy.

(4) The earliest planting date, final planting date, acreage reporting date, and premium billing 

date are the same as in the underlying insurance policy.

23 Insurance Period

(1) The insurance period is limited to the time period when it is customary to apply the postapplication of nitrogen, as specified in the Endorsement and actuarial documents.

(2) The insurance period varies by region and is based on the date the crop was planted. The 

starting date and ending date of the insurance period can be found in the actuarial 

documents. Variance dates are intended to provide flexibility during abnormal climatic 

conditions relative to the historic norm and are applicable in the event of claim, as indicated 

in the PACE LASH.

24 Coverage Level

The insured may select a PACE coverage level election percent from 75 to 90 percent in 5 

percent increments for PACE. The PACE coverage level election percent may differ from the 

coverage level on the underlying policy.

25 Causes of Loss

PACE indemnifies in accordance with the Endorsement when there is an inability to post-apply

nitrogen during the insurance period.
December 2021 FCIC 20660U 5

26 Units

The unit structure provided under the BP and the Coarse Grains CP and applicable to the insured 

acreage may apply under the PACE with the following limitation. 

(1) Units by irrigated practices do not apply. 

(2) Whole farm units are allowed only if specified in the Special Provisions.

(3) Provided the insured has historical records at the basic unit and/or optional unit level (as 

applicable) sufficient to calculate an approved yield on such units, then PACE may be 

elected on an optional or basic unit basis if the underlying policy uses enterprise, enterprise 

by practice, or whole farm units. And optional units may be elected for PACE if the 

underlying policy uses basic units. All acres in an insured PACE unit must be insured if 

they are eligible for coverage. If acres in a PACE insured unit are non-irrigated corn and 

not high risk, then they are eligible and insured, and premium will be due on those acres, 

even if the Final Post-Application Percent is deemed to be zero percent.

(4) The insured may elect PACE coverage on some eligible units and not others, provided 

sufficient records exist to fulfill the requirements of (3) above, but the insured must elect 

PACE on all units where post-application Nitrogen practice is predominantly used if 

optional or basic units are elected for PACE. Premium will be charged on all acres in an 

insured PACE unit where the crop is eligible (even if the Final Post-Application Percent is 

deemed to be zero percent on any given acreage). In the event a unit contains acreage that 

is not eligible, those acres that are not insurable will be excluded from PACE coverage, and 

no premium will be due on those acres. The insured must specify PACE units on or prior 

to Sales Closing; otherwise, all eligible acres and units in the underlying policy will be 

insured and premium will be due on such acres (even if the final post application percent is 

deemed to be zero percent). The township, section and range must be specified by the 

SCD, otherwise all eligible acres in all units in the underlying policy will be insured under 

PACE and premium will be due.
December 2021 FCIC 20660U 6

27 Application and Reporting Instructions

A. Purpose 

The purpose of the PACE application is to apply for PACE and to verify that the 

applicant is eligible to participate in the crop insurance program. Information 

provided on the application will confirm the applicant is in compliance with 

necessary provisions and eligible to receive premium subsidy prior to submitting an 

application.

B. Application

In addition to all the requirements in section 2(c) of the Basic Provisions, on the PACE 

application:

(1) The insured must elect PACE.

(2) The insured must select a separate coverage level for PACE from 75 to 90 percent.

(3) The insured must provide the intended split of nitrogen to be applied pre-application 

and post-application as percentages of the total application (the sum of the

percentages must equal 100 percent).

(4) The insured must provide the intended total nitrogen application rate per acre.

C. Additional Records

PACE requires a Producer Nitrogen Report to be submitted in the event of a possible loss 

regarding nitrogen practices and applications. It is recommended that the agent review the 

applicant’s records upon completion of the PACE application to assure the correct entity 

and other application determinations can be verified.

The insured must have acceptable records that support the information from the Producer 

Nitrogen Report. The acceptable records include:

(1) Sales receipts that show the:
December 2021 FCIC 20660U 7

27 Application and Reporting Instructions (continued)

(a) Insured’s name;

(b) Date fertilizer purchased;

(c) Type of fertilizer purchased;

(d) The brand name of fertilizer (if applicable);

(e) Percentages of nitrogen (N), phosphorus (P), and potassium (K); and

(f) The total amount of fertilizer purchased.

(2) Contemporaneous records that show:

(a) The dates the fertilizer was applied; 

(b) The amount of fertilizer applied per date; and

(c) The acreage of fertilizer coverage per field on which fertilizer was applied.

28 Written Agreements

Written agreements that alter the terms of this Endorsement are not permitted. Additionally, this

Endorsement cannot be elected if the underlying insurance policy is modified by a written 

agreement.

29-30 (Reserved)
December 2021 FCIC 20660U 8

PART 4 GUARANTEES AND PREMIUMS

31 The PACE Guarantee

A. General Process

The PACE guarantee for each unit in which a split application of nitrogen practice was used

will be calculated as follows:

(1) The approved yield is multiplied by the number of eligible acres in the PACE insured 

unit;

(2) The result of (1) is multiplied by the PACE coverage level election percent;

(3) The result of (2) is multiplied by the projected price;

(4) The result of (3) is multiplied by the insured’s share; and

(5) The result of (4) is multiplied by the preliminary PACE loss factor. 

B. Example

Assume the insured has an approved yield of 200 bushels per acre, uses a split application of 

nitrogen practice on 100 acres in the unit, the insured elects a 90 percent PACE coverage 

level election percent, the projected price is $4.00, the insured’s share is 100 percent, and 

the PACE loss factor is 0.18. The harvest price is less than the projected price. The PACE 

guarantee would be:

(1) 200 bushels/acre x 100 acres = 20,000 bushels

(2) 20,000 bushels x 90% PACE coverage level election = 18,000 bushels

(3) 18,000 bushels x $4.00 = $72,000

(4) $72,000 x 100 percent share = $72,000

(5) $72,000 x 0.18 PACE loss factor = $12,960 PACE guarantee

32 Premium Calculation

A. Total Premium

The PACE guarantee for each unit is multiplied by the premium rate established for each 

yield response factor to establish the total premium. Using the example in Paragraph 12B, 

the actuarial documents provide a premium rate of 0.025. The total premium would be 

$12,960 x .025 = $324.
December 2021 FCIC 20660U 9

32 Premium Calculation (continued)

B. Subsidy

The subsidy factor is multiplied by the total premium for the unit to determine the amount of 

premium subsidy. The premium subsidy for 90 percent coverage is 44 percent. Continuing

the example, the premium subsidy would be $324 x 0.44 = $142.56.

C. Producer Premium

Subtract the amount of premium subsidy from the total premium for the unit to determine 

the amount of producer paid premium. Completing the example in Paragraph 13B, the 

producer paid premium would be $324 - $142.56 = $181.44.
December 2021 FCIC 20660U 10

33 Indemnity

A. Indemnity Calculation Steps

(1) Determine the number of acres in each unit in which pre-application nitrogen was 

applied but the post-application was prevented by an insurable cause of loss in 

accordance with the PACE LASH.

(2) Determine the final post-application percent and final PACE loss factor. If the 

insured’s actual pre-plant nitrogen exceeds (i) the maximum nitrogen rate times (ii) 

the difference between one and the declared post-application percent, by more than a 

5 percent variance, the Final Post-Application Percent should be recalculated and 

rounded down to the nearest 5 percent. The Final PACE Loss Factor should then be 

referenced with the Final Post-Application Percent.

(a) For example, using the example in Paragraphs 12B and 13, an insured has a 

production guarantee per acre of 200 bushels. Their maximum nitrogen per acre 

is 200 x 1.2 = 240 lbs. N/acre. The declared post-application percent is 30

percent of 240, and the actual total nitrogen applied per acre is 180 lbs. N/acre 

on the PACE loss acres. The final post-application percent is equal to (1 - [180 / 

240]) = 25 percent. 

(i) Since the final post-application percentage does not match the declared, 

the loss factor must be adjusted downward to reflect the actual postapplication percentage. The new loss factor is 16 percent (at 25 percent

post-application), rather than the original 18 percent (at 30 percent postapplication). Actual loss factors should be referenced in the corresponding 

actuarial documents.

(3) The indemnity would be calculated by:

(a) Multiplying the approved yield by the greater of the projected or harvest price 

defined in the underlying insurance policy;

(b) Multiplying the result of (a) by the insured’s PACE loss acres;

(c) Multiplying the result of (b) by the insured’s PACE coverage level election 

percent;

(d) Multiplying the result of (c) by the insured’s share; and
December 2021 FCIC 20660U 11

33 Indemnity (continued)

(e) Multiplying the result of (d) by the final PACE loss factor. 

(f) For example, using the example in Paragraphs 12B and 13, the insured was 

prevented from post-application of nitrogen on 100 acres. The insured has 

approved yield of 200 bushels, the projected price is $4.00, the insured selects 

90 percent PACE coverage level election percent, has 100 percent share, and has 

a final PACE loss factor of 17 percent. The harvest price is less than the 

projected price.

(i) 200 bushels/acre x $4.00/bu. = $800/acre

(ii) $800/acre x 100 acres = $80,000

(iii) $80,000 x 90 percent PACE coverage = $72,000

(iv) $72,000 x 100 percent share = $72,000

(v) $72,000 x 17 percent loss factor = $12,240 indemnity

(4) The amount of indemnity owed under this Endorsement may be reduced by a PACE

offset in the event an indemnity is also owed on the underlying insurance policy and 

exceeds the deductible on the underlying insurance policy, where the PACE offset is 

calculated by:

(a) Subtracting the underlying insurance policy coverage level from one;

(b) Multiplying the result of (a) by the approved yield;

(c) Multiplying the result of (b) by the greater of the projected price or harvest price 

defined in the underlying insurance policy;

(d) Multiplying (c) by the PACE insured acres;

(e) Multiplying (d) by the share; and

(f) Subtracting (e) from the PACE indemnity. If this is greater than zero, and your 

underlying insurance policy has paid an indemnity on those PACE loss acres, 

then the PACE offset is equal to the lesser of this result or the indemnity on your 

underlying insurance policy.

Example, Preliminary PACE Indemnity: The insured was prevented from 

post-application of nitrogen on 100 acres. The insured has an approved yield of 

200 bushels/acre. The greater of the projected price and harvest price is $4.00. 

The insured elects 90 percent PACE coverage level, has 100% share, and has a 

final PACE loss factor of 17%. The harvest price is less than the projected 

price.
December 2021 FCIC 20660U 12

33 Indemnity (continued)

200 bushels/acre x $4.00/bu. = $800/acre

$800/acre x 100 acres = $80,000

$80,000 x 90% coverage = $72,000

$72,000 x 100% share = $72,000

$72,000 x 17% loss factor = $12,240 preliminary PACE indemnity

Example, Final PACE Indemnity and PACE Offset: Using the example 

above, the insured elected an 85 percent coverage level on their underlying 

insurance policy, and the underlying policy is YP, and the greater of the projected 

price or harvest price is $4. Suppose the final yield is 100. The harvest price is 

less than the projected price. The PACE offset and final PACE indemnity is 

calculated as follows:

100% - 85% = 15% (or 0.15) underlying deductible percent

0.15 x 200 bu./acre = 30 bu./acre

30 bu./acre x $4.00/bu. = $120/acre

$120/acre x 100 acres = $12,000

$12,000 x 1.00 share = $12,000 

$12,240 - $12,000 = $240 (preliminary PACE offset)

YP Indemnity = $28,000

The preliminary PACE indemnity is $12,240, and the preliminary PACE offset is $240. The 

YP indemnity is greater than zero, therefore the final pace office is the lesser of $240 and the 

YP indemnity of $28,000. Therefore, the indemnity for PACE will be reduced by up to 

$240. The final PACE indemnity is thus $12,240 - $240 = $12,000.
December 2021 FCIC 20660U 13

Exhibit 1

Acronyms and Abbreviations

Acronym Full Title

AIP Approved Insurance Provider

CIH Crop Insurance Handbook

FCIC Federal Crop Insurance Corporation

GSH General Standards Handbook

LASH Loss Adjustment Standards Handbook

DSSH Document and Supplemental Standards Handbook

LAM Loss Adjustment Manual

RMA Risk Management Agency

ADM Actuarial Data Master

PACE Post-Application Coverage Endorsement

PASD Product Administration and Standards Division
December 2021 FCIC 20660U 14

Exhibit 2

Definitions

Underlying Insurance Policy - the Common Crop Insurance Policy Basic Provisions and the Coarse 

Grains Crop Provisions.

Post-Application Window (Insurance Period) - the time period in which the post-application of 

nitrogen must be applied under the standards of good farming practice, as published in the actuarial 

documents.

Post-Application Variance Window - the 10th and 90th percentile dates of heat accumulation 

associated with the estimated v3 and v10 stages of corn. To account for outlier climatic events, the 

post-application window can be shifted forward or backward up to the variance dates as published in 

the actuarial documents, as specified in the PACE LASH.

Post-Apply Rate - the percentage of total nitrogen applied during the post-application window, 

expressed as a percent. The total of the post-application rate and the pre-application rate must be 100 

percent.

Production Guarantee (Per Acre) - has the same meaning as in Section 1 of the Common Crop 

Insurance Policy Basic Provisions.

Pre-Apply Rate - the percentage of total nitrogen applied prior to and at planting, expressed as a 

percent. 

Split Application - the recognized good farming practice whereby the producer applies a portion of 

the total amount of nitrogen prior to planting and the remainder of the nitrogen is applied prior to the 

crop reaching the V10 growth stage.

Total Nitrogen Application Rate - the total amount of nitrogen applied for those acres that used a 

split application of nitrogen practice.

Final Yield - the insured’s post-harvest actual yield per acre for the current crop year.
December 2021 FCIC 20660U 15

Exhibit 3

Post-Application Coverage Endorsement Application

A. Post-Application Coverage Endorsement Application Overview

The Post-Application Coverage Endorsement (PACE) Application must be developed by 

the AIP according to these standards and submitted by the producer to the AIP on or before 

the sales closing date for the first crop year the insured wishes to elect the Endorsement. 

The Application must contain the following information:

(1) Insured Information

(a) “Insured’s Name” (Substantive)

(b) “Policy Number” (Substantive)

(c) “Street or Mailing Address” (Substantive)

(d) “City, State and Zip Code” (Substantive)

(e) “County Name” (Substantive)

(f) “Identification Number” (Substantive)

(g) “Identification Number Type” (Substantive)

(2) Crop Information

(a) “Crop(s)” (Substantive)

(b) “Crop Year” (Substantive)

(c) “PACE Plan of Insurance” (Substantive)

(d) “Legal Description” (Substantive)

(3) Terms and Conditions 

The following information must be on the form: (Substantive)

(a) “I hereby elect this Post-Application Coverage Endorsement (Endorsement) and 

by this election I understand:

(i) That I must have an underlying insurance policy written under the 

Common Crop Insurance Policy Basic Provisions and a Coarse Grains 

Crop Provisions in effect at an additional coverage level to be eligible for 

this Endorsement.

(ii) This Endorsement applies to all acreage in the county to which a split 

application of nitrogen practice is applied.
December 2021 FCIC 20660U 16

Exhibit 3

Post-Application Coverage Endorsement Application (Continued)

(iii) That by signing the application for this Endorsement it will continue from 

year to year unless I or [Insert AIP Name] cancel or change my election by

written notice on or before the cancellation date or my coverage is 

otherwise canceled or terminated under the terms of my policy.

(iv) That if my Common Crop Insurance Policy Basic Provisions and my 

Coarse Grains Crop Provisions (underlying insurance policy) are cancelled 

or terminated, this Endorsement will automatically be cancelled or 

terminated effective on the same date.

(v) That any other options or endorsements elected on my underlying 

insurance policy will continue under this Endorsement.

(vi) That I must use a split application of nitrogen practice acceptable as a good 

farming practice on all the acreage insured under this Endorsement.

(vii) This Endorsement does not apply to any acreage that was prevented from 

planting.”

(b) “I elect a PACE coverage level election percent of [from 75 to 90 percent] for 

all acreage covered under this Endorsement.” (Substantive)

(c) “I intend to apply percent of my nitrogen pre-application and ____

percent post-application (between 25 percent and 80 percent).” (Substantive)

(4) Required Signatures

(a) “Applicant/Insured’s Printed Name, Applicant/Insured’s Signature and Date” 

(Substantive) 

(b) “Agent’s Printed Name, Agent’s Signature, Agent’s Signature Date, and Agent’s 

Code Number” (Substantive) 

(5) Required Statements

(a) Certification Statement (Substantive) (See DSSH, exhibit 2)

(b) Privacy Act Statement (Substantive) (See DSSH, exhibit 3)

(c) Nondiscrimination Statement (Substantive) (See DSSH, exhibit 4)
December 2021 FCIC 20660U 17

Exhibit 3

Post-Application Coverage Endorsement Application (Continued)

B. Post-Application Coverage Endorsement Application Details

1 Applicant Information

A “Applicant’s Name” Substantive

B “Applicant’s Authorized Representative” Substantive

C “Street and/or Mailing Address” Substantive

D “City and State” Substantive

E “Zip Code” Substantive

F “Applicant’s Telephone Number” Substantive

G “Policy Number” Substantive

H “Identification Number” Substantive

I “Identification Number Type” Substantive

J “Person Type” Substantive

K “Spouse’s Name” Substantive

L “Spouse’s Identification Number” Substantive

M “Is applicant at least 18 years old? Yes □ No □” Substantive

2 Crop Information

A “Effective Crop Year” Substantive

B “Crop” Substantive

C “State and County” Substantive

D “PACE Plan of Insurance” Substantive

E

“Legal Description:” ___ “Section:” ___ “Township:” ___ “Range:” 

___ “Other Land Identifier (e.g., Spanish land grants, metes and 

bounds, etc.)” 

For those units in 

which a split 

application nitrogen 

practice is used. From 

the underlying 

insurance policy 

acreage report.

3 Other Information

A “Name of Previous AIP (if any)” Substantive

B “Policy Number under Previous AIP (if any)” Substantive
December 2021 FCIC 20660U 18

Exhibit 3

Post-Application Coverage Endorsement Application (Continued)

C

“I hereby elect this Post-Application Coverage Endorsement 

(Endorsement) and by this election I understand: 

(1) That I must have an underlying insurance policy 

written under the Common Crop Insurance Policy Basic 

Provisions and a Coarse Grains Crop Provisions in effect 

at an additional coverage level to be eligible for this 

Endorsement. 

(2) This Endorsement applies to all acreage in the county 

to which a split application of nitrogen practice is applied. 

(3) That by signing the application for this Endorsement 

it will continue from year to year unless I or [Insert AIP 

Name] cancel or change my election by written notice on 

or before the cancellation date or my coverage is 

otherwise canceled or terminated under the terms of my 

policy. 

(4) That if my Common Crop Insurance Policy Basic 

Provisions and my Coarse Grains Crop Provisions 

(underlying insurance policy) are cancelled or terminated, 

this Endorsement will automatically be cancelled or 

terminated effective on the same date. 

(5) That any other options or endorsements elected on my 

underlying insurance policy will continue under this 

Endorsement. 

(6) That I must use a split application of nitrogen practice 

acceptable as a good farming practice on all the acreage 

insured under this Endorsement. 

(7) This Endorsement does not apply to any acreage that 

was prevented from planting.”

Note: 

Include a 

note 

regardin

g 

additiona

l space if 

needed 

to 

complete 

lists, 

e.g., (See 

reverse 

side for 

additiona

l space)

Substantive

D “I elect a coverage level of [from 75 to 90 percent] for all 

acreage covered under this Endorsement.” Substantive

E

“I intend to apply percent of my nitrogen preapplication and percent post-application (between 

25 percent and 80 percent and the percentages must equal 100 

percent).”

Substantive
December 2021 FCIC 20660U 19

Exhibit 3

Post-Application Coverage Endorsement Application (Continued)

4 Required Statements

A Conditions of Acceptance Statements See DSSH, exhibit 1. Substantive

B Certification Statement See DSSH, exhibit 2. Substantive

C Privacy Act Statement See DSSH, exhibit 3. Substantive

D Nondiscrimination Policy Statement See DSSH, exhibit 4. Substantive

5 Required Signatures

A “Applicant/Insured’s Printed Name, Applicant/Insured’s Signature, and 

Applicant/Insured’s Signature Date” Substantive

B “Agent’s Printed Name, Agent’s Signature, Agent’s Signature Date, and 

Agent’s Code Number” Substantive
December 2021 FCIC 20660U 20

Exhibit 3

Post-Application Coverage Endorsement Application (Continued)

C. Post-Application Coverage Endorsement Application Instructions

Applicant’s Name Enter the applicant’s name

Applicant’s Authorized Representative Enter the applicant’s authorized representative, if 

applicable

Street and/or Mailing Address Enter the Street and/or Mailing Address

City and State Enter the City and State

Zip Code Enter the Zip Code

Applicant’s Telephone Number Enter the Applicant’s Telephone Number

Approved Insurance Provider Name and 

Address

Enter the Approved Insurance Provider Name and 

Address

Policy Number Enter the Policy Number

Identification Number Enter the Identification Number

Identification Number Type Enter the Identification Number Type

Person Type Enter the Person Type

Spouse’s Name Enter the Spouse’s Name

Spouse’s Identification Number Enter the Spouse’s Identification Number

Is applicant at least 18 years old? Yes □ No Answer Yes or No

Effective Crop Year Enter the Effective Crop Year

Crop Enter the Crop

State and County Enter the State and County

PACE Plan of Insurance Enter the Plan of Insurance

Name of Previous AIP (if any) Enter the Name of Previous AIP (if any)

Policy Number under Previous AIP (if any) Enter the Policy Number under Previous AIP (if any)
December 2021 FCIC 20660U 21

Exhibit 4

Post-Application Coverage Endorsement Acreage Report

A. Post-Application Coverage Endorsement Acreage Report Overview

In addition to the requirements for the acreage report in section 6 of the underlying insurance

policy, additional information needs to be submitted for PACE. 

(1) Insured Information

(a) “Insured’s Name” (Substantive)

(b) “Policy Number” (Substantive) 

(c) “Street and/or Mailing Address” (Substantive) 

(d) “City, State and Zip Code” (Substantive) 

(e) “County Name” (Substantive) 

(f) “Identification Number” (Substantive) 

(g) “Identification Number Type” (Substantive)

(2) Crop Information

(a) “Crop(s)” (Substantive) 

(b) “Crop Year” (Substantive) 

(c) “State and County” (Substantive)

(d) “PACE Plan of Insurance” (Substantive) 

(e) “Unit Number” (Substantive)

(f) “Unit Structure Code” (Substantive)

(g) “PACE Coverage Level Percent” (Substantive)

(h) “Legal Description:” ___ “Section:” ___ “Township:” ___ “Range:” ___ “Other 

Land Identifier (e.g., Spanish land grants, metes and bounds, etc.)” for acreage 

in which a split application of nitrogen practice was used (Substantive)

(i) “Field Location Identification” for acreage in which a split application of 

nitrogen practice was used (Substantive)

(j) “Production guarantee (per acre)” (Substantive)

(k) “Reported Acres” for acreage in which a split application of nitrogen practice 

was used (Substantive)
December 2021 FCIC 20660U 22

Exhibit 4

Post-Application Coverage Endorsement Acreage Report (Continued)

(l) “Date Planting Completed” for acreage in which a split application of nitrogen 

practice was used (Substantive)

(m) Provide the following question above the Certification Statement. “I have 

verified my identification number affixed to this Acreage Report is true and 

accurate. [ ] Yes [ ] No. If the affixed identification number is not correct or 

you have not had an opportunity to verify your identification number, please 

contact [INSERT AIP CONTACT POINT] and submit a Policy Change.”

(3) Required Signatures

(a) “Insured’s Printed Name, Insured’s Signature and Insured’s Signature Date” 

(Substantive) 

(b) “Agent’s Printed Name, Agent’s Signature, Agent’s Signature Date, and 

Agent’s Code Number” (Substantive) 

(4) Required Statements

(a) Certification Statement (Substantive) (See DSSH, exhibit 2)

(b) Privacy Act Statement (Substantive) (See DSSH, exhibit 3)

(c) Nondiscrimination Statement (Substantive) (See DSSH, exhibit 4)

B. Post-Application Coverage Endorsement Acreage Report Details

1 Acreage Report Information

A “Insured’s Name” Substantive

B “Insured’s Authorized Representative” Substantive

C “Street and/or Mailing Address” Substantive

D “City and State” Substantive

E “Zip Code” Substantive

F “Insured’s Telephone Number” Substantive

G “Policy Number” Substantive

H “Identification Number” Substantive

I “Identification Number Type” Substantive

2 Crop Information

A “Effective Crop Year” Substantive

B “Crop” Substantive

C “State and County” Substantive

D “PACE” Substantive

E “Unit Number” Substantive

F “Unit Structure Code” Substantive

G “Coverage Level Percent” Substantive
December 2021 FCIC 20660U 23

Exhibit 4

Post-Application Coverage Endorsement Acreage Report (Continued)

H

“Legal Description:” ___ “Section:” ___ 

“Township:” ___ “Range:” ___ “Other Land 

Identifier (e.g., Spanish land grants, metes 

and bounds, etc.)” for acreage in which a split 

application of nitrogen practice was used 

(Substantive)

For the acreage in 

which a split 

application of 

nitrogen was applied

Substantive

I “Field Location Identification”

For the acreage in 

which a split 

application of 

nitrogen was applied

Substantive

J “Production guarantee (per acre)” Substantive

K “Reported Acres”

Number of acres in 

which a split 

application of 

nitrogen was applied

Substantive

L “Date Planting Completed”

For the acreage in 

which a split 

application of 

nitrogen was applied

Substantive

M

Provide the following question above the 

Certification Statement. “I have verified my 

identification number affixed to this Acreage Report 

is true and accurate. [ ] Yes [ ] No. If the affixed 

identification number is not correct or you have not 

had an opportunity to verify your identification 

number, please contact [INSERT AIP CONTACT 

POINT] and submit a Policy Change.”

Substantive

3 Required Statements

A Conditions of Acceptance Statements See DSSH, exhibit 1. Substantive

B Certification Statement See DSSH, exhibit 2. Substantive

C Privacy Act Statement See DSSH, exhibit 3. Substantive

D Nondiscrimination Policy Statement See DSSH, exhibit 4. Substantive

4 Required Statements

A “Insured’s Printed Name, Insured’s Signature and 

Insured’s Signature Date”

Substantive

B “Agent’s Printed Name, Agent’s Signature, Agent’s 

Signature Date, and Agent’s Code Number”

Substantive
December 2021 FCIC 20660U 24
December 2021 FCIC 20660U 25

Exhibit 4

Post-Application Coverage Endorsement Acreage Report (Continued)

C. Post-Application Coverage Endorsement Acreage Report Instructions

All information available to the AIP should be preprinted on the documents prior to mailing to 

the insured.

1 General Information

A Insured’s Name Enter information as listed on application.

B Insured’s Authorized Representative Enter information as listed on application.

C Street and/or Mailing Address Enter information as listed on application.

D City and State Enter information as listed on application.

E Zip Code Enter information as listed on application.

F Insured’s Telephone Number Enter information as listed on application.

G Policy Number Enter information as listed on application.

H Claim Number Enter information as listed on application.

I Identification Number Enter information as listed on application.

2 Crop Information

A Effective Crop Year Enter information as listed on application.

B Crop Enter information as listed on application.

C State and County Enter information as listed on application.

D PACE Plan of Insurance Enter information as listed on application.

E Unit Number

For those units in which a split application 

nitrogen practice is used. From the underlying 

insurance policy acreage report.

F Unit Structure Code

For those units in which a split application 

nitrogen practice is used. From the underlying 

insurance policy acreage report.

G Underlying Insurance Policy Coverage 

Level

From the underlying insurance policy acreage 

report.

H

“Legal Description:” ___ “Section:” ___ 

“Township:” ___ “Range:” ___ “Other 

Land Identifier (e.g., Spanish land grants, 

metes and bounds, etc.)” 

For those units in which a split application 

nitrogen practice is used. From the underlying 

insurance policy acreage report.

I Field Identification location

For those units in which a split application 

nitrogen practice is used. From the underlying 

insurance policy acreage report.

J Production guarantee (per acre)

For those units in which a split application 

nitrogen practice is used. From the underlying 

insurance policy acreage report.
December 2021 FCIC 20660U 26

Exhibit 4

Post-Application Coverage Endorsement Acreage Report (Continued)

K Reported acres For those units in which a split application nitrogen 

practice is used. 

L Date planting complete

The date that all the acreage in the unit has been planted for 

those units in which a split application nitrogen practice is 

used. 

M Identification Number Verification

Provide the following question above the Certification 

Statement. “I have verified my identification number 

affixed to this Acreage Report is true and accurate. [ ] 

Yes [ ] No. If the affixed identification number is not 

correct or you have not had an opportunity to verify your 

identification number, please contact [INSERT AIP 

CONTACT POINT] and submit a Policy Change.”

3 Required Statements

A

Insured’s Printed Name, Insured’s

Signature and Insured’s Signature 

Date

The Insured will complete, sign and date this information.

B AIP Verifier’s Printed Name,

Signature, Code Number and Date

The AIP Verifier will complete, sign and date this 

information.
December 2021 FCIC 20660U 27

Exhibit 5

Post-Application Coverage Endorsement Nitrogen Report

A. Post-Application Coverage Endorsement Nitrogen Report Overview

The PACE Nitrogen Report must be completed by the insured and returned to the AIP with 

the Notice of Loss form and supporting records contained in Exhibit 6. The AIP may 

combine the records into one form provided all the “substantive” items are included.

1 General Information

A “Insured’s Name” Substantive

B “Insured’s Authorized Representative” Substantive

C “Insured’s Street and/or Mailing Address” Substantive

D “City and State” Substantive

E “Zip Code” Substantive

F “Insured’s Telephone Number” Substantive

G “Policy Number” Substantive

H “Claim Number” Substantive

I “Identification Number” Substantive

J “Identification Number Type” Substantive

K “Person Type” Substantive

L “Spouse’s Name” Substantive

M “Spouse’s Identification Number” Substantive

2 Crop Information

A “Effective Crop Year” Substantive

B “Crop” Substantive

C “State and County” Substantive

D “PACE Plan of Insurance” Substantive

3 Other Information

A Type and brand (if applicable) of all fertilizer applied Substantive

B All fertilizer nitrogen, phosphorus and potassium content Substantive

C A listing of all machinery and equipment used for fertilizer 

application Substantive

D Pre-Application Dates Substantive

E Pre-Application Units Substantive

F Pre-Application Acres Substantive

G Pre-Application Pounds of Nitrogen Applied Substantive

H Pre-Application Total Nitrogen Substantive

I Post-Application Dates Substantive

J Post-Application Units Substantive

K Post-Application Acres Substantive

L Post-Application Pounds of Nitrogen Applied Substantive

M Post-Application Total Nitrogen Substantive
December 2021 FCIC 20660U 28

Exhibit 5

Post-Application Coverage Endorsement Nitrogen Report (Continued)

4 Required Statements

A Certification Statement See DSSH, exhibit 2. Substantive

B Privacy Act Statement See DSSH, exhibit 3. Substantive

C Nondiscrimination Policy Statement See DSSH, exhibit 4. Substantive

5 Required Signatures

A “Insured’s Printed Name, Insured’s Signature and Insured’s Signature Date” Substantive

B “AIP Verifier’s Printed Name, Signature, Code Number and Date” Substantive

B. Post-Application Coverage Endorsement Nitrogen Report Instructions

All information available to the AIP should be preprinted on the documents prior to mailing 

to the insured.

1 General Information

A “Insured’s Name” Enter information as listed on application.

B “Insured’s Authorized Representative” Enter information as listed on application.

C “Street and/or Mailing Address” Enter information as listed on application.

D “City and State” Enter information as listed on application.

E “Zip Code” Enter information as listed on application.

F “Applicant’s Telephone Number” Enter information as listed on application.

G “Policy Number” Enter information as listed on application.

H “Claim Number” Enter information as listed on application.

I “Identification Number” Enter information as listed on application.

J “Identification Number Type” Enter information as listed on application.

K “Person Type” Enter information as listed on application.

L “Spouse’s Name” Enter information as listed on application.

M “Spouse’s Identification Number” Enter information as listed on application.

2 Crop Information

A “Effective Crop Year” Enter information as listed on application.

B “Crop” Enter information as listed on application.

C “State and County” Enter information as listed on application.

D “Plan of Insurance (PACE: 26, 27, 28)” Enter information as listed on application.

3 Other Information

A List the type, name, and/or brand of 

fertilizer applied, as applicable

Type/brand should be from the label of the fertilizer 

used.

B

List the nitrogen (N), phosphorus (P), and 

potassium (K) content of the fertilizer 

applied

Content should be from the label of the fertilizer 

used and should be in the format of 0-0-0 (N-P-K).
December 2021 FCIC 20660U 29

Exhibit 5

Post-Application Coverage Endorsement Nitrogen Report (Continued)

B. Post-Application Coverage Endorsement Nitrogen Report Instructions (continued)

C List the machinery and equipment 

used for all fertilizer application

List the name of the machinery or equipment along 

with a description.

D Pre-Application Dates List the dates that the pre-application of nitrogen was 

applied.

E Pre-Application Units This should be from the Acreage Report, list the units 

where pre-application was applied.

F Pre-Application Acres List the number of acres in each unit where the nitrogen 

was applied pre-application for each date.

G Pre-Application Pounds of Nitrogen 

Applied

Using the type/brand of fertilizer applied, the NPK 

content, and the rate of application preplant to identify 

the pounds of nitrogen per acre and multiply it by the 

total acres to obtain the total pounds of nitrogen applied 

per date.

H Pre-Application Total Nitrogen List the total number of acres and pounds of nitrogen 

applied. 

I Post-Application Dates List the dates that the post-application of nitrogen was 

applied.

J Post-Application Units This should be from the Acreage Report, list the units 

where post-application was applied.

K Post-Application Acres List the number of acres in each unit where the nitrogen 

was applied post-application for each date.

L Post-Application Pounds of Nitrogen 

Applied

Using the type/brand of fertilizer applied, the NPK 

content, and the rate of application post-plant to 

identify the pounds of nitrogen per acre and multiply it 

by the total acres to obtain the total pounds of nitrogen 

applied per date.

M Post-Application Total Nitrogen List the total number of acres and pounds of nitrogen 

applied. 

4 Required Statements

A Certification Statement See DSSH, exhibit 2.

B Privacy Act Statement See DSSH, exhibit 3.

C Nondiscrimination Policy Statement See DSSH, exhibit 4.

5 Required Signatures

O Insured’s Printed Name, Insured’s

Signature and Insured’s Signature Date

The Applicant/Insured will complete, sign and date 

this information.

P AIP Verifier’s Printed Name, Signature,

Code Number and Date

The AIP Verifier will complete, sign and date this 

information.
December 2021 FCIC 20660U 30

Exhibit 6

Notice of Probable Loss

A. Notice of Probable Loss Overview

The Notice of Loss is used to notify the AIP that the insure was prevented from applying 

the post-application nitrogen. This form should be returned to the AIP.

1 General Information

A “Insured’s Name” Substantive

B “Insured’s Authorized Representative” Substantive

C “Street and/or Mailing Address” Substantive

D “City and State” Substantive

E “Zip Code” Substantive

F “Insured’s Telephone Number” Substantive

G “Policy Number” Substantive

H “Claim Number” Substantive

I “Identification Number” Substantive

J “Identification Number Type” Substantive

K “Person Type” Substantive

L “Spouse’s Name” Substantive

M “Spouse’s Identification Number” Substantive

N “Assignment of Indemnity Yes □ No □” Substantive

O “Transfer of Right to an Indemnity Yes □ No □” Substantive

P “Date Notice of Probable Loss Issued” Substantive

2 Crop Information

A “Effective Crop Year” Substantive

B “Crop” Substantive

C “State and County” Substantive

D “Plan of Insurance” Substantive

E “Type” or “Price Option” Substantive

F “Practice” or “Insurance Period” Substantive

G “Cause of Loss” Substantive

H “Cause of Loss Date” Substantive

I “Prevented Acres” Substantive
December 2021 FCIC 20660U 31

Exhibit 6

Notice of Probable Loss (Continued) 

A. Notice of Probable Loss Overview (continued)

3 Required Statements

A Certification Statement See DSSH, exhibit 2. Substantive

B Privacy Act Statement See DSSH, exhibit 3. Substantive

C Nondiscrimination Policy Statement See DSSH, exhibit 4. Substantive

4 Required Signatures

A “Insured’s Printed Name, Insured’s Signature and Insured’s Signature Date” Substantive

B “AIP Verifier’s Printed Name, Signature, Code Number and Date” Substantive

B. Notice of Probable Loss Details

1 General Information

A Insured’s Name Enter information as listed on application.

B Insured’s Authorized Representative Enter information as listed on application.

C Street and/or Mailing Address Enter information as listed on application.

D City and State Enter information as listed on application.

E Zip Code Enter information as listed on application.

F Insured’s Telephone Number Enter information as listed on application.

G Policy Number Enter information as listed on application.

H Claim Number Enter information as listed on application.

I Identification Number Enter information as listed on application.

J Identification Number Type Enter information as listed on application.

K Person Type Enter information as listed on application.

L Spouse’s Name Enter information as listed on application.

M Spouse’s Identification Number Enter information as listed on application.

N Assignment of Indemnity Yes □ No □ Enter information as listed on application.

O Transfer of Right to an Indemnity Yes □ No □ Enter information as listed on application.

P Date Notice of Probable Loss Enter the Date of Notice of Probable Loss

Submission.

2 Crop Information

A Effective Crop Year Enter information as listed on application.

B Crop Enter information as listed on application.

C State and County Enter information as listed on application.

D Plan of Insurance Enter information as listed on application.

E Type or Price Option Enter information as listed on application.

F Practice or Insurance Period Enter information as listed on application.

G Cause of loss Insured provided information.

H Dates that cause of loss occurred Insured provided information.
December 2021 FCIC 20660U 32

Exhibit 6

Notice of Probable Loss (Continued) 

B. Notice of Probable Loss Details (continued)

I Units and acreage where a postapplication of nitrogen was prevented. Insured provided information.

3 Required Statements

A Certification Statement See DSSH, exhibit 2.

B Privacy Act Statement See DSSH, exhibit 3.

C Nondiscrimination Policy Statement See DSSH, exhibit 4.

4 Required Signatures

H Insured’s Printed Name, Insured’s

Signature and Insured’s Signature Date Completed and signed by Applicant/Insured.

I AIP Verifier’s Printed Name, Signature,

Code Number and Date Completed and signed by AIP Verifier.
December 2021 FCIC 20660U 33

Exhibit 7

Production Report

A. Production Report Overview

1 General Information

A “Insured’s Name” Substantive

B “Insured’s Authorized Representative” Substantive

C “Street and/or Mailing Address” Substantive

D “City and State” Substantive

E “Zip Code” Substantive

F “Insured’s Telephone Number” Substantive

G “Policy Number” Substantive

H “Claim Number” Substantive

I “Identification Number” Substantive

J “Identification Number Type” Substantive

K “Person Type” Substantive

L “Spouse’s Name” Substantive

M “Spouse’s Identification Number” Substantive

N “Assignment of Indemnity Yes □ No □” Substantive

O “Transfer of Right to an Indemnity Yes □ No □” Substantive

P “Date Notice of Probable Loss Issued” Substantive

2 Crop Information

A “Effective Crop Year” Substantive

B “Crop” Substantive

C “State and County” Substantive

D “Plan of Insurance” Substantive

E “Type” or “Price Option” Substantive

F “Practice” or “Insurance Period” Substantive

G “Cause of Loss” Substantive

H “Cause of Loss Date” Substantive

I “Prevented Acres” Substantive

3 Indemnity Calculation

A “Pre-Application Nitrogen Acres Applied” Substantive

B “Post-Application Nitrogen Acres Prevented” Substantive

C “Probable Indemnity” Substantive

4 Required Statements

A Certification Statement Substantive

B Privacy Act Statement Substantive

C Nondiscrimination Policy Statement Substantive
December 2021 FCIC 20660U 34

Exhibit 7

Production Report (Continued)

A. Production Report Overview (continued)

5 Required Signatures

A “Insured’s Printed Name, Insured’s Signature and Insured’s Signature Date” Substantive

B “AIP Verifier’s Printed Name, Signature, Code Number and Date” Substantive

B. Production Report Details

1 General Information

A Insured’s Name Enter information as listed on application.

B Insured’s Authorized Representative Enter information as listed on application.

C Street and/or Mailing Address Enter information as listed on application.

D City and State Enter information as listed on application.

E Zip Code Enter information as listed on application.

F Insured’s Telephone Number Enter information as listed on application.

G Policy Number Enter information as listed on application.

H Claim Number Enter information as listed on application.

I Identification Number Enter information as listed on application.

J Identification Number Type Enter information as listed on application.

K Person Type Enter information as listed on application.

L Spouse’s Name Enter information as listed on application.

M Spouse’s Identification Number Enter information as listed on application.

N Assignment of Indemnity Yes □ No □ Enter information as listed on application.

O Transfer of Right to an Indemnity Yes □ No □ Enter information as listed on application.

P Date Notice of Probable Loss Enter the Date of Notice of Probable Loss

Submission.

2 Crop Information

A Effective Crop Year Enter information as listed on application.

B Crop Enter information as listed on application.

C State and County Enter information as listed on application.

D Plan of Insurance Enter information as listed on application.

E Type or Price Option Enter information as listed on application.

F Practice or Insurance Period Enter information as listed on application.

G Cause of loss Insured provided information.

H Dates that cause of loss occurred Insured provided information.

I Units and acreage where a post-application of 

nitrogen was prevented. Insured provided information.
December 2021 FCIC 20660U 35

Exhibit 7

Production Report (Continued)

B. Production Report Details (continued)

3 Other Information

A Pre-Application Nitrogen Acres Applied

Enter units and acres from the PACE Nitrogen 

Report where pre-application of nitrogen was 

applied.

B Post-Application Nitrogen Acres Prevented

Enter units and acres from the PACE Nitrogen 

Report where post-application of nitrogen was 

prevented.

C Probable Indemnity See CISH Part 4 Section 15 for Indemnity 

Calculation Example.

4 Required Statements

A Certification Statement See DSSH, exhibit 2.

B Privacy Act Statement See DSSH, exhibit 3.

C Nondiscrimination Policy Statement See DSSH, exhibit 4.

5 Required Signatures

A Insured’s Printed Name, Insured’s

Signature and Insured’s Signature Date Completed and signed by Applicant/Insured.

B AIP Verifier’s Printed Name, Signature,

Code Number and Date Completed and signed by AIP Verifier.