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Natural Resources Conservation Service		 Kansas Go to Accessibility Information
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Frequently Used Forms

AD CCC FSA NRCS OF OPM OWCP SF Other

AD Forms
Form Number Title Source
AD-107 Report of Transfer or other Disposition or Construction of Property USDA Departmental Forms
AD-112 Report of Unserviceable, Lost or Damaged Property USDA Departmental Forms
AD-139 Final Salary Payment Report USDA Departmental Forms
AD-349 Employee Address USDA Departmental Forms
AD-616 Travel Voucher (Temporary Duty Station) USDA Departmental Forms
AD-728 Request and Authorization for Home to Work Transportation USDA Departmental Forms
AD-1043 Leave Transfer Program - Donor Application USDA Departmental Forms
AD-1046 Leave Transfer Program - Recipient Application USDA Departmental Forms
AD-1143 Corporate Systems Access Request Form USDA Departmental Forms
AD-1153 Application for Long-Term Contracted Assistance USDA Service Center eForms (USDA employee access)
Form Number: AD1153
AD-1160 Compatible Use Authorization USDA Service Center eForms (public access)
Form Number: AD1160
AD-1161 Application for Payment USDA Service Center eForms (public access)
Form Number: AD1161

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CCC Forms
Form Number Title Download Form
CCC-501A Member's Information USDA Service Center eForms (public access)
Form Number: CCC501
CCC-526 Payment Eligibility Average Adjusted Gross Income Certification USDA Service Center eForms (public access)
Form Number: CCC526
(also available in ProTracts - Forms)

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FSA Forms
Form Number Title Download Form
FSA-211
FSA-211A		 Power of Attorney
Power of Attorney Signature Continuation Sheet		 USDA Service Center eForms (public access)
Form Number: FSA211

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NRCS Forms
Form Number Title Download Form
NRCS-CPA-09 Power of Attorney USDA Service Center eForms (USDA employee access)
Form Number: CPA009
NRCS-CPA-13 Contract Review USDA Service Center eForms (USDA employee access)
Form Number: CPA013
NRCS-CPA-26e Highly Erodible Land and Wetland Conservation Determination NRCS-CPA-026e (PDF)
NRCS-CPA-38 Request for Certified Wetland Determination or Delineation USDA Service Center eForms (USDA employee access)
Form Number: CPA38
NRCS-CPA-52 Environmental Evaluation Worksheet NRCS-CPA-52
Use 2010 Revised Environmental Evaluation CPA-52 Worksheet (XLS)
NRCS-CPA-152 Conservation Program Contract Transfer Agreement ProTracts - Forms
NRCS-CPA-153 Agreement Covering Non-Compliance with Provisions of Contract Not available yet; Use NRCS-LTP-153
USDA Service Center eForms (USDA employee access)
Form Number: LTP153
NRCS-CPA-1155 Conservation Plan Schedule of Operations ProTracts or Toolkit
NRCS-CPA-1156 Revision of Plan or Schedule of Operations or Modification of a Contract ProTracts or Toolkit
NRCS-CPA-1200 Conservation Program Application ProTracts - Forms
NRCS-CPA-1202 Conservation Program Contract ProTracts
NRCS-CPA-1236 Assignment of Payment Not available yet; Use CCC-36
USDA Service Center eForms (USDA employee access)
Form Number: CCC36
NRCS-CPA-1245 Practice Approval and Payment Application ProTracts
NRCS-FNM-60 Electron Funds Transfer (EFT) Hardship Waiver Request USDA Service Center eForms (USDA employee access)
Form Number: FNM60
NRCS-ECS-414 Proper Grazing Use Use KS-ECS-414
NRCS-ECS-580 Plant Collection Information (seed or vegetative) Plant Materials Intranet - Forms
NRCS-IRM-03 Information System Security
Request for User Access to ITS Resources		 USDA Service Center eForms (USDA employee access)
Form Number: NRCS-IRM003
NRCS-PER-036 Earth Team Individual & Group Volunteer Award Nomination USDA Service Center eForms (USDA employee access)
Form Number: PER036
NRCS-PER-037 Earth Team Chief's Recognition Award Nomination USDA Service Center eForms (USDA employee access)
Form Number: PER037
NRCS-PER-038 Earth Team Employee Award Nomination USDA Service Center eForms (USDA employee access)
Form Number: PER038
NRCS-PER-039 Earth Team Partnership Award Nomination USDA Service Center eForms (USDA employee access)
Form Number: PER039

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OPM Forms
Form Number Title Download Form
OPM-71 Request for Leave or Approved Absence U.S. Office of Personnel Management (OPM) - OPM Forms

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Optional Forms (OF)
Form Number Title Download Form
OF-41 Routing and Transmittal Slip GSA Forms Library - Optional Forms (OF)
OF-301A Volunteer Services Agreement for Natural Resources Agencies (for Individuals or Groups) GSA Forms Library - Optional Forms (OF)
OF-306 Declaration for Federal Employment GSA Forms Library - Optional Forms (OF)
OF-612 Optional Application for Federal Employment GSA Forms Library - Optional Forms (OF)

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OWCP Forms
Form Number Title Download Form
CA-1 Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation U.S. Department of Labor
OWCP-1500 Health Insurance Claim Form U.S. Department of Labor

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Standard Forms (SF)
Form Number Title Download Form
SF-85 Questionnaire for Non-Sensitive Positions GSA Forms Library - Standard Forms (SF)
SF-91 Motor Vehicle Accident Report GSA Forms Library - Standard Forms (SF)
SF-94 Statement of Witness GSA Forms Library - Standard Forms (SF)
SF-171 Application for Federal Employment Cancelled
SF-270 Request for Advance or Reimbursement GSA Forms Library - Standard Forms (SF)
SF-1164 Claim for Reimbursement for Expenditures on Official Business GSA Forms Library - Standard Forms (SF)
SF-1198 Request by Employee for Allotment of Pay for Credit to Savings Account with a Financial Organization GSA Forms Library - Standard Forms (SF)
SF-1199A Direct Deposit Sign-Up Form GSA Forms Library - Standard Forms (SF)
or ProTracts - Forms

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Other
Form Number Title Download Form
  Kansas State Historical Society Archeological Site Form Kansas State Historical Society
  Kansas Wildlife Habitat Assessment Guide (KWHAG) KWHAG (XLS; 112 KB)
  NRCS Request for U.S. Army Corps of Engineers Jurisdictional Determination Jurisdictional Determination (DOC; 26 KB)
  Proof of Insurance and Liability of the Government Proof of Insurance (PDF; 23 KB)

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Last Modified: 04/25/2012