FSA Loan Application Guide2 - New Entry Sustainable Farming

Transcripción

FSA Loan Application Guide2 - New Entry Sustainable Farming
Plain Language Guide to
Applying for a
Farm Service Agency (FSA) Loan
In this guide, you will learn
about:
• Types of loans explained
• Step-by-step instructions
• Preparing your application
• Resources and contact information
• Definition of common terms
A Guidebook of the Northeast Network of
Immigrant Farming Projects
1
Northeast Network of Immigrant Farming Projects
Authored by Vanessa Bittermann
Reviewed by Daniel DeFreest, FSA Loan Officer, Westford, MA,
and Jennifer Hashley
www.NNIFP.org
September 2007
Boston Office:
New Entry Sustainable Farming Project
Agriculture, Food and Environment Program
Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy
Tufts University
150 Harrison Street
Boston, MA 02111
Lowell Office:
New Entry Sustainable Farming Project
9 Central Street, Suite 402
Lowell, MA 01852
978-654-6745
For additional information regarding this document, please contact Jennifer Hashley, NESFP Director at
[email protected] or by telephone: 617-636-3793. This document is available in electronic format or
as a printed copy. The latter may be obtained by contacting the NESFP at the above location.
Production of this document was supported by the SARE Professional Development Grant ENE05-092, USDACSREES 2501
Program, and by USDA Risk Management Agency (RMA Partnership Agreement No. 06IE08310159).
SARE
“In accordance with Federal law and US Department of Agriculture policy, this institution is prohibited from discriminating on the basis of
race, color, national origin, sex, age or disability. To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, Room
326-W, Whitten building, 1400 Independence Ave SW Washington DC 20250-9410 or call (202) 720-5964. USDA is an equal opportunity
employer.”
How to Apply for an FSA Loan
TABLE OF CONTENTS
Introduction..............................................................5
Overview of the application process.................................8
Step 1: What kind of loan do you need? .............................9
Step 2: Are you eligible to apply for an FSA loan? .................13
Step 3: Develop your business plan ..................................14
Step 4: Gather your documents.......................................22
Step 5: Apply for a bank loan first ...................................24
Step 6: Apply for an FSA Loan .........................................25
Step 7: The FSA Loan Application Decision..........................26
Step 8: Getting Your Loan Money .....................................27
Step 9: Grow your Farm Business!....................................28
Appendix A: Additional resources and contact information ......29
Appendix B: Glossary—Definition of Terms..........................33
Appendix C: FSA Loan Application Forms
Request for Direct Loan Assistance (Spanish)..................35
Request for Direct Loan Assistance (English) ..................39
Request for Verification of Employment .......................43
Farm Business Plan Worksheet ...................................46
Verification of Debts and Assets .................................52
3
How to Apply for an FSA Loan
4
How to Apply for an FSA Loan
Introduction
As a farmer, whether you are just starting out or have many years of experience,
there come times when you need to borrow money. Think about the following
questions:
•
Do you want to rent, lease, or buy a farm?
•
Do you need to buy things like a tractor, irrigation pipes, or a greenhouse for
your farm business?
•
Do you already own or rent farmland and want to expand your farm business?
•
Has a natural disaster such as drought, flooding, or a bad storm ruined your
crops or damaged your farm buildings or your equipment?
If you answered “yes” to any of these questions, you might be able to apply for a loan
from the Farm Service Agency (FSA).
What is the Farm Service Agency?
The FSA is part of the United States government. It is an agency that lends
money to farmers to help them start up and stay in business. The FSA also backs up
or “guarantees” loans made by banks to farmers. If you get a loan from the FSA or a
bank, you must pay the money back over time. In addition to the amount you borrow,
5
How to Apply for an FSA Loan
you also must pay interest back to the FSA or the bank. A loan can help you by giving
you a large amount of money up front when you need it for major expenses like buying
or renting land, machines, equipment, or farm supplies.
What is the purpose of this guide?
The FSA has different kinds of loans that you can apply for, depending on
your current farming status and what you need the loan for. This guide will help you to
answer the following questions:
•
•
•
•
What kind of loan do you need?
Are you eligible to apply?
What is the loan application process?
What papers or documents do you need to apply?
At the back of the guide, you will also find some definitions for words that you might
not be familiar with. There is also a list of important organizations that you can
contact to find more information and get help on how to apply for FSA loans.
This guide will help you get started in the process of applying for an FSA loan for
your farming business. However, you will also need to talk to many other people to
find out some of the information that is required. Everyone’s story or situation is
different, so applying for a loan will be a little bit different for you than it
is for another farmer going through the same process. This guide gives
general information, but you will need specific advice from your loan officer
and your business advisor in order to complete your loan application.
6
How to Apply for an FSA Loan
Introduction Summary:
The Farm Service Agency (FSA) is part of the U.S. government
The FSA makes loans directly to farmers for start-up, operating, and
emergency costs
The FSA also guarantees loans made by banks to farmers
This guide will help you to get started thinking about what kind of
loans you may be eligible for and how to begin the loan application
process
You will need to talk with many people such as FSA employees, bank
loan managers, and a business advisor to review your own particular
situation and loan needs
7
How to Apply for an FSA Loan
Overview of the Loan Application Process
There are many steps to applying for an FSA loan. This guide lists the basic steps that
you will be required to take:
1. Decide what kind of loan you need.
2. Find out if you are eligible to apply for the loan.
3. Develop a business plan showing how much money you need,
how you will use the loan money, and how you will be able to
pay it back.
4. Gather documents, including a résumé (work history), financial
statements, lease agreements or deeds, and business records.
5. Apply for a loan from a bank first.
6. If declined, meet with an FSA loan officer to apply for an FSAguaranteed loan or a direct loan from the FSA.
7. FSA will send you a letter to tell you if they approved your loan
or not.
8. If approved, FSA or your bank lender will give you the money
and details about paying the loan back.
9. Start farming!
8
How to Apply for an FSA Loan
Step 1: What Kind of Loan Do You Need?
There are many different kinds of loans available to farmers. Before you apply,
you need to decide what kind of loan you need. What will you use the loan money for?
You might end up applying for more than one loan at the same time if you need money
for different purposes. Use the chart below to think about the kind of loan you will
apply for. “Direct” loans are made by the FSA itself, using government
money. “Guaranteed” loans are made by private lenders such as banks,
Farm Credit System institutions, or credit unions.
After thinking about what you need a loan for, make a check
mark in the
boxes next to the loan types you will consider. We will talk more about the different
loan types in the next section.
What do you need money for?
•
•
•
Buy land
Construct buildings
Carry out soil or water conservation
projects on your farm
Loan types you should consider
•
•
Direct Farm Ownership
Guaranteed Farm Ownership
Beginning Farmer Down Payment Farm
Ownership
• Direct Farm Ownership
• Guaranteed Farm Ownership
•
•
Buy a farm for the first time
Buy livestock, feed, poultry, equipment, seed, farm supplies
• Carry out soil or water conservation
projects on your farm
•
•
•
•
•
Direct Operating
Guaranteed Operating
Recover from an emergency or natural disaster that has ruined your
• Direct Emergency
crops, livestock, farm buildings, or
your farming operations
Refinance your current farm loans
9
•
•
•
•
Direct Operating
Direct Emergency
Guaranteed Operating
Guaranteed Farm Ownership
How to Apply for an FSA Loan
Description of Loan Types: Loan Terms and Amounts
Now that you have thought about the kind of loan you need, it is important to
learn some details about how the loans work. What is the main purpose of the loan?
How much money do you need? How long will you have to pay back the loan?
There are three basic kinds of FSA loans:
1) farm ownership loans, which help you buy farms or farmland;
2) operating loans, which help you to buy supplies and equipment; and
3) emergency loans, which help you to recover from storms or natural
disasters that damage your farm business.
The table on Page 11 shows the different kinds of FSA loans, the highest
amount that the loans can offer, and the terms of the loans. The maximum loan
amount tells you the highest amount that you
can apply for under each different loan type, but
you can apply for any amount under the
3
Kinds of FSA loans:
maximum. You do not have to borrow the highest
1) Farm ownership loans
amount. The terms of a loan tell you how long
2) Operating loans
you will have to pay back the loan, what the
interest rate will be, and other conditions of the
3) Emergency loans
loan.
When you take out a loan through the FSA or any other bank, you have to pay
the loan back over time. For example, if you borrow $100,000, you will have to pay
back that $100,000 over a period of years. You will also have to pay for the loan
service that the FSA or bank is providing to you. The interest rate is the cost that you
pay to the FSA or your private lender to borrow money. This is money that you have to
pay in addition to the original amount of money that you borrow. In the example
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How to Apply for an FSA Loan
above, when you have finished making all of your payments for the $100,000 loan,
you will have paid more than that amount back to the bank because of the interest.
The interest rate is shown as a percentage rate (%). A lower interest rate means that
the cost of borrowing the money is lower, so you pay a smaller amount in interest fees.
A higher interest rate means that the cost is higher, and you will pay more to borrow
the money. Some interest rates are fixed, which means that the percentage rate (%)
stays at the same level the entire time you are paying back your loan. Other interest
rates are variable, which means that the percentage rate (%) can change from year to
Loan Program
Maximum Loan Amount
Terms & Conditions
Direct Farm Ownership
$200,000
■ Term: Up to 40 years
■ Interest rates will vary
■ Temporary limited resource interest
rates are available for people unable to
repay at regular rates
■ Interest rate 5% if half of loan amount
will be provided by other lender
Beginning Farmer
Down Payment Farm
Ownership
Direct Operating
40% of the farm purchase price
OR appraised value, whichever
is less
$200,000
■ Term: 15 years
■ Interest rate: 4%
Direct Emergency
100% actual or physical losses
■ Term: From 1 to 7 years for non-real
estate purposes
■ Up to 40 years for physical losses on
real estate
■ Interest rate: 3.75%
■ Term: from 1 to 7 years
■ Interest rates cannot be higher than
those charged lenders’ average farm
customers
■ Interest rate reduction of 4% available
for those unable to repay at regular
rates (with
certain limitations)
■ Term: up to 40 years
■ Interest rates cannot be higher than
rates charged to lenders’ average farm
customers
$500,000 maximum total FSA
loans
Guaranteed Operating
$899,000 (this amount changes
every year)
Guaranteed Farm
Ownership
$899,000 (this amount changes
every year)
11
■ Term: From 1 to 7 years
■ Interest rates will vary
■ Temporary limited resource interest
rates are available for people unable to
repay at regular rates
How to Apply for an FSA Loan
Beginning Farmer and Socially Disadvantaged Farmer Loans
Each year, the FSA makes sure that some of the Direct and Guaranteed loans
go to beginning farmers and to socially disadvantaged farmers. These loans work the
same way as regular Direct and Guaranteed loans, but there is money set aside every
year especially to help farmers who are just starting up and farmers who may face
discrimination based on gender, race, or ethnicity. If you think you are eligible, make
sure to ask your FSA loan officer about these programs.
You could qualify for a Beginning Farmer Direct or Guaranteed loan if you started
farming in the United States less than 10 years ago.
You could qualify for a Socially Disadvantaged Farmer Direct or Guaranteed loan if
you are:
•
•
•
•
•
•
12
a woman of any race or ethnicity
an African American
an American Indian
an Alaskan native
Hispanic
an Asian American, or a Pacific Islander
How to Apply for an FSA Loan
Step 2: Are You Eligible to Apply for an FSA Loan?
Depending on the kind of loan you want to apply for, you will have to meet certain
requirements. Different kinds of loans have different eligibility requirements. Before
you apply for a loan, you should make sure that you are eligible. Use the checklist
to find out if you can apply for the loan(s) you want. You must be able to answer “Yes”
to every item for the kind of loan you want to apply for.
Direct Loans (Farm Ownership, Operating, Emergency, Beginning Farmer)
Yes
No
Yes
No
I have enough training, education, or experience running a farm to show that I can effectively manage my
farm
Farm Ownership loans only: I have at least 3 years of experience in managing a farm business
Beginning Farmer loans only: I have operated a farm for less than 10 years
Beginning Farmer loans only: If I currently own a farm, it is less than 30% of the average farm size in
my county
Beginning Farmer Down Payment loans only: I can make a cash down payment of at least 10% of the
purchase price for the farm I want to buy, and the farm’s price is less than $250,000
I am a citizen of the United States or a legal resident alien
I am legally able to take out a loan (I am an adult and can make my own legal decisions)
I have tried to get a loan from a private lender, but have been turned down*
I can show that I have a good credit history (I pay my bills on time)
I will be the one who owns or runs the farm, and it is a family-sized farm
I have never had an FSA loan before that I failed to pay back
I am currently not behind on any loan payments that I owe to the United States government
Guaranteed Loans (Farm Ownership, Operating)
I am a citizen of the United States or a legal resident alien
I can show that I have a good credit history (I pay my bills on time)
I am legally able to take out a loan (I am an adult and can make my own legal decisions)
I have applied for a loan but the bank will not approve my loan without an FSA guarantee*
In the past, I have not caused the FSA to lose money by asking for debt forgiveness more than 3 times
I will be the one who owns or runs the farm, and it is a family-sized farm
I am not behind on any loan payments that I owe to the U.S. government
*The goal of the FSA loan program is to support farmers who can’t get loans from banks. Part of the
FSA loan process requires you to first apply to a bank for a loan and to show that you have been
rejected.
13
How to Apply for an FSA Loan
Step 3: Develop Your Business Plan
In order to get an FSA loan, you need to create a detailed business plan. A
business plan describes:
•
Your mission, vision, and goals for your farm business
•
Your current assets (valuable things or investments you own) and
liabilities (debts, loans, or payments you owe)
•
What your farm business will produce, and what makes your products
unique, valuable, or different from other farmers’ products
•
How/where you will advertise and sell your products and develop your farm
business
•
How you will earn enough money to pay your business expenses and support
your personal family living expenses
Thinking about all of these different issues may seem overwhelming to you. You might
be thinking, “Do I really need to create a full business plan? It seems like a
lot of work, and all I want to do is sell my products at farmers’ markets
and local stores or restaurants. How hard can that be?”
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How to Apply for an FSA Loan
The answer is YES, you should create a thoughtful business plan. Why? Here
are a few reasons:
Reasons to Create a Good Business Plan
1. A good business plan is required to get a loan. Lenders look closely at
business plans to judge whether they think your business can work.
1. A business plan will help you get organized. A business plan can help you to
make sure you are taking all of the necessary steps and remembering all of
the details.
2. The business plan will act as your guide. Later, you can look back at it to
measure your progress.
3. A business plan will help you to think carefully about why you want to farm.
Is it because you enjoy working for yourself, or you like being outside, or
raising food is your passion, or because it provides a supportive environment
for your family? As your business grows, you can look back at your
business plan and think about whether it is fulfilling those values.
Your business plan is very important. It shows that you have seriously thought about
your goals and plans for the future. It shows that you understand all parts of your farm
business. This means that you have thought about all of the possible expenses you will
have to pay, and how much you need to earn from your sales to pay those expenses. It
also shows why you think you can succeed in your business and how you plan to reach
your goals. Your business plan is like a road map that shows how you will move from
where you are now to where you want your farm business to be in the future. Finally, a
good business plan that describes your financial and lifestyle goals will help you to
evaluate your progress as you establish your new farm business.
15
How to Apply for an FSA Loan
Where do you start?
Creating a good business plan takes a lot of time and effort. You should
find a business advisor who can help you in the process.
There are many sources for professional advice. Your FSA Loan Officer may be
able to refer you to an advisor who has experience in advising farmers.
The Small Business Association (SBA), an independent government
agency, offers business planning assistance through its Small Business
Development Centers (SBDCs).
There is also an organization called SCORE
that can match you up with a volunteer business
advisor. SCORE volunteers are people who have a
lot of experience in running and managing
businesses, so they can give you advice on how to
create a good business plan.
It may be helpful to attend workshops that
focus on business planning. Check with the
Northeast Organic Farming Association of
Massachusetts (NOFA/Mass) to see if there is a
Practical Skills Workshop on farm business
planning. The Massachusetts Department of
Agricultural Resources (MDAR) also offers an
Agricultural Business Training Program each year.
In Lowell, the Lowell Small Business
Getting Help With
Your Business Plan
1) Small Business
Development Center
2) SCORE volunteer
service
3) NOFA/Mass Practical
Skills Workshops
4) Massachusetts Dept.
of Agricultural
Resources’
Agricultural Business
Training Program
5) Lowell Small Business
Assistance Center
Development Center (SBAC) offers business
counseling, training programs, and a drop-in resource center.
The contact information for SBA, SBDCs, SCORE, NOFA/Mass, MDAR, and
Lowell SBAC are listed at the back of this guide on pages 29-31.
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How to Apply for an FSA Loan
Farm Business Plan Guides
Here are three examples of farm business planning guides that can help you
think about all of the important parts of your business:
1. Building a Sustainable Business: A Guide to
Developing a Business Plan for Farms and Rural
Businesses.
Developed by the Minnesota Institute for Sustainable Agriculture
and co-published by the Sustainable Agriculture Network. ©
2003.
Available free online at www.misa.umn.edu/publications/
bizplan.html
2. Small Farm Decision-Making & Enterprise Planning
Workbook.
North Carolina State University Cooperative Extension. © 1992.
Available free online at http://agmarketing.extension.psu.edu/
begfrmrs/SmlFrmDecisionMakingWrkbk.pdf
3. Accion USA Business Plan Template.
Accion USA Small Business Resources. © 2007.
Available free online at http://www.accionusa.org/atf/cf/%
7B94AE2258-7F09-4D1D-843D-1585EF06DE5F%7D/Bplan.pdf
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How to Apply for an FSA Loan
Starting Your Business Plan
There are many different styles of business plans. Some are written
documents; others may be a set of worksheets that you complete. A list of
farm business planning guides are presented at the back of this book.
No matter what format you choose, you will have to think about
several key aspects of your farm business. Write down some
thoughts in the spaces below to start thinking about each part of
your business plan. Or, have somebody interview you by asking you the
Use the worksheets here as a starting place. Write down
or say out loud a few thoughts for each question. Remember, you will answer these kinds of questions in
more detail when you sit down to create your official
farm business plan with your advisor. This worksheet will
help you get started thinking about your plan.
questions below and taking notes on your answers.
1. Think about your values, vision and goals for your farm. What is
important to you?
For example:
I want to develop a farm business to support me and my family
I farm will follow sustainable agriculture principles that improve the soil, water, and wildlife habitat;
I will seek organic certification to provide safe, clean food for my community.
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
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How to Apply for an FSA Loan
2. Describe your farm business. How big is your farm? Who owns it? When
was it started?
For example:
I farm on 3 acres of rented land in Dracut, MA
Landowner: John Smith
I started this farm 3 years ago.
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
_________________________________________________
3. Describe your products. What are the key features of your products? Why
are your products unique? What are the benefits of buying your products?
For example:
Products: fresh vegetables, both traditional New England crops and specialty Asian crops.
Features: Fresh, local, naturally grown, specialty crops hard to find in supermarkets.
Unique: No one else in the area sells the specialty Asian crops.
Benefits: Fresh, tasty, healthy, high quality
___________________________________________________________
_______________________________________________________
___________________________________________________________
___________________________________________________________
_____________________________________________________
4. What are your markets? Where do you sell your products? Who are
your customers? How many customers do you have? Is your business seasonal
or year-round? What are the prices of your products? How do you set the prices?
For example:
Markets: 2 farmers’ markets in Lowell and Lynn; 1 Asian grocery store; my neighbors; a weekly flea market
Customers: Lowell/Lynn area residents—many are from Southeast Asia, but about 1/3 are Massachusetts natives;
Asian store owner
# of customers: About 50 returning customers at farmers’ markets and flea markets; approx. 200 new customers each
week; 1 wholesale customer
Length of season: Seasonal, selling fresh products from May—November
Prices: Based on market research among other local producers and USDA terminal market reports. Prices higher at
farmers’ markets than at flea market. Lower wholesale prices for Asian grocery store based on volume
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
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How to Apply for an FSA Loan
5. What is your marketing strategy? Who are your competitors? How will
you advertise, market, package, or display your products? How will you
manage your inventory? How will you price your products competitively?
For example:
Competitors: Other local vegetable farmers, about 5 other Asian growers in my area; Supermarket suppliers
Promotion: I have a pop-up tent with colorful tables and a banner with my farm name on it for markets. As little
packaging as possible to fully display fresh products. Stickers for wholesale boxes with my farm logo and
contact information.
Inventory: I will consult my sales records from past years to see how much inventory I sold throughout the season.
Based on this, along with developing more promotional strategies, I will aim to increase my sales by 10% this
season.
Pricing: I will research other sellers’ prices at farmers’ markets and flea markets, and check weekly USDA produce
reports. In order to increase revenue, I will not set my prices at rock bottom, but will stress their freshness
and high quality to appeal to customers.
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
_______________________________________________
6. Think about what resources you already have that will contribute to your
farm business. These things you already have are called your assets. What
are your assets?
For example:
Farming tools and equipment
Farm plot and farming experience
Money that I will put toward my start-up costs
Other members of my family who will help run the farm
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
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How to Apply for an FSA Loan
7. Think about your current obligations and debts .These are your liabilities. What
are your liabilities?
For example:
Home mortgage or rent
Car loan
Credit card balance
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
8. What is your financial strategy? How much money do you expect to make
each month/year? What will be your expenses? Will your income provide enough
money to cover your expenses?
For example:
Income: Based on last year’s sales, I expect to make at least $10,000 from my farm products
Expenses: $2,000 farm plot rent + $500 custom tilling + $1,200 seeds, tools, and supplies + $800 irrigation system +
$600 water + $1,000 transportation = $6,100
Total profit: Income $10,000 - Expenses $6,100 = $3,900
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
9. How will you measure your farm business performance?
For example:
Sales and Budget projections—weekly records of income and expenses
Expansion into new markets: increase wholesale sales to more than one grocery store
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
21
How to Apply for an FSA Loan
Step 4: Gather Your Documents
The next step in applying for an FSA loan is to collect your important
papers and complete required forms. You might want to ask
your business advisor for help when you fill out your forms. Even
though it might take a lot of time to put together your documents, it
will save you time later when the FSA is looking at your application.
Below is a list of the documents you will need for your FSA loan
application. Use this as a checklist, placing a
check mark as you complete each
document.
FSA Forms
Available free online at www.fsa.usda.gov/eforms/mainservlet.
Forms are also included at the back of this book on the Page # indicated below.
Form
Form Name
F FSA Form 410-1* (also
available in Spanish)
Application for Direct Loan Assistance
F FSA Form 440-32
Verification of Debts and Assets
F
F
FSA Form 2037
Farm Business Plan Worksheet: Balance Sheet
FSA Form 2038
Farm Business Plan Worksheet: Projected/Actual
Income and Expense
F Form 1910-5
Page #
Request for Verification of Employment
*You will have to pay a credit report fee to FSA so they can request your credit history. The amount of the fee varies,
depending on the structure of your farm business and how many people are applying for the loan.
NOTE: There may be more forms that you need to fill out, depending on your
situation. Your FSA Loan Officer should tell you which forms you need to complete.
22
How to Apply for an FSA Loan
Additional Documents
In addition to the loan application forms, you will need to gather several other
documents when you apply for an FSA loan:
Document
Description
F
Farm Description
A short (1-3 paragraphs, typed) description of your farm
business
F
Résumé
A work history describing your farm experience, training,
and farm management history. Your resume must show
that you have at least 1 year of farming experience
Proof that you have applied to a private bank or lender
for a farm loan and have been rejected. This could be a
rejection letter from your bank. Sometimes your FSA
Loan Advisor may take a verbal rejection rather than
requiring a written letter. See Step 5 below.
F
Loan Rejection Letter
F
Financial Records
Five years of your financial records, such as your income
tax return and your farm sales records
F
Leases and Contracts
Farm lease, rental agreements, or other contracts that
affect the operation of your farm business
F
Conservation Practices
Your FSA Loan Advisor will help you to meet this requirement showing that you comply with required
conservation programs.
Applying for a Guaranteed Loan
If you are applying for a guaranteed loan rather than a direct
FSA loan, you may need to fill out different forms or follow a
different process. Even if you are applying for a guaranteed loan,
you should contact an FSA Loan Officer for help with your
application, if you need it.
23
How to Apply for an FSA Loan
Step 5: Apply for a Bank Loan First
Before you can apply for an FSA loan, you must apply to a bank or
private lender first. This is because the purpose of FSA loans, under US
law, is to assist farmers who can’t get loans without government help.
Farmers who get FSA loans are often beginning farmers who can’t get a
private loan because they lack the resources, assets, or experience required by many
private lenders.
Here are some of the banks and other lenders serving the Lowell, Massachusetts
area where you could apply for you r loan:
• First Pioneer Farm Credit, ACA
2 Constitution Drive
Bedford, NH 03110-6010
Tel: 603.472.3554
Fax: 603.472.8048
Branch manager: David Bishop
[email protected]
www.firstpioneer.com
• Lowell Five
Merrimack Plaza
Lowell, MA 01852
Tel: (978) 452-1300
Fax: (978) 441-6534
www.lowellfive.com
•
24
• Enterprise Bank
430 Gorham St.
Lowell, MA 01852
Tel: (978) 656-5518
Fax: (978) 937-1919
www.enterprisebanking.com
• TD Banknorth
45 Central St.
Lowell, MA 01852
Tel: (978) 454-1114
www.tdbanknorth.com
• Bank of America
502 Bridge St.
Lowell, MA 01850
Tel: 1-800-841-4000
www.bankofamerica.com
How to Apply for an FSA Loan
Step 6: Apply for an FSA Loan
By now, you have done most of the hard work. You have created your business
plan, completed your application forms, and gathered your documents together to
prepare your FSA loan application.
Now it is time for you to schedule an appointment with your FSA Loan Officer to
submit your application. You probably already know your loan officer, so don’t be too
nervous! If you have made it to this point, your loan application should be all set.
Tips for Your Loan Application Meeting
1. Dress professionally and be on time for your appointment. This
shows that you are serious about the loan process and your farm
business.
2. Be prepared. Bring extra copies of your application forms and
documents. Remember to save copies for yourself as well!
3. Make sure to ask questions if there is anything you do
not understand. Your Loan Officer should be happy to
clarify issues that are confusing. Remember, this is your
farm business and you should understand all of the details!
4. Be open and honest. Answer honestly to questions that the loan
officer asks. Be excited! This is your chance to show how
excited, hopeful, and enthusiastic you are about starting or
expanding your farm business.
Your loan officer will talk with you about your farm business and your plans for the
future. If anything is missing from your application, the loan officer should let you
know right away so that you can gather the missing information.
25
How to Apply for an FSA Loan
Step 7: The FSA Loan Application Decision
Once you meet with your FSA Loan Officer and submit your application, FSA
will review your documents, check your credit history and references, and
make a decision. While your application is in review, FSA will send you letters
to confirm each step in the process.
You should receive a few letters from FSA, such as:
• A letter confirming that your application has been
received
• A letter notifying you that more information or
documentation is needed
• A letter containing the final decision on your application
If your application for a loan is rejected, FSA will tell you:
• The reason for rejection
• How you can appeal the decision
• How to re-apply
26
How to Apply for an FSA Loan
Step 8: Getting Your Loan Money
If your application is approved, FSA will notify you by letter. They will tell
you:
• How the loan money will be delivered to you (for example, by
check, by direct deposit into your bank account, or wire transfer)
• The terms of repayment on your loan, including the length of the
loan, your monthly payment amount, the interest rate, and how
to make your payments
Once You Have Your FSA Loan Money...
• Make sure you understand the conditions of the loan, including
• the interest rate,
• the length of the loan
• your monthly payment amount
• how to make your payments each month
• What the loan money can be used for
• Remember to pay your loan on time each month. If you cannot make a payment, contact your FSA loan officer or bank officer immediately to discuss
other payment options
• Keep all of your loan and financial records together in a safe place so that
you can find them easily
27
How to Apply for an FSA Loan
Step 9: Grow Your Farm Business!
Congratulations! You have completed the FSA loan application process. With
your loan money, you can purchase a farm, construct a new barn, buy a tractor, install
processing facilities, or use it to expand your farm business in whatever way you
choose. You also have a good business plan that will be your guide as your farm
business grows and changes. Good luck!
28
How to Apply for an FSA Loan
Appendix A: Additional Resources and Contact
Information
Farm Service Agency (FSA), a Division of the United States
Department of Agriculture (USDA)
Website: www.fsa.usda.gov
Farm Service Agency (FSA) - Hampshire/Hampden
County Office
195 Russell Street, Suite B5
Hadley, MA 01035-9521
Tel: (413) 585-1000
Fax: (413) 586-8648
Randy Kleiner, Farm Loan Manager— Worchester/Franklin/Hampshire/
Tel: (413) 585-1000 ext. 107
Berkshire/Hampden Counties
Email: [email protected]
Farm Service Agency (FSA) - Middlesex/Essex County Office
319 Littleton Road, Suite 203
Westford, MA 01866-4133
Tel: (978) 692-5163 ext. 100
Fax: (978) 392-1305
David DeFreest, Farm Loan Manager— Middlesex/Essex/Plymouth/Dukes/
Barnstable/Nantucket Counties
Tel: (978) 692-5163 ext. 113
Email: [email protected]
Small Business Administration (SBA)
SBA Answer Desk: 1-800-U-ASK-SBA (1827-5722)
Email: [email protected]
Website: www.sba.gov
29
800-
How to Apply for an FSA Loan
Small Business Administration (SBA) - Boston District Office
10 Causeway St., Room 265
Boston, MA 02222
Tel: (617) 585-5590
G.Jean Sawyer, Acting District Director
Tel: (617) 565-8514
Email: [email protected]
Small Business Development Center (SBDC) - Massachusetts
Office
227 Isenberg School of Management
121 President’s Drive
Amherst, MA 01003-9310
Tel: (413) 545-6301
Fax: (413) 545-1273
Website: www.msbdc.org
Georgianna Parkin, State Director
Tel: (413) 545-6301
Email: [email protected]
Small Business Development Center (SBDC) - Salem State
College
121 Loring Ave., Suite 310
Salem, MA 01970
Tel: (978) 542-6343
Fax: (978) 5426345
Website: www.salemstate.edu/sbdc
Walter Manninen, Senior Business Counselor
Tel: (978) 542-6343
Email: [email protected]
SCORE Small Business Counselors—
Northeastern Massachusetts Chapter
Danvers Savings Bank
100 Cummings Center, Suite 101K
Beverly, MA 01915
30
How to Apply for an FSA Loan
Tel: (978) 922-9441
Website: www.scorenemass.org
SCORE Small Business Counselors—Lowell Office
The Lowell Plan/L.F.D.C.
11 Kearney Square
Lowell, MA 01852
Tel: (978) 459-9899
Northeast Organic Farming Association—
Massachusetts (NOFA/MA)
411 Sheldon Rd.
Barre, MA 01005
Tel: (978) 355-2853
Website: www.nofamass.org
Tom Szekely, Practical Skills Workshop Coordinator
PO Box 611
Lincoln, MA 01773
Tel: (781) 894-4358
Email: [email protected]
Massachusetts Department of Agricultural Resources (MDAR)
Main Office
251 Causeway St., Suite 500
Boston, MA 02114
Tel: (617) 626-1700
Fax: (617) 626-1850
Website: www.mass.gov/agr
Massachusetts Department of Agricultural Resources (MDAR)
Agricultural Business Training Program
Rick Chandler
25 West Experiment Station
Amherst, MA 01003
Tel: (413) 577-0459
Email: [email protected]
31
How to Apply for an FSA Loan
ACCION USA
56 Roland St., Suite 300
Boston, MA 02129
Tel: 1-866-245—783
Fax: (617)-625-7020
Website: www.accionusa.org
Lowell Small Business Assistance Center (SBAC)
88 Middle St., 2nd Floor
Lowell, MA 01852
Tel: (978) 322-8400
Fax: (978) 441-6824
Website: www.lowellsbac.org
Russ Smith, Executive Director/Lead Business Counselor
Tel: (978) 322-8400
Email: [email protected]
32
How to Apply for an FSA Loan
Appendix B: Glossary of Terms
Assets: Valuable property owned by a person, both tangible (like land, buildings,
vehicles) and intangible (like training, experience).
Default: When a person does not pay back a loan that they owe to a bank or lender.
When someone defaults on a loan, the bank or lender has the right to foreclose
on (take back) the loan money or property.
Direct Loan: A farm loan made directly to a farmer by the FSA using US government
money. Direct loans are managed by the FSA.
Emergency Loan: A farm loan made directly to a farmer by the FSA to cover losses
from storms, natural disaster, or other emergencies.
Farm Credit System (FCS): A nationwide cooperative system of banks that lend
money to farmers. The FCS was originally a government-funded program, but is
now self-funded and owned by member-borrowers. It is made up of three parts:
the Banks for Cooperatives; the Farm Credit Banks; and the Federal Farm Credit
Banks Funding Corp. As a cooperative system, when a farmer borrows money
through FCS, he/she becomes a member and part owner of the lending
organization.
Farm Ownership Loan: A loan made by a bank or lender to help farmers buy
farmland or farm property, or to build new farm buildings.
Farm Service Agency (FSA): A part of the U.S. government, under the U.S.
Department of Agriculture, that manages farm loan programs. The FSA farm
loan programs especially help beginning farmers and socially disadvantaged
farmers. The FSA farm loan program is managed by state and county offices,
although the main national office is in Washington, DC.
Fixed interest rate: An interest rate that does not change during the time that a
loan is being paid back.
Foreclose: To take back or repossess loaned money or property when the borrower
fails to pay back the loan.
33
How to Apply for an FSA Loan
Guaranteed Loan: A farm loan made by a private bank or lender using private
money that is backed up or “guaranteed” by FSA. Many banks will only make a
loan to a farmer if it is guaranteed by FSA. This means that if the farmer defaults
(does not pay back the loan), the FSA will pay the bank for the loan.
Interest rate: The amount of money charged by a bank to a borrower; the cost of the
loan. It is expressed as a percentage (%) of the loan amount to be paid each year.
For example, a one year loan of $1,000 with an interest rate of 10% means that
the borrower would pay $100 in interest on top of the $1,000 he/she pays back
to the bank: $1,000 x .10 = $100. Therefore, the borrower must pay the bank
back $1,100 in total: $1,000 + $100 = $1,100.
Liabilities: Debts that a person or business owes.
Maximum loan amount: The highest amount of money a farmer can borrow
under a particular kind of loan.
Operating Loan: A farm loan made by a bank or lender to help farmers buy
equipment, supplies, livestock, feed and seed. An Operating Loan can also be
used for soil and water conservation efforts on the farm.
Terms of a loan: The conditions set by a lender when making a loan. The terms of a
loan include the length of the loan (how long the borrower has to pay it back);
the interest rate (the cost of the loan, given as a percentage % on the total loan
amount); and what the loan money can be used for. The terms also state the
monthly loan amount, late fees, and penalties for non-payment.
Variable interest rate: An interest rate that changes from year to year (or more
often) while the borrower is paying the loan back.
34
Formulario aprobado - OMB No. 0560-0167
Este formulario está disponible electrónicamente
FSA-410-1
U.S. DEPARTMENT OF AGRICULTURE
Farm Service Agency
(09-10-03)
SOLICITUD PARA ASISTENCIA DE PRÉSTAMO DIRECTO
INSTRUCCIONES PARA EL SOLICITANTE: Indique el nombre y nombre comercial si posee alguno. Los solicitante de entidades comerciales deben proveer la
información adicional listada en el punto 33. Los individuos que deseen solicitar un préstamo juntos, serán considerados como una operación conjunta). Un esposo y
esposa pueden solicitar como un individuo.)
1. NOMBRE COMPLETO DEL SOLICITANTE (LISTE TODOS
LOS NOMBRES QUE UTILIZA ACTUALMENTE SU NEGOCIO)
6. CONDADO DE RESIDENCIA DEL
SOLICITANTE
10. NOMBRE COMPLETO DEL CO-SOLICITANTE
7. CANTIDAD DE MIEMBROS DEL GRUPO
2. DIRECCIÓN DEL SOLICITANTE (SI USTED OPERA COMO
FAMILIAR DEL SOLICITANTE
ENTIDAD COMERCIAL INDIQUE EL LUGAR DONDE SE
ENCUENTRA INCORPORADA O REGISTRADA LA ENTIDAD)
11. DIRECCIÓN DEL CO-SOLICITANTE
3. NÚMERO DE TELÉFONO DEL SOLICITANTE
(CON CÓDIGO DE ÁREA)
12. NÚMERO DE TELÉFONO DEL CO-SOLICITANTE
(CON CÓDIGO DE ÁREA)
8.
CONDADO O CONDADOS QUE ESTÁN SIENDO CULTIVADOS
13. FECHA DE NACIMIENTO DEL CO-SOLICITANTE
(MM-DD-AAAA)
4. FECHA DE NACIMIENTO DEL SOLICITANTE (MM-DD-AAAA)
5. NÚMERO DE SEGURO SOCIAL O NÚMERO DE
IDENTIFICACIÓN IMPOSITIVA DEL SOLICITANTE
15. TIPO DE
OPERACIÓN:
INDIVIDUAL
CORPORACIÓN
16. ESTADO CIVIL, SOLAMENTE DE
LOS SOLICITANTES INDIVIDUALES:
9A.
ACRES DE PROPIEDAD
9B.
ACRES ARRENDADOS
SOCIEDAD
GRUPO EMPRESARIAL
COOPERATIVA
COMPAÑÍA. DE
RESPONSABILIDAD LIMITADA
SEPARADO
CASADO
14. NÚMERO DE SEGURO SOCIAL O NÚMERO DE
IDENTIFICACIÓN IMPOSITIVA DEL CO-SOLICITANTE
OTRO TIPO (IDENTIFICAR)
A menos que seleccione una de las otras casillas, los individuos que operan
juntos serán considerados una operación conjunta
NO-CASADO (INCLUYE SOLTERO, DIVORCIADO Y VIUDO)
SÍ
NO
17. ¿Usted o algún miembro de su organización ha estado en liquidación judicial, ha sido exonerado o presentó una solicitud de reorganización en
bancarrota?. Si marca "SÍ" provea una explicación en el Punto 35.
18. ¿Usted o algún miembro de su organización o la organización en sí misma están involucrados en alguna litigación pendiente? Si marca "SÍ" provea una explicación en el Punto 35.
19. ¿Usted o algún miembro de su organización ejerció el comercio bajo algún otro nombre? Si marca "SÍ", indique los nombres utilizados en el Punto 35.
20A. ¿Usted o algún miembro de su organización recibió previamente un préstamo directo o garantizado por Farm Service Agency (FSA) o de Farmers
Home Administration o de sus agencias sucesorias?
20B. Si marcó "SÍ" en el Punto 20 A ¿alguna vez el gobierno le condonó alguna deuda por medio de una amortización a pérdidas y ganancias, acuerdo de resolución de deuda,
concesión, amortización, cancelación, ajuste, reducción o bancarrota? Si se declaró en bancarrota, provea una explicación en el Punto 35. Si marcó "NO" en el Punto 20A déjelo en
blanco.
21. Si obtuvo un préstamo garantizado, ¿el gobierno le pagó al prestador una reclamo de pérdida por incobrable? Si no recibió un préstamo garantizado, déjelo en blanco.
22. ¿Usted o algún miembro de su organización se encuentra en mora en el pago de alguna deuda federal? Si marca "SÍ" brinde los detalles en el Punto 35.
23. ¿Es ciudadano de los Estados Unidos? Si marca "NO", debe presentar la documentación correspondiente para acreditar su estatus de nacional de
EE.UU. no-ciudadano o residente extranjero calificado bajo las leyes aplicables de inmigración.
24. ¿Es usted veterano de guerra de los EE.UU.? Si marca "SÍ", por favor indique la rama o división y las fechas de servicio en el Punto 35.
25. ¿Está desarrollando o ha desarrollado previamente alguna actividad agrícola o ganadera? Si marca "Sí", indique la cantidad de años y una breve descripción en el Punto 35.
26. ¿Es usted empleado de FSA o está relacionado o estrechamente asociado con algún empleado de FSA? Si marca "SÍ", explíquelo en el Punto 35.
27A. PROPÓSITO DEL PRÉSTAMO
27B. MONTO APROXIMADO DEL PRÉSTAMO NECESITADO
28A. SI ES APLICABLE, PROPÓSITO DEL PRÉSTAMO SUBSIGUIENTE
28B. MONTO APROXIMADO DEL PRÉSTAMO SUBSIGUIENTE NECESITADO
29A. NOMBRE Y DIRECCIÓN DEL EMPLEADOR DEL SOLICITANTE
30A. NOMBRE Y DIRECCIÓN DEL EMPLEADOR DEL CO-SOLICITANTE
29B. Nº DE TELÉFONO DEL EMPLEADOR DEL SOLICITANTE:
29C. INGRESO ANUAL APROXIMADO DEL SOLICITANTE
30B. Nº DE TELÉFONO DEL EMPLEADOR DEL CO-SOLICITANTE:
30C. INGRESO ANUAL APROXIMADO DEL CO-SOLICITANTE
$
$
$
$
31. COMPLETADO POR FSA
A. FECHA DE RECEPCIÓN DEL FORMULARIO FSA-410-1 (MM-DD-AAAA)
C. CARGO POR INFORME CREDITICIO
B. FECHA EN QUE SE COMPLETÓ LA SOLICITUD (MM-DD-AAAA)
D. FECHA DE RECEPCIÓN (MM-DD-AAAA)
E. INICIALES
$
F. TIPO DE ASISTENCIA
FO
OL
EM
SUBORDINACIÓN
OTRO (ESPECIFICAR)
De conformidad con las disposiciones de la Ley de Reducción de Trámites Burocráticos (Paperwork Reduction Act) de 1995, ninguna agencia puede realizar o patrocinar, ni ninguna persona puede estar
obligada a responder a una solicitud de información a menos que la misma esté identificada con un número de control válido OMB. El número OMB de esta solicitud de información es 0560-0167. El tiempo
necesario para completar esta solicitud de información se estima en un promedio de 60 minutos por respuesta, incluido el tiempo necesario para analizar las instrucciones, realizar la búsqueda en las fuentes
de datos existentes, recabar y mantener los datos necesarios y completar y revisar la recolección de información. POR FAVOR DEVUELVA ESTE FORMULARIO COMPLETADO A LA OFICINA FSA DE SU CONDADO.
35
FSA-410-1 (09-10-03)
Página 2 de 4
INFORMACIÓN DE CARÁCTER VOLUNTARIO PARA FINES DE MONITOREO: La información sobre raza, etnia y género es solicitada por el Gobierno Federal con el fin de supervisar el
cumplimiento por parte de FSA de las leyes federales que prohíben la discriminación contra los solicitantes de préstamo. Usted no está obligado a suministrar esta información, pero lo
instamos a que lo haga. Sin embargo, si decide no suministrar esta información, es posible que no tenga acceso a los fondos destinados a sectores específicos para los cuales usted podría ser
elegible. Esta información no será utilizada para evaluar su solicitud o para tomar una medida antidiscriminatoria en su contra. Si usted no presenta esta información, FSA tiene obligación de
anotar su raza, etnia y género sobre la base de la observación. (*Estos datos son solicitados únicamente con fines estadísticos. Se pueden seleccionar una o más casillas.)
32. SOLAMENTE PARA SOLICITANTES INDIVIDUALES:
A. *ETNIA
Hispano o Latino
B. *RAZA (Seleccione tantas casillas como sean aplicables)
Indígena americano o Nativo de Alaska
Nativo de Hawai o de las Islas del Pacífico
Asiático
Negro o Afroamericano
No-Hispano o Latino
Blanco
D. PARA USO DE FSA
C. GÉNERO
Masculino
Provisto
Femenino
Observado
33. SOLAMENTE PARA SOLICITANTES DE ENTIDADES COMERCIALES:
La entidad comercial debe proveer:
A. Documentos Organizativos y Operacionales (por ejemplo, Acta Constitutiva, Acta de Inscripción, Estatuto Social, Acuerdos Societarios o de Operación Conjunta, etc).
B. Cualquier prueba de su inscripción actual ante las agencias estatales regulatorias (válida y al día).
C. Una resolución debidamente adoptada para solicitar y obtener financiación.
D. Número de identificación impositiva.
E. Planilla de balance con fecha que no supere los 90 días de antigüedad.
34. SOLAMENTE PARA MIEMBROS INDIVIDUALES DE UNA ENTIDAD COMERCIAL:
El miembro individual debe proveer:
A. Información de los Puntos (1) hasta (7) que se encuentran a continuación. los Puntos (8) y (9) son voluntarios, pero requeridos para acceder a los fondos destinados a sectores específicos, tal como
corresponda.
B. Planilla de balance con fecha que no supere los 90 días. (Si no existen activos de propiedad individual, las operaciones conjuntas de esposo y esposa pueden presentar un balance consolidado.
NOTA: Se requerirá responsabilidad individual independientemente del tipo de organización del negocio.
(1)
Nombre y dirección completos
(2)
Nº de Seguro Social
(3)
Ocupación principal
(4)
% de
propiedad
(7)
Género
(6)
Nacionalidad
(5)
Fecha de nacimiento
(MM-DD-AAAA)
Sí
No
¿Es usted ciudadano,
nacional no-ciudadano o
extranjero calificado?
(9) *Raza:
(8) *Etnia:
Hispano/Latino
No-Hispano/Latino
Indígena americano o Nativo de Alaska
Negro/Afroamericano
Asiático
Nativo de Hawai/Islas del Pacífico
(1)
Nombre y dirección completos
(2)
Nº de Seguro Social
(3)
Ocupación principal
(4)
% de
propiedad
Masculino
Femenino
(10) PARA USO DE FSA
Blanco
Provisto
Observado
(7)
Género
(6)
Nacionalidad
(5)
Fecha de nacimiento
(MM-DD-AAAA)
Sí
No
¿Es usted ciudadano,
nacional no-ciudadano o
extranjero calificado?
(9) *Raza:
(8) *Etnia:
Hispano/Latino
Indígena americano o Nativo de Alaska
Negro/Afroamericano
No-Hispano/Latino
Asiático
Nativo de Hawai/Islas del Pacífico
(1)
Nombre y dirección completos
(2)
Nº de Seguro Social
(3)
Ocupación principal
(4)
% de
propiedad
Masculino
Femenino
(10) PARA USO DE FSA
Blanco
Provisto
Observado
(5)
(7)
Género
(6)
Nacionalidad
Fecha de nacimiento
(MM-DD-AAAA)
Sí
No
¿Es usted ciudadano,
nacional no-ciudadano o
extranjero calificado?
(9) *Raza:
(8) *Etnia:
Hispano/Latino
Indígena americano o Nativo de Alaska
Negro/Afroamericano
No-Hispano/Latino
Asiático
Nativo de Hawai/Islas del Pacífico
(1)
Nombre y dirección completos
(2)
Nº de Seguro Social
(3)
Ocupación principal
(4)
% de
propiedad
(9) *Raza:
Provisto
Observado
Indígena americano o Nativo de Alaska
Negro/Afroamericano
No-Hispano/Latino
Asiático
Nativo de Hawai/Islas del Pacífico
(7)
Género
(6)
Nacionalidad
(5)
Fecha de nacimiento
(MM-DD-AAAA)
Hispano/Latino
Femenino
(10) PARA USO DE FSA
Blanco
Sí
¿Es usted ciudadano,
nacional no-ciudadano o
extranjero calificado?
(8) *Etnia:
Masculino
Blanco
No
Masculino
Femenino
(10) PARA USO DE FSA
Provisto
Observado
35. REPUESTAS ADICIONALES. Escriba el número del Punto al cual corresponde cada respuesta. Si necesita más espacio, use hojas de papel adicionales del mismo tamaño
que esta página.
36
FSA-410-1 (09-10-03)
Página 3 de 4
Se requiere la presentación de una planilla de balance firmada con fecha que no supere los 90 días. Las entidades comerciales deben presentar planillas de balance de los miembros individuales. Puede
utilizar este formulario o adjuntar su propia planilla. Si usted tiene registrada una planilla de balance ante FSA que tiene una fecha inferior a 90 días, no es necesario que complete esta sección en este
momento.
36.
PLANILLA DE BALANCE
AL DÍA:
$ VALOR
A. ACTIVOS CORRIENTES AGRÍCOLAS
1. Dinero en efectivo
2. Cuenta corriente
$
$
Cuentas y documentos a pagar agrícolas
(Incluir monto principal e interés)
$
2.
Fecha de
vencimiento
de pago
1.
Acreedor
Otras inversiones:
5. Otras
4. Certificados a plazo
$ VALOR
E. DEUDAS CORRIENTES AGRÍCOLAS
3. Cuenta de Ahorro
3.
Tasa de
interés
4.
Cuota anual
o mensual
($)
$
$
6. Cuentas y documentos a cobrar (exigibles)
7. Cultivos y forraje
9. Precio por unidad ($)
8. Unidades
11.
Nro.
10. Ganado para la venta
12. Unidad
de peso
13.
Precio por unidad($)
Préstamo CCC:
5. Tipo
6. Cantidad
7. Fecha de vencimiento
Porción actual del principal adeudado en concepto de:
8. Pasivos intermedios
9. Pasivos de largo plazo
Intereses acumulados sobre:
14. Cultivos a cosechar
15. Acres
10. Pasivos intermedios
16. Costo/Acre ($)
11. Pasivos de largo plazo
Impuestos acumulados sobre:
12. Bienes inmobiliarios, propiedad personal y contribuciones
13. Impuesto a las ganancias y Seguro Social
17. Materiales/provisiones y gastos prepagados
18. Arrendamientos
14. Alquileres acumulados/pagos de arrendamiento
19. Otros
15. Otros (sentencias, gravámenes, etc.)
20. TOTAL DE LOS ACTIVOS CORRIENTES AGRÍCOLAS
16. TOTAL DE LOS PASIVOS CORRIENTES AGRÍCOLAS
F. DEUDAS INTERMEDIOS AGRÍCOLAS (porción adeudada más allá de 12 meses)
B. ACTIVOS INTERMEDIOS AGRÍCOLAS
3. Nro.
2.
Fecha de
vencimiento de
pago
1.
Acreedor
1. Cuentas y documentos a cobrar más allá de 12 meses (exigibles)
2. Ganado de cría
4. Precio por unidad ($)
3.
Tasa de
interés
4.
Monto
atrasado
5. Maquinaria, equipamiento y vehículos
6. Existencias en cooperativa
7A. Seguro de Vida, Valor efectivo
(7B. Monto nominal
)
Reserva de propiedad agrícola:
8. Tipo
9. Cantidad
10. Precio/Unidad ($)
5. Préstamos garantizados por
pólizas de seguro de vida
6. Reserva de propiedad agrícola
11. Otros
7. Otros
12. TOTAL ACTIVOS INTERMEDIOS AGRÍCOLAS
C. ACTIVOS DE LARGO PLAZO AGRÍCOLAS (Propiedad inmobiliaria agrícola)
1. Acres
2. Fecha de
compra
3. Impuesto
4. Costo
anual
8. TOTAL DE PASIVOS INTERMEDIOS AGRÍCOLAS
G. DEUDAS DE LARGO PLAZO AGRÍCOLAS (porción adeudada más allá de 12
meses)
4.
2.
3.
1.
Monto en
Fecha de
Tasa de
Acreedor
mora ($)
vencimiento
interés
de pago
$
$
5. Existencias en cooperativa
6. Participación de capital en sociedades/corporaciones/operaciones/cooperativas
7. Otras
5. Otros
8. TOTAL DE ACTIVOS DE LARGO PLAZO AGRÍCOLAS
6. TOTAL DE PASIVOS DE LARGO PLAZO AGRÍCOLAS
9. TOTAL DE ACTIVOS AGRÍCOLAS
D. ACTIVOS NO-AGRÍCOLAS
7. TOTAL DE PASIVOS AGRÍCOLAS
H. DEUDAS NO-AGRÍCOLAS
.
Cuentas y documentos a pagar no-agrícolas
1. Artículos del hogar
1.
Acreedor
2. Automóviles, vehículos recreativos, etc.
3. Valor efectivo de seguro de vida
2.
Fecha de
vencimiento
de pago
3.
Tasa de
interés
4.
Cuota anual
o mensual
4. Acciones, títulos, valores
5. Negocio no-agrícola
6. Otros activos no-agrícolas
7A. Propiedad inmobiliaria no-agrícola (7B. Impuesto anual $
)
5. TOTAL DE PASIVOS NO-AGRÍCOLAS
6. TOTAL DE PASIVOS AGRÍCOLAS
8. TOTAL DE ACTIVOS NO- AGRÍCOLASS
37
7. TOTAL DE PASIVOS
9. TOTAL DE ACTIVOS AGRÍCOLAS
8. VALOR NETO
10. TOTAL DE ACTIVOS
9. TOTAL DE PASIVOS Y VALOR NETO
FSA-410-1 (09-10-03)
Página 4 de 4
37. INFORMACIÓN SOBRE PROGRAMAS ESPECIALES
Determinados programas de FSA están diseñados por ley para solicitantes de sectores específicos. Si usted está interesado en alguno de los programas descritos a continuación, o si tienen preguntas
referidas a si usted cumple los requisitos de elegibilidad para un programa específico, la oficina FSA que procese su solicitud lo ayudará con estos temas.
A.
SOLICITANTES SOCIALMENTE DESAVENTAJADOS: Una parte de los fondos FSA asignados a préstamos para propiedad y operación agrícola, están destinados por ley a los solicitantes que hayan
sido pasibles de prejuicio racial, étnico o de género debido a su identidad como miembro de un grupo, sin consideración de sus cualidades individuales. Bajo la ley aplicable, los grupos que cumplen esta
condición son: mujeres, afroamericanos, indígenas americanos, nativos de Alaska, hispanos, asiáticos y nativos de las Islas del Pacífico.
B.
ASISTENCIA PARA GRANJEROS PRINCIPIANTES: FSA posee autoridad para asistir a los granjeros y ganaderos principiantes por medio de los programas de préstamo de propiedad y operación.
Una parte de los fondos de estos programas de préstamo están destinados por ley a los granjeros y ganaderos principiantes. Además, FSA tiene un programa para granjeros principiantes para pago
inicial, el cual recibe financiación especial. En algunos Estados, FSA posee acuerdos con programas estatales para granjeros principiantes con el fin de ayudarlos a cumplir las necesidades de crédito
de este sector.
C.
PRÉSTAMOS PARA SOLICITANTES DE RECURSOS LIMITADOS: Los préstamos para propiedad y operación agrícola para solicitantes de recursos limitados están disponibles para aquellos
solicitantes FSA calificados. Este programa provee préstamos con tasas de interés reducida a granjeros y ganaderos de bajos ingresos cuyas operaciones agrícolas y recursos son tan limitados que no
están en condiciones de pagar las tasas corrientes de los préstamos FSA. Este programa también tiene como intención proporcionarles a los granjeros y ganaderos principiantes una oportunidad de
iniciar exitosamente una operación agrícola.
38. DECLARACIÓN REQUERIDA POR LA LEY DE PRIVACIDAD
Las siguientes declaraciones se hacen en concordancia con la Ley de Privacidad (Privacy Act) de 1974 (5 U.S.C. 552a): la Farm Service Agency (FSA) está autorizada por la ley llamada Consolidated Farm
and Rural Development Act (7 U.S.C. 1921 et seq.), u otras leyes y las regulaciones promulgadas citadas en adelante, para pedir la información solicitada en sus formularios de solicitud. La información
solicitada es necesaria para que FSA determine la elegibilidad para el crédito y otros tipos de asistencia financiera, dar servicio a su préstamo y realizar análisis estadísticos. La información proporcionada
puede ser suministrada a otras agencias del Department of Agriculture, Deapartment of the Treasury, Department of Justice u otras agencias encargadas de la aplicación de la ley, Department of Defense,
Department of Housing and Urban Development, Department of Labor, United States Postal Service u otras agencias federales, estatales o locales tal como sea requerido o permitido por la ley. Además, la
información puede ser derivada a las partes interesadas bajo las disposiciones de la ley llamada Freedom of Information Act (FOIA), a consultores financieros, consejeros, instituciones de préstamo, mayoristas
de préstamos, agentes y fuentes de crédito privados o comerciales, contratistas de cobranza o servicio, agencias de informes crediticios, abogados privados contratados por FSA o por el Department of Justice,
firmas comerciales del sector que compren bienes muebles o cultivos o que los vendan en comisión, miembros o personal del Congreso, cortes u organismos con poder para dictar sentencia o tasadores con
licencia o certificación estatal. La declaración de la información solicitada es voluntaria. Sin embargo, si no se proporciona determinados datos de información, incluyendo su número de Seguro Social o
número de identificación impositiva federal, se puede demorar el procesamiento de la solicitud o puede ser rechazada.
39. INFORMACIÓN GENERAL
A.
DERECHO BAJO LAS DISPOSICIONES DE LA FINANCIAL PRIVACY ACT DEL AÑO 1978 y TÍTULO XI, 1113(h) PUB. L. 95-630: FSA tiene derecho a acceder a los registros financieros mantenidos
por instituciones financieras relacionados a la asistencia que le proporciona, como así también, a la cobranza de préstamos que le han sido otorgados a usted o garantizados por el gobierno. Los registros
financieros que involucren su transacción estarán a disposición de FSA sin mediar notificación o autorización adicional, pero no serán revelados o difundidos por esta institución a otra agencia o
Departamento gubernamental sin su consentimiento, excepto como sea requerido por la ley.
B.
LA LEY DE IGUALDAD DE OPORTUNIDAD DE CRÉDITO les prohíbe a los otorgantes de crédito ejercer discriminación contra los prestatarios sobre la base de la raza, color, religión, sexo, origen
nacional, estado civil, edad (a condición de que el prestatario esté capacitado para participar de un contrato vinculante), debido a que todo o parte de los ingresos del prestatario provenga de un programa
de asistencia pública o debido a que el prestatario haya ejercido de buena fe cualquier derecho otorgado por cualquiera de las disposiciones de la ley llamada Consumer Credit Protection Act.
C.
NORMAS FEDERALES SOBRE COBRANZA: La morosidad, incumplimiento de pago, ejecuciones hipotecarias y abusos relacionados a los préstamos hipotecarios del Gobierno Federal pueden ser
costosos y perjudiciales para su crédito, actualmente y en el futuro. El Gobierno Federal, como prestador hipotecario de esta transacción, y también sus agencias, agentes y cesionarios, están autorizados
para tomar cualquiera y todas las siguientes medidas en el caso de que se atrasen los pagos del préstamo hipotecario descrito en la solicitud adjunta: (1 ) Notificar su nombre e información sobre su
cuenta a una agencia de informes crediticios, (2) imponer intereses y cargos adicionales por el período de tiempo que no se haga efectivo el pago, (3) imponer cargos para cubrir los costos administrativos
adicionales en que incurra el gobierno para dar servicio a su cuenta, (4) descontarle sumas que le adeuden otros programas federales; (5) derivar su cuenta a un abogado privado, agencia de cobranza o
agencia de servicio hipotecario para cobrar la suma adeudada, ejecutar la hipoteca, vender la propiedad y entablar demanda procurando una sentencia contra usted por su incumplimiento; (6) derivar su
cuenta al Department of Justice para su litigación; (7) si usted es un actual o ex empleado del Gobierno Federal, puede tomar una acción para hacer descuentos de su salario o beneficios de retiro del
servicio civil; (8) derivar su deuda al Department of the Treasury para verificar y descontarle el monto adeudado de cualquier suma que le adeude una agencia federal, como por ejemplo del reintegro del
impuesto a las ganancias y (9) reportar al Internal Revenue Service cualquier anulación de su deuda como ingreso sujeto a impuestos. Todas estas medidas se podrán aplicar y se aplicarán para
recuperar deudas cuando se determine que hacerlo redundará en el mejor interés del Gobierno Federal.
40. CERTIFICACIONES
A.
B.
RESTRICCIONES Y DECLARACIÓN DE ACTIVIDADES DE LOBBY
1.
El solicitante del préstamo certifica que: si cualquier parte de los fondos, por o en nombre del solicitante del préstamo, han sido o serán pagados a alguna persona para influenciar o intentar ejercer
influencia sobre un funcionario o empleado de alguna agencia, un miembro, un funcionario o empleado del Congreso, o un empleado de un miembro del Congreso en conexión con el otorgamiento
de cualquier contrato federal, la asignación de cualquier subvención o préstamo federal, y la extensión, continuación, renovación, enmienda o modificación de cualquier contrato federal,
subvención o préstamo, el solicitante del préstamo debe completar y presentar el formulario llamado Standard Form - LLL, ''Disclosure of Lobbying Activities,'' en concordancia con sus
instrucciones.
2.
El solicitante del préstamo requerirá que el texto de esta certificación sea incluida en el otorgamiento de documentos de todas las sub-adjudicaciones a terceros (incluyendo contratos, subcontratos
y sub-subvenciones, bajo subvenciones y préstamos) y que todos los destinatarios secundarios certificarán y declararán correspondientemente.
3.
Esta certificación es una representación material del hecho sobre el que se basa la veracidad al momento en que realizó esta transacción. La presentación de esta declaración es un prerrequisito
para hacer o participar de esta transacción tal como dictado por 31 U.S.C. 1352. Toda persona que no presente la declaración requerida será sujeta de una penalidad civil.
ABUSO DE SUSTANCIAS CONTROLADAS
El solicitante del préstamo certifica que es un individuo o entidad solicitante que no ha sido condenado bajo ley Federal o Estatal referida a la plantación, cultivo, cosecha, producción o almacenamiento
de sustancias controladas durante los cinco años previos de cosecha. Consulte la ley del año 1985 llamada Food Security Act (Pub. L. 99-198). El solicitante de préstamo, asimismo certifica que ni
como individuo ni como miembro de una entidad, no cumple con los requisitos de elegibilidad para obtener beneficios federales sobre la base de una condena por distribución de sustancias controladas
o por ningún delito que involucre la posesión de una sustancia controlada bajo lo dispuesto por 21 U.S.C. § 862.
C.
PRUEBA DE CRÉDITO
El individuo o parte autorizada certifica que el crédito necesitado, con o sin una garantía de préstamo, no pudo ser obtenido por el solicitante individual, o en el caso de una entidad comercial, el crédito
necesitado no pudo obtenerse considerando todos los activos de propiedad de la entidad comercial y de todos los miembros individuales de la misma.
D.
AUTORIZACIÓN PARA PRESENTAR UNA DECLARACIÓN DE ESTADO FINANCIERO BAJO EL ARTÍCULO 9 DE SU CÓDIGO ESTATAL DE COMERCIO
Si el Estado en el que usted reside ha adoptado las revisiones del año 1988 a su Código de Comercio, ya no es necesario que firme la declaración de estado financiero que permite a FSA obtener el derecho
de garantía prendaria sobre su propiedad. Si su préstamo es aprobado y financiado, FSA presentará una declaración de estado financiero a la brevedad posible, antes de que usted acepte el CONVENIO DE
GARANTÍA SOBRE LA PROPIEDAD. POR MEDIO DE MI FIRMA ESTAMPADA AL PIE DEL PRESENTE FORMULARIO, OTORGO AUTORIZACIÓN A FSA PARA PRESENTAR UNA DECLARACIÓN DE
ESTADO FINANCIERO ANTES DE EJECUTAR EL CONVENIO DE GARANTÍA SOBRE LA PROPIEDAD, COMO ASÍ TAMBIÉN PRESENTAR ENMIENDAS Y CONTINUACIONES DE LA DECLARACIÓN
DEL ESTADO FINANCIERO EN LO SUCESIVO.
E.
CONSENTIMIENTO
YO, EL SOLICITANTE DEL PRÉSTAMO, POR MEDIO DE MI FIRMA EN LA PRESENTE SOLICITUD, CERTIFICO HABER RECIBIDO LAS NOTIFICACIONES SEÑALADAS ANTERIORMENTE Y
ACEPTAR Y CUMPLIR LAS CONDICIONES DECLARADAS EN LA MISMA. YO, CERTIFICO QUE LAS DECLARACIONES EFECTUADAS POR MÍ EN LA PRESENTE SOLICITUD SON VERACES,
COMPLETAS Y CORRECTAS A MI LEAL SABER Y ENTENDER Y SON REALIZADAS DE BUENA FE CON EL FIN DE OBTENER UN PRÉSTAMO. COMPRENDO QUE EL PERÍODO DE 60 DÍAS
DE APROBACIÓN NO COMENZARÁ A TRANSCURRIR HASTA QUE HAYA PRESENTADO UNA SOLICITUD COMPLETA. (ADVERTENCIA: LA SECCIÓN 1001 DEL TÍTULO 18, DEL CÓDIGO DE
LOS ESTADOS UNIDOS DISPONE SANCIONES PENALES PARA TODA PERSONA QUE HAGA DECLARACIONES FALSAS EN LAS SOLICITUDES DE PRÉSTAMO. SI ALGUNA INFORMACIÓN
DE ESTA SOLICITUD ES HALLADA FALSA O INCOMPLETA, PUEDE CONSIDERARSE LA DENEGACIÓN DEL CRÉDITO SOLICITADO.
41A. FIRMA DEL SOLICITANTE O
38 AUTORIZADO
REPRESENTANTE
41B. FECHA MM-DD-AAAA)
42A. FIRMA DEL CO-SOLICITANTE DEL
PRÉSTAMO O REPRESENTANTE AUTORIZADO
42B. FECHA MM-DD-AAAA))
Form Approved - OMB No. 0560-0167
This form is available electronically.
FSA-410-1
U.S. DEPARTMENT OF AGRICULTURE
Farm Service Agency
(09-10-03)
REQUEST FOR DIRECT LOAN ASSISTANCE
INSTRUCTIONS TO APPLICANT: Show name, and trade name if any. Business entity applicants must provide additional information listed in
Item 33. Individuals who want to apply for a loan together will be considered a joint operation. (Either a husband or wife can apply as an
individual.)
1. APPLICANT'S EXACT FULL LEGAL NAME (LIST ALL
NAMES YOUR BUSINESS IS CURRENTLY USING)
6. APPLICANT'S COUNTY OF RESIDENCE
10. CO-APPLICANT'S EXACT FULL LEGAL NAME
2. APPLICANT'S ADDRESS (IF YOU ARE OPERATING AS A
BUSINESS ENTITY LIST WHERE YOU ARE
INCORPORATED OR OTHERWISE REGISTERED)
7. APPLICANT'S NUMBER OF HOUSEHOLD
MEMBERS
11. CO-APPLICANT'S ADDRESS
3. APPLICANT'S TELEPHONE NO. (INCLUDING AREA CODE)
8. COUNTY OR COUNTIES BEING FARMED
12. CO-APPLICANT'S TELEPHONE NO. (INCLUDING
AREA CODE)
13. CO-APPLICANT'S BIRTH DATE (MM-DD-YYYY)
4. APPLICANT'S BIRTH DATE (MM-DD-YYYY)
5. APPLICANT'S SOCIAL SECURITY NUMBER OR TAX
IDENTIFICATION NUMBER
14. CO-APPLICANT'S SOCIAL SECURITY NUMBER
OR TAX IDENTIFICATION NUMBER
9A. ACRES OWNED
9B. ACRES RENTED
15. TYPE OF
OPERATION:
INDIVIDUAL
PARTNERSHIP
TRUST
CORPORATION
COOPERATIVE
LIMITED LIABILITY CO.
16. INDIVIDUAL APPLICANTS ONLY
MARITAL STATUS:
SEPARATED
MARRIED
OTHER (IDENTIFY)
Unless you select one of the other boxes, individuals operating together will
be considered a joint operation.
UNMARRIED (INCLUDING SINGLE, DIVORCED, AND WIDOWED)
YES
17.
Have you or any member of your organization ever been in receivership, been discharged in bankruptcy, or filed a petition for reorganization in
bankruptcy? If "YES", please provide details in Item 35.
18.
Are you, or any member of your organization, or the organization itself, involved in any pending litigation? If "YES", provide details in Item 35.
19.
Have you ever or has any member of your organization ever, conducted business under any other name? If "YES", give name in Item 35.
NO
20A. Have you or any member of your organization ever obtained a direct or guaranteed farm loan from the Farm Service Agency (FSA) or Farmers Home
Administration or the successor agencies?
20B. If Item 20A is "YES", did the government ever forgive any debt through a write-off, debt settlement, compromise, write-down, charge-off, adjustment,
reduction, or bankruptcy? If bankruptcy, please provide details in Item 35. If Item 20A is "NO", leave blank.
21.
If you obtained a guaranteed loan, did the government pay the lender a loss claim? Leave blank if you did not obtain a guaranteed loan.
22.
Are you or any member of your organization delinquent on any federal debt? If "YES", provide details in Item 35.
23.
Are you a citizen of the United States? If "NO", appropriate documentation must be submitted for a United States non-citizen national, or a qualified
alien under applicable Federal immigration laws.
24.
Are you a U.S. veteran? If "YES", please indicate Branch and Dates of Service in Item 35.
25.
Are you now, or have you ever farmed or ranched? If "YES", provide the number of years and brief explanation in Item 35.
26.
Are you an FSA employee or are you related to or closely associated with any FSA employee? If "YES", please explain in Item 35.
27A. PURPOSE OF LOAN
27B. APPROXIMATE AMOUNT OF LOAN NEEDED
28A. IF APPLICABLE, PURPOSE OF SUBSEQUENT LOAN
28B. APPROXIMATE AMOUNT OF SUBSEQUENT LOAN NEEDED
29A. NAME AND ADDRESS OF APPLICANT'S EMPLOYER
30A. NAME AND ADDRESS OF CO-APPLICANT'S EMPLOYER
29B. TELEPHONE NO. OF APPLICANT'S EMPLOYER:
29C. APPLICANT'S APPROXIMATE ANNUAL INCOME
30B. TELEPHONE NO. OF CO-APPLICANT'S EMPLOYER:
30C. CO-APPLICANT'S APPROXIMATE ANNUAL INCOME
$
$
$
$
31. FSA USE ONLY
A. DATE FORM FSA-410-1 RECEIVED (MM-DD-YYYY)
C. CREDIT REPORT FEE
B. DATE APPLICATION COMPLETE (MM-DD-YYYY)
D. DATE RECEIVED (MM-DD-YYYY)
E. INITIALS
$
F. TYPE OF ASSISTANCE:
FO
OL
EM
SUBORDINATION
OTHER (SPECIFY)
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number.
The valid OMB control number for this information collection is 0560-0167. The time required to complete this information collection is estimated to average 60 minutes per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. RETURN THIS COMPLETED FORM TO YOUR
COUNTY FSA OFFICE.
39
FSA-410-1 (09-10-03)
Page 2 of 4
VOLUNTARY INFORMATION FOR MONITORING PURPOSES: Race, ethnicity and gender information is requested by the Federal Government in order to monitor
FSA's compliance with federal laws prohibiting discrimination against loan applicants. You are not required to furnish this information, but are encouraged to do so.
Failure to complete this information may result in you not receiving access to targeted funds for which you may have been eligible. This information will not be used in
evaluating your application or to discriminate against you in any way. If you do not furnish it, FSA is required to note your race, ethnicity and gender on the basis of
observer identification. (*This data is requested for statistical purposes only. One or more boxes may be selected.)
32. FOR INDIVIDUAL APPLICANTS ONLY:
A. *ETHNICITY
B. *RACE (Choose as many boxes as applicable)
Hispanic or Latino
Not Hispanic or Latino
American Indian or Alaskan Native
Native Hawaiian or Other Pacific Islander
Asian
Black or African-American
White
D. FOR FSA USE
C. GENDER
Male
Provided
Female
Observed
33. FOR BUSINESS ENTITY APPLICANTS ONLY:
The business entity must provide:
A. Any Organizational and Operational Documents (e.g. Charter, Articles of Incorporation, Bylaws, Partnership or Joint Operation Agreements, etc).
B. Any evidence of its current registration with relevant state regulatory agencies (good standing).
C. A duly adopted resolution to apply for and obtain financing.
D. Tax identification number.
E. Balance Sheet not more than 90 days old.
34. FOR BUSINESS ENTITY INDIVIDUAL MEMBERS ONLY:
The individual member must provide:
A. Information in Items (1) through (7) below. Items (8) and (9) are voluntary, but required for access to targeted funds, as applicable.
B. Balance Sheet not more than 90 days old. (If there are no individually owned assets, then husband and wife joint operations may submit one consolidated
balance sheet)
NOTE: Individual liability will be required regardless of the type of business organization.
(1)
Full Legal Name and Complete Address
(2)
Social Security No.
(3)
Principal Occupation
(5)
(4)
Birthdate
% of
Ownership (MM-DD-YYYY)
(7)
Gender
(6)
Citizenship
Yes
No
Male
Are you a citizen,
non-citizen national,
or qualified alien?
(9) *Race:
(8) *Ethnicity:
Hispanic/Latino
American Indian/Alaska Native
Black/African-Amer.
Not Hispanic/Latino
Asian
Native Hawaiian/Pacific Islander
(1)
Full Legal Name and Complete Address
(2)
Social Security No.
(3)
Principal Occupation
Female
(10) FOR FSA USE
White
Provided
Observed
(7)
Gender
(6)
Citizenship
(5)
(4)
Birthdate
% of
Ownership (MM-DD-YYYY)
Yes
No
Are you a citizen,
non-citizen national,
or qualified alien?
(9) *Race:
(8) *Ethnicity:
Hispanic/Latino
American Indian/Alaska Native
Black/African-Amer.
Not Hispanic/Latino
Asian
Native Hawaiian/Pacific Islander
(1)
Full Legal Name and Complete Address
(2)
Social Security No.
(3)
Principal Occupation
Male
Female
(10) FOR FSA USE
White
Provided
Observed
(5)
(4)
Birthdate
% of
Ownership (MM-DD-YYYY)
(7)
Gender
(6)
Citizenship
Yes
No
Are you a citizen,
non-citizen national,
or qualified alien?
(9) *Race:
(8) *Ethnicity:
Hispanic/Latino
American Indian/Alaska Native
Black/African-Amer.
Not Hispanic/Latino
Asian
Native Hawaiian/Pacific Islander
(1)
Full Legal Name and Complete Address
(2)
Social Security No.
(3)
Principal Occupation
(9) *Race:
Provided
Observed
American Indian/Alaska Native
Black/African-Amer.
Not Hispanic/Latino
Asian
Native Hawaiian/Pacific Islander
(7)
Gender
(6)
Citizenship
(5)
Birthdate
(4)
% of
Ownership (MM-DD-YYYY)
Hispanic/Latino
Female
(10) FOR FSA USE
White
Yes
Are you a citizen,
non-citizen national,
or qualified alien?
(8) *Ethnicity:
Male
White
No
Male
Female
(10) FOR FSA USE
Provided
Observed
35. ADDITIONAL ANSWERS. Write the item number to which each answer applies. If you need more space, use additional sheets of paper the same size as this page.
On each sheet, write the applicant's name.
40
FSA-410-1 (09-10-03)
Page 3 of 4
36. A signed and dated balance sheet not more than 90 days old is required. Business entities must provide individual members' balance sheets. You may use this form or attach
your own. If you have a balance sheet on file with FSA that is less than 90 days old, you need not complete this section at this time.
BALANCE SHEET
AS OF
$VALUE
A. CURRENT FARM ASSETS
1. Cash on hand
2. Checking
$
$
$AMOUNT
E. CURRENT FARM LIABILITIES
Farm Accounts and Notes Payable
3. Savings
(Include Principal and Interest)
$
2.
Payment
Due
Date
1.
Creditor
Other Investments:
5. Other
4. Time Certificates
3.
Interest
Rate
4.
Monthly or
Annual
Installment
($)
$
$
6. Accounts and Notes to be Received (Receivables)
7. Crops and Feed
8. Units
11.
No.
10. Livestock to be Sold
9. Price Per Unit ($)
12. Unit
Weight
13.
Price Per Unit ($)
CCC Loan:
5. Type
6. Quantity
7. Due Date
Current Portion of Principal Due on:
8. Intermediate Liabilities
9. Long Term Liabilities
Accrued interest on:
14. Growing Crops
15. Acres
10. Intermediate Liabilities
16. Cost/Acre ($)
11. Long Term Liabilities
Accrued Taxes on:
12. Real Estate, Personal Property and Assessments
13. Income Tax and Social Security
17. Supplies and Prepaid Expenses
14. Accrued Rent/Lease Payments
18. Leases
15. Other (judgments, liens, etc.)
19. Other
20. TOTAL CURRENT FARM ASSETS
16. TOTAL CURRENT FARM LIABILITIES
F. INTERMEDIATE FARM LIABILITIES (portion due beyond 12 months)
B. INTERMEDIATE FARM ASSETS
4. Price Per Unit ($)
3. No.
2.
Payment
Due
Date
1.
Creditor
1. Accounts and Notes to be Received beyond 12 months (Receivables)
2. Breeding Livestock
3.
Interest
Rate
4.
Amount
Delinquent
($)
5. Machinery, Equipment and Vehicles
6. Co-op Stock
7A. Cash Value, Life Insurance
(7B. Face Amount $
)
Farmer-Owned Reserve:
8. Type
9. Quantity
10. Price/Unit ($)
5. Loans Secured by Life Insurance
Policies
6. Farmer-Owned Reserve
11. Other
7. Other
12. TOTAL INTERMEDIATE FARM ASSETS
C. LONG TERM FARM ASSETS (Farm Real Estate)
1. Acres
2. Date Bought 3. Annual Tax
8. TOTAL INTERMEDIATE FARM LIABILITIES
G. LONG TERM FARM LIABILITIES (portion due beyond 12 months)
4.
2.
3.
1.
Amount
Payment
Interest
Creditor
Delinquent
Due
Rate
($)
Date
4. Cost
$
$
5. Co-op Stock
6. Equity in Partnerships/Corporations/Joint Operations/Cooperatives
7. Other
5. Other
6. TOTAL LONG TERM FARM LIABILITIES
8. TOTAL LONG TERM FARM ASSETS
9. TOTAL FARM ASSETS
D. NONFARM ASSETS
7. TOTAL FARM LIABILITIES
H. NONFARM LIABILITIES
Nonfarm Accounts and Notes Payable.
1. Household Goods
1.
Creditor
2. Car, Recreational Vehicles, etc.
3. Cash Value of Life Insurance
2.
Payment
Due
Date
3.
Interest
Rate
4.
Monthly or
Annual
Installment
($)
4. Stocks, Bonds
5. Nonfarm Business
6. Other Nonfarm Assets
7A. Nonfarm Real Estate
(7B. Annual Tax $
)
5. TOTAL NONFARM LIABILITIES
6. TOTAL FARM LIABILITIES
8. TOTAL NONFARM ASSETS
41
7. TOTAL LIABILITIES
9. TOTAL FARM ASSETS
8. NET WORTH
10. TOTAL ASSETS
9. TOTAL LIABILITIES AND NET WORTH
FSA-410-1 (09-10-03)
Page 4 of 4
37. SPECIAL PROGRAM INFORMATION
Certain FSA programs are, by law, designed to reach targeted applicants. If you are interested in any of the programs described below, or have questions about these programs
and whether you may qualify for a specific program, the FSA office processing your application will help you.
A.
SOCIALLY DISADVANTAGED APPLICANTS: A portion of FSA farm ownership and operating loan funds are, by law, targeted to applicants who have been subjected to
racial, ethnic or gender prejudice because of their identity as a member of a group, without regard to individual qualities. Under the applicable law, groups meeting this
condition are: Women, Blacks, American Indians, Alaskan Natives, Hispanics, Asians, and Pacific Islanders.
B.
BEGINNING FARMER ASSISTANCE: FSA has the authority to assist beginning farmers and ranchers through the farm operating and ownership loan programs. A portion
of FSA farm ownership and operating loan funds are, by law, targeted to beginning farmers and ranchers. In addition, FSA has a beginning farmer down payment program,
which receives special funding. In some States, FSA has agreements with State beginning farmer programs to help meet the credit needs of beginning farmers and ranchers.
C.
LIMITED RESOURCE LOANS: Limited resource farm ownership and operating loans are available to qualified FSA applicants. This program provides loans at reduced
interest rates to low-income farmers and ranchers whose farm operations and resources are so limited that they cannot pay the regular rates for FSA loans. The program is
also intended to provide beginning farmers with an opportunity to start a successful farming operation.
38. STATEMENT REQUIRED BY THE PRIVACY ACT
The following statements are made in accordance with the Privacy Act of 1974 (5 U.S.C. 552a): The Farm Service Agency (FSA) is authorized by the Consolidated Farm and Rural
Development Act (7 U.S.C. 1921 et seq.), or other Acts, and the regulations promulgated thereunder, to solicit the information requested on its application forms. The information
requested is necessary for FSA to determine eligibility for credit or other financial assistance, service your loan, and conduct statistical analyses. Supplied information may be
furnished to other Department of Agriculture agencies, the Department of the Treasury, the Department of Justice or other law enforcement agencies, the Department of Defense,
the Department of Housing and Urban Development, the Department of Labor, the United States Postal Service, or other Federal, State, or local agencies as required or permitted
by law. In addition, information may be referred to interested parties under the Freedom of Information Act (FOIA), to financial consultants, advisors, lending institutions, packagers,
agents, and private or commercial credit sources, to collection or servicing contractors, to credit reporting agencies, to private attorneys under contract with FSA or the Department
of Justice, to business firms in the trade area that buy chattel or crops or sell them for commission, to Members of Congress or Congressional staff members, to courts or
adjudicative bodies or to state-certified or state licensed appraisers. Disclosure of the information requested is voluntary. However, failure to disclose certain items of information
requested, including your Social Security Number or Federal Tax Identification Number, may result in a delay in the processing of an application or its rejection.
39. GENERAL INFORMATION
A.
RIGHT TO FINANCIAL PRIVACY ACT OF 1978 and TITLE XI, 1113(h) OF PUB. L. 95-630: FSA has a right of access to financial records held by financial institutions in
connection with providing assistance to you, as well as collecting on loans made to you or guaranteed by the government. Financial records involving your transaction will be
available to FSA without further notice or authorization but will not be disclosed or released by this institution to another government Agency or Department without your
consent except as required by law.
B.
THE FEDERAL EQUAL CREDIT OPPORTUNITY ACT prohibits creditors from discriminating against borrowers on the basis of race, color, religion, sex, national origin,
marital status, age (provided the borrower has the capacity to enter into a binding contract), because all or a part of the borrower's income derives from any public assistance
program, or because the borrower has in good faith exercised any right under the Consumer Credit Protection Act.
C.
FEDERAL COLLECTION POLICIES: Delinquencies, defaults, foreclosures and abuses of mortgage loans involving programs of the Federal Government can be costly and
detrimental to your credit, now and in the future. The mortgage lender in this transaction, its agents and assigns as well as the Federal Government, its agencies, agents and
assigns, are authorized to take any and all of the following actions in the event loan payments become delinquent on the mortgaged loan described in the attached application:
(1 ) Report your name and account information to a credit bureau, (2) Assess additional interest and penalty charges for the period of time that payment is not made, (3)
Assess charges to cover additional administrative costs incurred by the Government to service your account, (4) Offset amounts owed to you under other Federal programs;
(5) Refer your account to a private attorney, collection agency or mortgage servicing agency to collect the amount due, foreclose the mortgage, sell the property and seek
judgment against you for any deficiency; (6) Refer your account to the Department of Justice for litigation; (7) If you are a current or retired Federal employee, take action to
offset your salary, or civil service retirement benefits; (8) Refer your debt to the Department of the Treasury for cross-servicing and offset against any amount owed to you by
any Federal Agency, such as an income tax refund; and (9) Report any resulting written-off debt to the Internal Revenue Service as taxable income. All of these actions can
and will be used to recover debts owed to the Federal Government, when in its best interests.
40. CERTIFICATIONS
A.
B.
RESTRICTIONS AND DISCLOSURE OF LOBBYING ACTIVITIES
1.
The loan applicant certifies that: if any funds, by or on behalf of the loan applicant, have been or will be paid to any person for influencing or attempting to
influence an officer or employee of any agency, a Member, an officer or employee of Congress, or an employee of a Member of Congress in connection with the
awarding of any Federal contract, the making of any Federal grant or Federal loan, and the extension, continuation, renewal, amendment, or modification of any Federal
contract, grant, or loan, the loan applicant shall complete and submit Standard Form - LLL, ''Disclosure of Lobbying Activities,'' in accordance with its instructions.
2.
The loan applicant shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including contracts, subcontracts,
and subgrants, under grants and loans) and that all subrecipients shall certify and disclose accordingly.
3.
This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this statement is a
prerequisite for making or entering into this transaction imposed by 31 U.S.C. 1352. Any person who fails to file the required statement shall be subject to a civil penalty.
ABUSE OF CONTROLLED SUBSTANCES
The loan applicant certifies that he/she as an individual, or an entity applicant, has not been convicted under Federal or State law of planting, cultivating, growing, producing,
harvesting, or storing a controlled substance within the previous 5 crop years. See the Food Security Act of 1985 (Pub. L. 99-198). The loan applicant also certifies that he or
she as an individual, or any member of an entity applicant, is not ineligible for Federal benefits based on a conviction for the distribution of controlled substances or any offense
involving the possession of a controlled substance under 21 U.S.C. § 862.
C.
TEST FOR CREDIT
The individual or authorized party certifies that the needed credit, with or without a loan guarantee, cannot be obtained by the individual applicant, or in the case of a business
entity, the needed credit cannot be obtained considering all assets owned by the business entity and all of the individual members.
D.
PERMISSION TO FILE A FINANCING STATEMENT UNDER ARTICLE 9 OF YOUR STATE'S UNIFORM COMMERCIAL CODE
If your state has adopted the 1998 revisions to its Uniform Commercial Code, you no longer have to sign the financing statement which allows FSA to obtain a security
interest in your property. If your loan is approved and funded, FSA will file a financing statement at the earliest possible date, before you enter into a SECURITY
AGREEMENT. BY SIGNING BELOW I GIVE FSA PERMISSION TO FILE A FINANCING STATEMENT PRIOR TO THE EXECUTION OF THE SECURITY AGREEMENT
AS WELL AS TO FILE AMENDMENTS AND CONTINUATIONS OF THE FINANCING STATEMENT THEREAFTER.
E.
ACKNOWLEDGMENT
I, THE UNDERSIGNED LOAN APPLICANT, UPON SIGNING THIS LOAN APPLICATION, CERTIFY THAT I HAVE RECEIVED THE ABOVE NOTIFICATIONS AND
ACCEPT AND COMPLY WITH THE CONDITIONS STATED THEREON. I CERTIFY THAT THE STATEMENTS MADE BY ME IN THIS APPLICATION ARE TRUE,
COMPLETE, AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF AND ARE MADE IN GOOD FAITH TO OBTAIN A LOAN. I UNDERSTAND THAT THE
60-DAY PROMPT APPROVAL PERIOD WILL NOT BEGIN UNTIL A COMPLETE APPLICATION HAS BEEN FILED. (WARNING: SECTION 1001 OF TITLE 18, UNITED
STATES CODE PROVIDES FOR CRIMINAL PENALTIES TO THOSE WHO PROVIDE FALSE STATEMENTS ON LOAN APPLICATIONS. IF ANY INFORMATION ON
THIS APPLICATION IS FOUND TO BE FALSE OR INCOMPLETE, SUCH FINDING MAY BE GROUNDS FOR DENIAL OF THE REQUESTED CREDIT.)
41A.
SIGNATURE OF LOAN APPLICANT
42
OR AUTHORIZED
REPRESENTATIVE
41B. DATE (MM-DD-YYYY) 42A.
SIGNATURE OF LOAN CO-APPLICANT
OR AUTHORIZED REPRESENTATIVE
42B. DATE (MM-DD-YYYY)
Form RD 1910-5
(Rev. 11-06)
Form Approved
OMB No. 0575-0172
UNITED STATES DEPARTMENT OF AGRICULTURE
HOUSING AND URBAN DEVELOPMENT
VETERANS ADMINISTRATION
(Community Planning and Development, and
Housing - Federal Housing Commissioner)
REQUEST FOR VERIFICATION OF EMPLOYMENT
LENDER, LOCAL PROCESSING AGENCY (LPA), AND LOAN PACKAGER: Complete items 1 through 7. Have the applicant complete item 8 and sign. Forward the completed
form directly to the employer named in item 1. CONTRACTOR: Complete items 1 through 7. Have applicant or borrower complete item 8 and sign. Forward the completed form
directly to the USDA or lender office identified in item 2. EMPLOYER/PROVIDER: Complete either parts II and IV or parts III and IV. Return form directly to the office identified in
item 2 of Part 1.
PART I - REQUEST
2. FROM: (Name and Address of Lender or Local Processing Agency)
This item must be completed before sending to employer.
1. TO: (Name and Address of Employer)
5. DATE
4. TITLE OF LENDER OFFICIAL
OF LPA, USDA OFFICIAL,
MFH PROJECT MGR.,
OR USDA LOAN PACKAGER
3. I certify that this verification has been sent directly to the employer and
has not passed through the hands of the applicant or any other
interested party.
6. HUD/FHA/CPD, VA OR USDA NO.
(Signature of Lender, Official of LPA, USDA Official/USDA Loan Packager or Government contractor)
7. NAME AND ADDRESS OF
APPLICANT
I have applied for a mortgage loan, a farm loan or a rehabilitation loan or to be an
occupant in an MFH project and stated that I am or was employed by you. My signature in
the block below authorizes verification of my employment information.
8. TAXPAYER'S IDENTIFICATION NO. OR SOCIAL SECURITY NO.
SIGNATURE OF APPLICANT
PART II - VERIFICATION OF PRESENT EMPLOYMENT/INCOME
EMPLOYMENT DATA
PAY DATA
9. APPLICANT'S DATE OF EMPLOYMENT
12A. BASE PAY (Current) OR OTHER INCOME
$
$
$
10. PRESENT POSITION
Yes
Monthly $
Weekly
$
$
QUARTERS
$
$
$
PRO PAY
$
OVERSEAS OR
COMBAT
$
CLOTHING
COMMISSIONS
$
$
$
BONUS
$
$
No
Monthly Amount
FLIGHT OR
HAZARD
Past Year
Year to Date as
$
$
$
BASE PAY
OVERTIME
Type
BASE PAY
of
No
For Military Personnel Only
RATIONS
12B. EARNINGS
Type
BONUS
Hourly
Other (Specify)
11. PROBABILITY OF CONTINUED EMPLOYMENT
13. IF OVERTIME OR BONUS IS
APPLICABLE
IS ITS CONTINUANCE LIKELY?
OVERTIME
Yes
Annual $
14. REMARKS (If paid hourly, please indicate average hours worked each week during current and past year)
a. Number of hours
worked per week
b. Anticipated increase or decrease
in salary in next 12 months
c. Anticipated overtime hours to
be worked in next 12 months
PART III - VERIFICATION OF PREVIOUS EMPLOYMENT
15. DATES OF EMPLOYMENT
17. REASONS FOR LEAVING
16. SALARY RANGE AT TERMINATION PER
YEAR
MONTH
WEEK
BASE PAY
OVERTIME
COMMISSIONS
BONUS
$
$
$
$
18. POSITION HELD
PART IV
Federal statutes provide severe civil and criminal penalties for any person who knowingly makes false or fraudulent statements or representations to a government
agency or officer with the intention of influencing any action by such agency or officer.
19. SIGNATURE
20. TITLE OF EMPLOYER
21. DATE
Printed name and phone number
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB
control number. The valid OMB control number for this information collection is 0575-0172. The time required to complete this information collection is
estimated
to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the
43
data needed, and completing and reviewing the collection of information.
SEE ATTACHED PRIVACY ACT NOTICE
NOTICE TO APPLICANT REGARDING PRIVACY ACT INFORMATION
The information requested on this form is authorized to be collected by the Rural Housing Service (RHS), Rural Business-Cooperative
Services (RBS), Rural Utilities Service (RUS) or the Farm Service Agency (FSA) (''the agency'') by title V of the Housing Act of 1949, as
amended (42 U.S.C. 1471 et seq.) or by the Consolidated Farm and Rural Development Act (7 U.S.C. 1921 et seq.), or by other laws
administered by RHS, RBS, RUS or FSA.
Disclosure of information requested is voluntary. However, failure to disclose certain items of information requested, including your Social
Security Number or Federal Identification Number, may result in a delay in the processing of an application or its rejection. Information
provided may be used outside of the agency for the following purposes:
1.
When a record on its face, or in conjunction with other records, indicates a violation or potential violation of law, whether civil,
criminal or regulatory in nature, and whether arising by general statute or particular program statute, or by regulation, rule, or order issued
pursuant thereto, disclosure may be made to the appropriate agency, whether Federal, foreign, State, local, or tribal, or other public
authority responsible for enforcing, investigating or prosecuting such violation or charged with enforcing or implementing the statute, or
rule, regulation, or order issued pursuant thereto, if the information disclosed is relevant to any enforcement, regulatory, investigative, or
prosecutive responsibility of the receiving entity.
2.
A Record from this system of records may be disclosed to a Member of Congress or to a congressional staff member in response to
an inquiry of the congressional office made at the written request of the constituent about whom the record is maintained.
3. Rural Development will provide information from this system to the U.S. Department of the Treasury and to other Federal agencies
maintaining debt servicing centers, in connection with overdue debts, in order to participate in the Treasury Offset Program as required
by the Debt Collection Improvement Act, Pub. L. 104-134, Section 31001.
4.
Disclosure of the name, home address, and information concerning default on loan repayment when the default involves a security
interest in tribal allotted or trust land. Pursuant to the Cranston-Gonzales National Affordable Housing Act of 1990 (42 U.S.C. 12701 et
seq.), liquidation may be pursued only after offering to transfer the account to an eligible tribal member, the tribe, or the Indian Housing
Authority serving the tribe(s).
5.
Referral of names, home addresses, social security numbers, and financial information to a collection or servicing contractor,
financial institution, or a local, State, or Federal agency, when Rural Development determines such referral is appropriate for servicing
or collecting the borrower's account or has provided for in contracts with servicing or collection agencies.
6.
It shall be a routine use of the records in this system of records to disclose them in a proceeding before a court or adjudicative
body, when: (a) the agency or any component thereof; or (b) any employee of the agency in his or her official capacity; or (c) any
employee of the agency in his or her individual capacity where the agency has agreed to represent the employee; or (d) the United States
is a party to litigation or has an interest in such litigation, and by careful review, the agency determines that the records are both relevant
and necessary to the litigation, provided; however, that in each case the agency determines that disclosure of the records is a use of the
information contained in the records that is compatible with the purpose for which the agency collected the records.
7.
Referral of names, home addresses, and financial information for selected borrowers to financial consultants, advisors, lending
institutions, packagers, agents, and private or commercial credit sources, when Rural Development determines such referral is
appropriate to encourage the borrower to refinance the Rural Development indebtedness as required by title V of the Housing Act of
1949, as amended (42 U.S.C. 1471), or to assist the borrower in the sale of the property.
8.
Referral of legally enforceable debts to the Department of the Treasury, Internal Revenue Service (IRS), to be offset against any tax
refund that may become due the debtor for the tax year in which the referral is made, in accordance with the IRS regulations at 26 C.F.R.
301.6402-6T, Offset of Past Due Legally Enforceable Debt Against Overpayment, and under the authority contained in
31 U.S.C. 3720A.
9.
Referral of information regarding indebtedness to the Defense Manpower Data Center, Department of Defense, and the United
States Postal Service for the purpose of conducting computer matching programs to identify and locate individuals receiving Federal
salary or benefit payments and who are delinquent in their repayment of debts owed to the U. S. Government under certain programs
administered by Rural Development in order to collect debts under the provisions of the Debt Collection Act of 1982 (5 U.S.C. 5514)
by voluntary repayment, administrative or salary offset procedures, or by collection agencies.
10. Referral of names, home addresses, and financial information to lending institutions when Rural Development determines the
individual may be financially capable of qualifying for credit with or without a guarantee.
11. Disclosure of names, home addresses, social security numbers, and financial information to lending institutions that have a lien
against the same property as Rural Development for the purpose of the collection of the debt. These loans can be under the direct and
guaranteed loan programs.
12. Referral to private attorneys under contract with either Rural Development or with the Department of Justice for the purpose of
foreclosure and possession actions and collection of past due accounts in connection with Rural Development.
13. It shall be a routine use of the records in this system of records to disclose them to the Department of Justice when: (a) The agency
or any component thereof; or (b) any employee of the agency in his or her official capacity where the Department of Justice has agreed to
represent the employee; or (c) the United States government, is a party to litigation or has an interest in such litigation, and by careful
review, the agency determines that the records are both relevant and necessary to the litigation and the use of such records by the
Department of Justice is therefore deemed by the agency to be for a purpose that is compatible with the purpose for which the agency
collected the records.
44
NOTICE TO APPLICANT REGARDING PRIVACY ACT INFORMATION-CONTINUED
14. Referral of names, home addresses, social security numbers, and financial information to the Department of Housing and Urban
Development (HUD) as a record of location utilized by Federal agencies for an automatic credit prescreening system.
15. Referral of names, home addresses, social security numbers, and financial information to the Department of Labor, State Wage
Information Collection Agencies, and other Federal, State, and local agencies, as well as those responsible for verifying information
furnished to qualify for Federal benefits, to conduct wage and benefit matching through manual and/or automated means, for the
purpose of determining compliance with Federal regulations and appropriate servicing actions against those not entitled to program
benefits, including possible recovery of improper benefits.
16. Referral of names, home addresses, and financial information to financial consultants, advisors, or underwriters, when Rural
Development determines such referral is appropriate for developing packaging and marketing strategies involving the sale of Rural
Development loan assets.
17. Rural Development, in accordance with 31 U.S.C. 3711(e)(5), will provide to consumer reporting agencies or commercial reporting
agencies information from this system indicating that an individual is responsible for a claim that is current.
18. Referral of names, home and work addresses, home telephone numbers, social security numbers, and financial information to
escrow agents (which also could include attorneys and title companies) selected by the applicant or borrower for the purpose of closing
the loan.
19. Disclosures pursuant to 5 U.S.C. 552a(b)(12): Disclosures may be made from this system to consumer reporting agencies as
defined in the Fair Credit Reporting Act (15 U.S.C. 1681a(f) or the Federal Claims Collection Act (31 U.S.C. 3701(a)(3)).
45
Form Approved - OMB No. 0560-0154
This form is available electronically.
U.S. DEPARTMENT OF AGRICULTURE A. Name (Producer)
Farm Service Agency
FSA-2038
(04-26-05)
FARM BUSINESS PLAN WORKSHEET
Projected/Actual Income and Expense
B. Social Security or Tax ID No.
C. Address (Include City, State, ZIP Code)
D. Phone No. (Including Area Code)
(See Page 2 for Nondiscrimination and Public Burden Statements)
E. For Production Cycle Beginning:
20
Projected Income and Expense
20
Thru:
Actual Income and Expense
PART A - INCOME
1. Crop Sales:
1A. Description
Production
1C.
1D.
Yield
% Share
1B.
Acres
1E.
# Units
1F.
Farm Use
1G.
# Units
Purchases
1H.
$/Unit
1I.
Total $
1J.
# Units
Sales
1K.
$/Unit
1L.
Total $
2. Livestock and Poultry Sales:
2A. Description
2B.
Purch/Raised
P
2C.
# Units
R
2D.
Weight
Purchases
2E.
$/Unit
2F.
Total $
3D.
Weight
Purchases
3E.
$/Unit
3F.
Total $
4B.
# Head
4C.
Production/Head/Year
2G.
Death Loss
Sales
2H.
# Units
2I.
Weight
3H.
# Units
3I.
Weight
2J.
$/Unit
2K.
Total $
3J.
$/Unit
3K.
Total $
3. Dairy Livestock Sales:
3A. Description
3B.
Purch/Raised
P
R
3C.
# Head
3G.
Death Loss
Sales
4. Milk Sales:
4A. Description
4D.
Total Production
4E
Price
4F.
Sales $
Sales
5E.
$/Unit
5F.
Total $
5. Livestock Product Sales:
5A. Description
46
5B.
Production
5C.
Measure
5D.
# Units
Page 2 of 2
FSA-2038 (04-26-05)
PART A - INCOME (Continued)
6. Ag Program Payments
$ Amount
8. Custom Hire Income
$ Amount
7. Crop Insurance Proceeds
$ Amount
9. Other Income
$ Amount
10. Total Income (Items 1 through 9)
PART B - EXPENSES
$ Amount
$ Amount
11. Car and Truck
23. Rent - Land/Animals
12. Chemicals
24. Repairs and Maintenance
13. Conservation
25. Seeds and Plants
14. Custom Hire
26. Supplies
15. Feed Supplement
27. Taxes - Real Estate
16. Feed Grain and Roughage
28. Utilities
17. Fertilizers and Lime
29. Veterinary/Breeding/Medicine
18. Freight and Trucking
30. Other Expenses
19. Gas/Fuel/Oil
31. Other - Irrigation
20. Insurance Expenses
21. Labor Hired
22. Rent - Machinery/Equipment/Vehicles
32. Interest
33. Total Expenses (Items 11 through 32)
PART C - NON-OPERATING
34. Owner Withdrawal (Total Family Living Expenses
and Non-Farm Debt Payments)
36. Non-Farm Income
35. Income Taxes
37. Non-Farm Expense
PART D - CAPITAL
38. Capital Sales
40. Capital Expenditures
39. Capital Contributions
41. Capital Withdrawals
PART E - ACKNOWLEDGMENT
I agree to follow this plan as outlined above and on attached schedules, and to discuss with the agency loan official any important changes that may become
necessary. This plan does not release any security interest of the government. "I recognize that making any false statements on this Farm Business Plan or
any other loan document may constitute a violation of federal criminal law."
42A. APPLICANT'S SIGNATURE
42B. DATE (MM-DD-YYYY)
42C. CO-APPLICANT'S SIGNATURE
42D. DATE (MM-DD-YYYY)
NOTE:
The following statements are made in accordance with the Privacy Act of 1974 (5 USC 552a): the Farm Service Agency (FSA) is authorized by the Consolidated Farm and Rural Development Act,
as amended (7 USC 1921 et seq.), or other Acts, and the regulations promulgated thereunder, to solicit the information requested on its application forms. The information requested is necessary
for FSA to determine eligibility for credit or other financial assistance, service your loan, and conduct statistical analyses. Supplied information may be furnished to other Department of Agriculture
agencies, the Internal Revenue Service, the Department of Justice or other law enforcement agencies, the Department of Defense, the Department of Housing and Urban Development, the
Department of Labor, the United States Postal Service, or other Federal, State, or local agencies as required or permitted by law. In addition, information may be referred to interested parties under
the Freedom of Information Act (FOIA), to financial consultants, advisors, lending institutions, packagers, agents, and private or commercial credit sources, to collection or servicing contractors, to
credit reporting agencies, to private attorneys under contract with FSA or the Department of Justice, to business firms in the trade area that buy chattel or crops or sell them for commission, to
Members of Congress or Congressional staff members, or to courts or adjudicative bodies. Disclosure of the information requested is voluntary. However, failure to disclose certain items of
information requested, including your Social Security Number or Federal Tax Identification number, may result in a delay in the processing of an application or its rejection.
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB
control number. The valid OMB control number for this information collection is 0560-0154. The time required to complete this information collection is estimated to average 1 hour per response,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. RETURN THIS
COMPLETED FORM TO YOUR COUNTY FSA OFFICE.
The
U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, gender, religion, age, disability, political beliefs, sexual orientation,
and marital or family status. (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape,
etc.) should contact USDA's TARGET Center at (202) 720-2600 (voice and TDD). To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, Room 326-W, Whitten Building, 1400
Independence Avenue, SW, Washington, D.C. 20250-9410 or call (202) 720-5964 (voice or TDD). USDA is an equal opportunity provider and employer.
47
Form Approved - OMB No. 0560-0154
This form is available electronically.
U.S. DEPARTMENT OF AGRICULTURE A. Name (Applicant/Borrower)
Farm Service Agency
FSA-2037
(05-05-05)
FARM BUSINESS PLAN WORKSHEET
Balance Sheet
B. Social Security or Tax ID No.
C. Address (Include City, State, ZIP Code)
D. Phone No. (Including Area Code)
(See Page 4 for Nondiscrimination and Public Burden Statements)
E. Date (MM-DD-YYYY)
PART 1 - CURRENT ASSETS
PART 2 - CURRENT LIABILITIES
1A. Cash and Equivalents
$ Value
2A. Accounts Payable
$ Amount
1B. Marketable Bonds and Securities
1C. Accounts Receivable
2B. Income Taxes Payable
2C. Real Estate Taxes Payable
1D. Crop Inventory
1E.
Measure
1F.
# Units
1G.
$/Unit
$ Value
Notes Payable Due Within 12 Months
2D. Creditor
2F. Interest
Rate
2E. Purpose
2G. Accrued
Interest
2H. Payment
Amount
2I. Next Payment
Date (MM-DD-YYYY)
2J. Principal
Balance
(1)
1I.
# Acres
1H. Growing Crops
1J.
Cost/Acre
$ Value
(2)
(3)
1K. Market Livestock-Poultry
1L.
# Head
1M.
Weight
1N.
$/Unit
$ Value
(4)
2K. Accrued Interest On:
(1) Current Liabilities
(2) Intermediate Liabilities
(3) Long Term Liabilities
1O. Livestock Products
1P.
Measure
1Q.
# Units
1R.
$/Unit
$ Value
2L. Current Portion of Principal Due On:
(1) Intermediate Liabilities
(2) Long Term Liabilities
1S. Prepaid Expenses and Supplies
2M. Other Current Liabilities
1T. Other Current Assets
1U. TOTAL CURRENT ASSETS (Items 1A through 1T)
48
2N. TOTAL CURRENT LIABILITIES (Items 2A through 2M)
$ Amount
Page 2 of 4
FSA-2037 (05-05-05)
PART 3 - INTERMEDIATE ASSETS
PART 5 - INTERMEDIATE LIABILITIES
3A. Machinery & Equipment/Farm Vehicles (Entered on Page 4)
5A. Creditor
3B.
Breeding Stock
3C.
Raised/Purch
3D.
# Head
3E.
$/Head
5C. Interest
Rate
$ Value
5B. Purpose
5D. Accrued
Interest
5E. Payment
Amount
5F. Next Payment
Date (MM-DD-YYYY)
5G. Principal
Balance
(1)
(2)
(3)
3F. Notes Receivable
(4)
(5)
3G. Not Readily Marketable Bonds & Securities
(6)
3H. Other Intermediate Assets
(7)
3I. TOTAL INTERMEDIATE ASSETS (Items 3A through 3H)
5H. TOTAL INTERMEDIATE LIABILITIES (Item 5G (1 through 7))
PART 4 - LONG TERM ASSETS
PART 6 - LONG TERM LIABILITIES
4A. Building & Improvements
$ Value
6A. Creditor
6C. Interest
Rate
6B. Purpose
6D. Accrued
Interest
6E. Payment
Amount
6F. Next Payment
Date (MM-DD-YYYY)
(1)
(2)
4B.
Real Estate-Land
4C.
4D.
4E.
Total Acres Crop Acres %Owned
4F.
$/Acre
$ Value
(3)
(4)
(5)
(6)
4G. Other Long Term Assets
$ Value
(7)
4H. TOTAL LONG TERM ASSETS
6H. TOTAL LONG TERM LIABILITIES (Item 6G (1 through 7))
4I. TOTAL FARM ASSETS (From Items 1U, 3I and 4H)
6I. TOTAL FARM LIABILITIES
49
6J. TOTAL FARM EQUITY (Item 4I minus Item 6I)
6G. Principal
Balance
Page 3 of 4
FSA-2037 (05-05-05)
PART 7 - PERSONAL ASSETS
PART 8 - PERSONAL LIABILITIES
$ Value
8A. Creditor
8C. Interest
Rate
7A. Cash & Equivalents
7B. Stocks, Bonds
8B. Purpose
8D. Accrued
Interest
8E. Payment
Amount
8F. Next Payment
Date (MM-DD-YYYY)
8G. Principal
Balance
(1)
7C. Cash Value Life Insurance
7D. Other Current Assets
(2)
7E. Household Goods
7F. Car, Recreational Vehicle, Etc.
(3)
7G. Other Intermediate Assets
7H. Retirement Accounts
(4)
7I. NonFarm Business
7J. NonFarm Real Estate
8H. Other Liabilities
7K. Other Long Term Assets
7L. TOTAL PERSONAL ASSETS (Items 7A through 7K)
8I. TOTAL PERSONAL LIABILITIES
7M. TOTAL ASSETS (Item 4I and Item 7L)
8J. TOTAL LIABILITIES (Item 6I and Item 8I)
8K. TOTAL EQUITY (Item 7M minus Item 8J)
PART 9 - ACKNOWLEDGMENT
The information above and on attached schedules is furnished for the purpose of securing and maintaining credit and is certified to be true and correct.
The undersigned authorizes the FSA to make all inquiries deemed necessary to verify the accuracy of the information contained above to determine my
credit-worthiness and to answer questions about their credit experience with me. I agree to notify FSA promptly to any material changes to the above.
"I recognize that making any false statements on this Farm Business Plan or any other document may constitute a violation of criminal law."
9A. APPLICANT'S SIGNATURE
9B. DATE (MM-DD-YYYY)
9C. CO-APPLICANT'S SIGNATURE
9D. DATE (MM-DD-YYYY)
9E. COMMENTS
50
Page 4 of 4
FSA-2037 (05-05-05)
PART 10 - MACHINERY AND EQUIPMENT
10A.
Qty.
10B.
Description
10C.
Manufacturer
10D.
Size/Type
10E.
Condition
10F.
Year
10G.
Serial Number
10H.
$ Value
11C.
Manufacturer
11D.
Size/Type
11E.
Condition
11F.
Year
11G.
Serial Number/VIN
11H.
$ Value
PART 11 - FARM VEHICLES
11B.
Description
11A.
Qty.
NOTE:
The following statements are made in accordance with the Privacy Act of 1974 (5 USC 552a): the Farm Service Agency (FSA) is authorized by the Consolidated Farm and Rural Development Act,
as amended (7 USC 1921 et seq.), or other Acts, and the regulations promulgated thereunder, to solicit the information requested on its application forms. The information requested is necessary
for FSA to determine eligibility for credit or other financial assistance, service your loan, and conduct statistical analyses. Supplied information may be furnished to other Department of Agriculture
agencies, the Internal Revenue Service, the Department of Justice or other law enforcement agencies, the Department of Defense, the Department of Housing and Urban Development, the
Department of Labor, the United States Postal Service, or other Federal State, or local agencies as required or permitted by law. In addition, information may be referred to interested parties under
the Freedom of Information Act (FOIA), to financial consultants, advisors, lending institutions, packagers, agents, and private or commercial credit sources, to collection or servicing contractors, to
credit reporting agencies, to private attorneys under contract with FSA or the Department of Justice, to business firms in the trade area that buy chattel or crops or sell them for commission, to
Members of Congress or Congressional staff members, or to courts or adjudicative bodies. Disclosure of the information requested is voluntary. However, failure to disclose certain items of
information requested, including your Social Security Number or Federal Tax Identification number, may result in a delay in the processing of an application or its rejection.
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB
control number. The valid OMB control number for this information collection is 0560-0154. The time required to complete this information collection is estimated to average 11/2 hours per
response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
RETURN THIS COMPLETED FORM TO YOUR COUNTY FSA OFFICE.
51
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, gender, religion, age, disability, political beliefs, sexual orientation, and marital or family status. (Not all
prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact USDA's TARGET Center at (202) 720-2600 (voice and TDD).
To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, Room 326-W, Whitten Building, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410 or call (202) 720-5964 (voice or TDD). USDA is an equal opportunity
provider and employer.
Form Approved - OMB No. 0560-0166
This form is available electronically.
U. S. DEPARTMENT OF AGRICULTURE
Farm Service Agency
FSA-440-32
(06-03-02)
VERIFICATION OF DEBTS AND ASSETS
(See Page 2 for Privacy Act and Public Burden Statements)
PART A - INSTRUCTIONS: FSA OFFICIAL completes Items 2 through 3C, and have the APPLICANT complete Items 1 and 4A
through 8. This form is to be transmitted directly to the lender and is not to be transmitted through the applicant or any other
party.
2. FROM: (Address of FSA Office)
1. TO: (Name and Address of Financial Institution)
This certifies that the United States Department of Agriculture, acting through FSA, has complied with the applicable provisions of Title XI,
the Right to Financial Privacy Act of 1978, Public Law 95-630, in seeking financial information regarding the applicant(s) listed in Items
4A, 5A, and 6A.
3B. Title
3A. Signature of FSA Official
3C. Date (MM-DD-YYYY)
To Financial Institution: I have applied for assistance from the United States Department of Agriculture and have indicated that I owe a
debt to or have an asset invested with your firm. You are hereby authorized to provide the information requested below. Your response is
solely a matter of courtesy for which no responsibility is attached to your institution or its officers.
4A. Name and Address of Applicant
4B. Signature of Applicant
4C. Date (MM-DD-YYYY)
5A. Name and Address of Applicant
5B. Signature of Applicant
5C. Date (MM-DD-YYYY)
6A. Name and Address of Applicant
6B. Signature of Applicant
6C. Date (MM-DD-YYYY)
7. Type(s) of Loans (e.g., automobile equipment,
cattle and credit cards):
7A. Type of Loan or
Account No.
7B. Type of Loan or
Account No.
7C. Type of Loan or
Account No.
7D. Type of Loan or
Account No.
8. Account number(s) (e.g., checking, savings,
money market and mutual funds):
PART B - TO BE COMPLETED BY FINANCIAL INSTITUTION
A.
9. Date of origination (MM-DD-YYYY)
B.
C.
D.
10. Principal Balance
$
$
$
$
11. Accrued Interest
$
$
$
$
12. Daily Interest Accrual
$
$
$
$
14. Previous 12-month high balance
$
$
$
$
15. Previous 12-month low balance
$
$
$
$
13. Effective date of Items 10 and 11 (MM-DD-YYYY)
16. Current interest rate applicant is being charged
is earning
%
%
%
%
17. Installment or annuity amount
$
$
$
$
18. Amount past due
$
$
$
$
19. Description of collateral
20. Maturity date or final due date (MM-DD-YYYY)
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, gender, religion, age, disability, political beliefs, sexual
orientation, and marital or family status. (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large print,
audiotape, etc.) should contact USDA's TARGET Center at (202) 720-2600 (voice and TDD). To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, Room 326-W, Whitten Building,
1400 Independence Avenue, SW, Washington, D. C. 20250-9410 or call (202) 720-5964 (voice or TDD). USDA is an equal opportunity provider and employer.
52
FSA-440-32 (06-03-02) Page 2
ALL INFORMATION PROVIDED WILL BE RELEASED TO THE APPLICANT AT THEIR REQUEST
21. Please rate the applicant's repayment record:
Prompt
Usually prompt
Not prompt
22. How many years has the applicant conducted
business with your firm?
YES
NO
23. Do your lien instruments, if applicable, contain a hereafter acquired clause?
24. Do your lien instruments, if applicable, contain a future advance clause?
25. Does your firm impose a penalty if the deposit or investment accounts described on this form are withdrawn prior to maturity?
26. Would you extend additional credit?
27. Would you extend additional credit with an FSA Guarantee?
28. Remarks
Federal statutes provide severe civil and criminal penalties for any person who knowingly makes false or fraudulent statements or
representations to a government agency or officer with the intention of influencing any action by such agency or officer.
29A. Signature of Financial Institution's Representative
NOTE:
29B. Title
29C. Date (MM-DD-YYYY)
30. Telephone Number
(Including Area
Code)
The following statements are made in accordance with the Privacy Act of 1974 (5 USC 552a), the Farm Service Agency (FSA) is authorized by the Consolidated Farm
and Rural Development Act, as amended (7 USC 1921 et seq.), or other Acts, and the regulations promulgated thereunder, to solicit the information requested on its
application forms. The information requested is necessary for FSA to determine eligibility for credit or other financial assistance, service your loan, and conduct
statistical analyses. Supplied information may be furnished to other Department of Agriculture agencies, the Internal Revenue Service, the Department of Justice or
other law enforcement agencies, the Department of Defense, the Department of Housing and Urban Development, the Department of Labor, the United States Postal
Service, or other Federal, State, or local agencies as required or permitted by law. In addition, information may be referred to interested parties under the Freedom of
Information Act (FOIA), to financial consultants, advisors, lending institutions, packagers, agents, and private or commercial credit sources, to collection or servicing
contractors, to credit reporting agencies, to private attorneys under contract with FSA or the Department of Justice, to business firms in the trade area that buy chattel
or crops or sell them for commission, to Members of Congress or Congressional staff members, or to courts or adjudicative bodies. Disclosure of the information
requested is voluntary. However, failure to disclose certain items of information requested, including your Social Security Number or Federal Tax Identification
Number, may result in a delay in the processing of an application or its rejection.
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information
unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0560-0166. The time required to complete this
information collection is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and
maintaining the data needed, and completing and reviewing the collection of information. RETURN THIS COMPLETED FORM TO YOUR COUNTY FSA OFFICE.
53

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