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ACCEPTANCE BY GRANTEE 2 0110 3 5 8 4 <br />I Craig R. Derickson (name), State Conservationist (title), <br />being the duly autllorized representative of the United States Department of Agriculture, Natural <br />Resources Conservation Service, do hereby accept this Conservation Easement Deed with <br />respect to the rights and duties of the United States of America, Grantee. <br />Dated this,��day of �_.��, , 2� <br />State Conservationist <br />Title <br />This instrument was drafted by the Office of the General Counsel, U.S. Department of <br />Agriculture, Washington, D.C. 20250-1400. <br />NONDISCRIMINATION STATEMENT <br />The U.S. Department of Agriculture {USDA) prohibits discrimination in all its program and <br />activities on the basis of race, color, national origin, age, disability, and where applicable, sex, <br />marital status, familial status, parental status, religion, sexual orientation, genetic information, <br />political beliefs, reprisal, or because all or a part of an individual's income is derived from any <br />public assistance program. (Not all prohibited bases apply to all programs.) Persons with <br />disabilities who require alternative means for communication of program information (Braille, <br />large print, audiotape, etc.) should contact USDA's TARGET Center at (1202) 720-2600 (voice <br />and TDD). To file a complaint of discrimination write to USDA, Director, Office of Civil <br />Rigl�ts, 1400 Independence Avenue, S.W., Washi»gton, D.C. 20250-9410 or call (800) 705-3272 <br />(voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer. <br />PRIVACY ACT STATEMENT <br />The above statements are made in accordance with tfie Privacy Act of 1974 (U.S.C. 522a). <br />Furnishing this infonnation is voluntary; however, failure to furnish correct, complete <br />information will result in the withholding or withdrawal of such technical or financial assistance. <br />The information may be furnished to other USDA agencies, the Internal Revenue Service, the <br />Department of Justice, or other State or Federal Law enforcement agencies, or in response to <br />orders of a court, magistrate, or administrative tribunal. <br />� <br />