Submit the original of the completed form in hard copy or facsimile to the appropriate County FSA office.
Customers who have established electronic access credentials with USDA may electronically transmit this form to the USDA servicing office, provided that the customer submitting the form is the only person required to sign the transaction.
Features for transmitting the form electronically are available to those customers with access credentials only. If you would like to establish online access credentials with USDA, follow the instructions provided at the USDA eForms web site.
Creditor completes items 5A through 6B.
Items 1 - 4 are for FSA use only.
Items 5A - 6B.
Fld Name/ Item No. |
Instructions |
5A Creditor's Name and Address |
Enter the creditor's name and address (including zip code). |
5B Creditor's Title |
Enter the creditor's title. |
6A Signature of Creditor |
Enter the creditor's signature.
|
6B Date |
Enter the date (MM-DD-YYYY) signed the form. |
Page
File Type | application/msword |
File Title | Instructions For FSA-441-13 |
Author | Preferred Customer |
Last Modified By | alvin.young |
File Modified | 2006-01-05 |
File Created | 2006-01-05 |