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  1. For assistance in completing this form or FPPA process, contact the local NRCS Field Office or USDA Service Center. NRCS employees, consult the FPPA Manual and/or policy for additional instructions to complete the AD-1006 form.

  2. Complete form AD-1006, “Farmland Conversion Impact Rating” and contact the state soil scientist before sending it to the local NRCS District Conservationist. Preparers of HUD environmental review records must complete Parts I, III, VI, and VII of form AD-1006.

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  4. (See Instructions on reverse side) Form AD-1006 (10-83) This form was electronically produced by National Production Services Staff STEPS IN THE PROCESSING THE FARMLAND AND CONVERSION IMPACT RATING FORM

  5. 523.61 Form AD-1006 – Farmland Conversion Impact Rating For Noncorridor Projects: Instructions and Example

  6. If an agency elects not to make its own determination, it should make a request to NRCS on Form AD-1006, the Farmland Conversion Impact Rating Form, available at NRCS offices, for determination of whether the site is farmland subject to the Act.

  7. Form AD 1006 - Farmland Conversion Impact Rating – for non-corridor projects (PDF) Form NRCS-CPA-106 - for corridor type projects (PDF) Template Farmland Letter from MnDOT to MDA Commissioner (Word) Analysis process. Early environmental documents should discuss any potential agricultural impacts.

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