FSA-2450 Temporary Amendment - consent to payment of proceeds fro

This form is available electronically.

FSA-2450

U.S. DEPARTMENT OF AGRICULTURE
Farm Service Agency

(Proposal 2)

Form Approved - OMB No. 0560-XXXX
Position 1

TEMPORARY AMENDMENT OF CONSENT TO PAYMENT OF
PROCEEDS FROM SALE OF FARM PRODUCTS
(See Page 2 for the Privacy Act and Paperwork Burden Statements.)

PART A - ACCEPTANCE BY PURCHASER
1B. Purchaser's Telephone Number

1A. Purchaser's Name and Address

1C. Signature of Purchaser

1D. Title of Purchaser

1E. Date Signed

PART B - SELLER (BORROWER)
2A. Seller's (Borrower) Name and Address

2B. Seller's (Borrower)
Telephone Number

PART
PART B
C -- FSA
FSA USE
USE ONLY
ONLY
3. Please refer to FSA-2042, Consent to Payment of Proceeds from Sale of Products (Consent) or FSA-2043, Assignment of
Proceeds from the Sale of Dairy Products and Release of Security Interest (Assignment), as applicable, executed by the subject
borrower and purchaser also executed by FSA, dated (a)
.
FSA agrees that said Consent or Assignment is amended, for a temporary period beginning (b)
, to allow payments as follows:
and ending (c)
TO FSA:

(d)

$

(e)

of the purchase price, or
% of the purchase price figured to the nearest dollar,
payable (f)
(Weekly, Monthly, etc.)

TO Borrower:

(g)

any remaining balance of the purchase price.

After the end of such temporary period, payments will again be subject the Consent or Assignment referred to in Item 3 above of
this amendment.
4A. FSA County Office Name and Address
4B. FSA County Office
Telephone Number

4C. Signature of Agency Official

4D. Title of Agency Official

4E. Date Signed

The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, disability, and where
applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part of an individual's
income is derived from any public assistance program. (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 to USDA, Director, Office of Civil Rights, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, or call (800) 795-3272 (voice) or (202)
720-6382 (TDD). USDA is an equal opportunity provider and employer.

FSA-2450 (Proposal 2) Page 2
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 loans, 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, 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 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-XXXX. The time required to complete this information collection is estimated to average 10 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.