SEEDED ACREAGE REPORT
The
Seeded Acre Report
must be completed
signed
and returned to us by June 30th.
This form is to report how many acres you were able to seed this year to ensure your farm is properly insured. If you were able to seed more or less than the estimated acres you provided on your application, this may change your premium amount as it is on a per acre basis. You will receive written notification of any adjustments to your policy and premium.
PLEASE REFER TO “HOW TO COMPLETE YOUR SEEDED ACREAGE REPORT” FOR FULL INSTRUCTIONS
IF YOU ARE NEW TO GLOBAL AG RISK SOLUTIONS
You will need to fill this report out fully as we will not have any data from previous years.
IF YOU RECEIVED A PRE-POPULATED SEEDED ACREAGE REPORT
Make sure to read through and ensure all information is accurate, correcting any information that is not accurate. If you are not farming a land location listed, please cross out the entire row with a single line.
Please complete & return Seeded Acreage Report to
Please note that we will accept any list or spreadsheet detailing your acres and legal land
locations, however you must fully complete the top portion of the provided seeded acreage
report and sign it.
6 7 8
9
How to Complete your Seeded Acreage Report
The name you assign to your field Acres that could not be worked or seeded due to being too wet
Legal land description for each parcel of land Acres not in a condition or intended to be seeded. Including summer fallow, sloughs, etc. Enter the specific commodity seeded to the field Sum of your Seeded Acres and Too Wet to Seed acres (Box A + Box B) = Box D
(‘Red Spring Wheat’ instead of ‘Wheat’)
Specify Y or N if irrigated If you no longer own or operate a legal land description provided, please draw a line through the entire row
Acres seeded to the crop on the legal land
Enter the Total Insurable acres from the bottom of Box D Enter current insured acres from your PCI Policy
Enter in Box F the difference between Box D and E
PRODUCTION COST INSURANCE
Seeded Acreage Instructions
1 2 3 4 5 6
C
7
D
8
Field Name
Qtr Sec Twp Rge Mer
Commodity
Y/N
Acres
Unproductive Total Insurable
Acres
Acres (A + B)
Field 1 9 SW 16 12 14 S2 Wheat Red Spring 100 10 110
1 2 3 4 5 10 11 12
Total Insurable Acres
D
430
Current Insured Acres from PCI Policy
E
400
Difference (D – E)
F
30
If Box F has a positive number, you will be invoiced for these acres If Box F has a negative number, you will be refunded for these acres No adjustments will be made for any difference of 15 acres
I acknowledge, reporting is due June 30. If the Insured fails to submit the Seeded Acreage Report by the deadline, the Insurer may, at its sole
discretion, determine and establish the Productive Crop Acreage or deny liability under this Policy. The acres reported on this form will be the final
insured acres on your PCI Policy. Any discrepancies must be reported within 30 days. After 30 days, no changes to the insured acreage will be
accepted.
A
B
C
D
Field Name
Qtr Sec Twp Rge Mer
Commodity
(Be Specific)
Irrigated
Y/N
Seeded
Acres
Too Wet
to Seed
Unproductive
Acres
Total Insurable
Acres
(A + B)
PRODUCTION COST INSURANCE
Seeded Acreage Report
PCI Policy #
PCI2020-
Customer #
Farm Name
Contact Name
Total Insurable Acres
D
Current Insured Acres from PCI Policy
E
Difference (D – E)
F
If Box F has a positive number, you will be invoiced for these acres If Box F has a negative number, you will be refunded for these acres No adjustments will be made for any difference of 15 acres