Form FSA-2014, Verification of Income, is the USDA Farm Service Agency (FSA) form that confirms an applicant's income when FSA reviews a request for assistance. An employer completes Parts B and D to verify employment pay, and another income provider completes Parts C and D to verify other income. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the official PDF and its instructions are published by USDA at the link below.
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What is FSA-2014?
Form FSA-2014, Verification of Income, is the USDA Farm Service Agency (FSA) form used to verify an applicant's income so that FSA can make feasibility determinations on the applicant's request for assistance.
The form is not completed by the applicant. It is a third-party statement with four parts:
- Part A is for FSA use only and identifies the servicing office in Item 2.
- Part B, Verification of Employment, is completed by the employer (Items 1 through 7): date of employment, present position, probability of continued employment, base pay, and pay for the past year, the current year to date and the projected next year.
- Part C, Verification of Other Income, is completed by another provider of information (Items 1 through 4): the source, frequency and amount of any other income, and comments.
- Part D, Certification, is completed by the employer or other provider: name, title, signature, telephone number and date.
The employer or other provider forwards the finished form directly to the office named in Part A, Item 2. The USDA instructions also describe how a customer with USDA electronic access credentials can transmit the form electronically.
Who needs to file FSA-2014?
Employers of an FSA applicant complete Parts B and D of Form FSA-2014 to verify the applicant's employment and pay. Other information providers, meaning any source of the applicant's other income, complete Parts C and D. Both then forward the form directly to the office identified in Part A, Item 2.
The applicant is the person whose income is being verified; the form is used to verify the applicant's income for the request for assistance. FSA fills out Part A only.
The person who completes Part D must be authorized to complete the form on behalf of the employer or income provider; the form asks for that person's name, title and signature.
Exclusions drawn from the instructions: an employer does not complete Part C, an other-income provider does not complete Part B, and no one other than FSA completes Part A.
When to file FSA-2014
Form FSA-2014 is completed when FSA needs to verify an applicant's income to make a feasibility determination on the applicant's request for assistance. The instructions set no separate due date for it. The employer or other information provider forwards it directly to the servicing office named in Part A, Item 2, once the relevant part and Part D are completed. Part B asks for a current year-to-date figure with an "as of" date, so enter the date that matches the figures you report.
How to fill out FSA-2014
Leave Part A for FSA
Part A is for FSA use only. Do not write in it, but note the office identified in Part A, Item 2, because the completed form is forwarded there.
Enter employment details in Part B
Employer: in Item 1 enter the applicant's date of employment, in Item 2 the present position and in Item 3 the probability of continued employment.
Mark the applicant's base pay
Part B, Item 4: check the box for the applicant's base pay and enter the dollar amount next to it. If you check Weekly, also enter the number of hours per week.
Report past, current and projected pay
Item 5: base pay, overtime, commissions and bonus for the past year. Item 6: the same amounts for the current year to date, with the "as of" date. Item 7: the amounts projected for next year.
Describe other income in Part C
Other information providers complete Items 1 through 4: the source of any other income, how often it is received, the amount, and any pertinent comments.
Read the certification in Part D
Item 1 is the certification printed on the form. Read it before you enter your name and signature.
Enter name and title
Part D, Item 2: the name of the person authorized to complete the form. Item 3: that person's title.
Add telephone number and date
Item 5: the telephone number of the person who completed the form. Item 6: the date the authorized person signed.
Review, sign and download the PDF
Check that only the correct parts are completed and that the "as of" date and amounts are filled in. Download or print the completed PDF from FillingPDF, then sign Part D, Item 4 by hand if you will mail or fax it.
How to submit FSA-2014
The completed form goes to the appropriate USDA servicing office by hard copy, by facsimile, or electronically for customers with USDA access credentials.
- Hard copy or fax: submit the original of the completed form to the appropriate USDA servicing office. If you mail or fax it, print the form and sign it by hand.
- Directly from the provider: an employer (Parts B and D) or other information provider (Parts C and D) forwards the form directly to the office identified in Part A, Item 2.
- Electronic transmission: customers who have established electronic access credentials with USDA may transmit the form to the servicing office, provided the customer submitting it is the only person required to sign. Where the form is approved for electronic transmission, use the buttons on the form. These features are available only to customers with credentials; the USDA eForms website explains how to establish them.
The form gives no mailing address or fax number of its own; use the office named in Part A, Item 2. FillingPDF lets you fill out and download the PDF; submission follows the channels above.
Common mistakes to avoid
- Writing in Part A, which is for FSA use only; the servicing office in Part A, Item 2 is where the form must be forwarded.
- Having an employer complete Part C, or an other-income provider complete Part B; employers complete Parts B and D, other providers Parts C and D.
- Checking a base pay box in Part B, Item 4 without the dollar amount next to it, or choosing Weekly without the number of hours per week.
- Leaving the "as of" date blank in Part B, Item 6 while entering year-to-date pay.
- Mailing or faxing the form without a handwritten signature in Part D, Item 4; the instructions say to print the form and sign it manually.
- Sending the form to the wrong place instead of directly to the office identified in Part A, Item 2.
- Transmitting the form electronically when someone other than the submitting customer must also sign, or without USDA access credentials.
- Omitting the signer's title, telephone number or signing date in Part D, Items 3, 5 and 6.
Frequently asked questions
What is Form FSA-2014, Verification of Income?
Form FSA-2014 is the USDA Farm Service Agency form used to verify an applicant's income. FSA uses the verification of income to make feasibility determinations on the applicant's request for assistance. An employer or other income provider completes it, not the applicant.
Who fills out the verification of income form FSA-2014?
An employer completes Parts B and D. Another information provider, such as a source of other income, completes Parts C and D. FSA completes Part A only. Whoever completes Part D must be authorized to do so and enters name, title, signature, phone number and date.
Where do I send Form FSA-2014 after completing it?
Forward it directly to the office identified in Part A, Item 2. The instructions say to submit the original in hard copy or by fax to the appropriate USDA servicing office; the form itself prints no separate address or fax number.
Can I submit Form FSA-2014 electronically?
Only if you are a USDA customer with established electronic access credentials and you are the only person required to sign. Then you can use the buttons on the form, where it is approved for electronic transmission. Everyone else prints, signs by hand, and mails or faxes it.
Do I need a handwritten signature on Form FSA-2014?
Yes, if you mail or fax it. The instructions say to print the form and manually enter your signature in Part D, Item 4. Electronic transmission is the only alternative and requires USDA access credentials.
What goes in Part B, Item 4 of Form FSA-2014?
The employer checks the box that shows the applicant's base pay and writes the dollar amount next to it. If Weekly is checked, the employer also enters the number of hours per week.
Is there a deadline for Form FSA-2014?
No separate deadline is printed in the instructions. The form is completed when FSA needs to verify income for a request for assistance, and the provider forwards it to the office in Part A, Item 2.
Can I fill out Form FSA-2014 online on FillingPDF?
Yes. You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is an independent service and does not send the form to USDA; you submit it through the channels USDA describes.
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