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Form RD 1940-1
(Rev. 01-05)
REQUEST FOR OBLIGATION OF FUNDS
INSTRUCTIONS-TYPE IN CAPITALIZED ELITE TYPE IN SPACES MARKED (
Complete Items 1 through 29 and applicable Items 30 through 34. See FMI.
1. CASE NUMBER
ST
CO
BORROWER ID
0
LOAN NUMBER
)
FISCAL YEAR
0
2. BORROWER NAME
3. NUMBER NAME FIELDS
(1, 2, or 3 from Item 2)
4. STATE NAME
5. COUNTY NAME
6. RACE/ETHNIC
CLASSIFICATION
1 - WHITE
2 - BLACK
3 - AI/AN
4 - HISPANIC
5 - A/PI
10. SEX CODE
1 - MALE
2 - FEMALE
GENERAL BORROWER/LOAN INFORMATION
5-ASSOC. OF FARMERS
8. COLLATERAL CODE
7. TYPE OF
6-ORG.. OF FARMERS
1 - REAL ESTATE 4 - MACHINERY ONLY
APPLICANT 7-NONPROFIT-SECULAR
SECURED
5 - LIVESTOCK ONLY
8-NONPROFIT-FAITH
1 - INDIVIDUAL
BASED
2 - PARTNERSHIP
3 - CORPORATION 9- OTHER
4-PUBLIC BODY
3 - FAMILY UNIT
4 - ORGAN. MALE OWNED
5 - ORGAN. FEMALE OWNED
6 - PUBLIC BODY
14. DIRECT PAYMENT
11. MARITAL STATUS
1 - MARRIED 3 - UNMARRIED (INCLUDES
2 - SEPARATED WIDOWED/DIVORCED)
15. TYPE OF PAYMENT
(See FMI)
2 - REAL ESTATE 6 - CROPS ONLY
AND CHATTEL 7 - SECURED BY
3 - NOTE ONLY OR
BONDS
CHATTEL ONLY
13. CREDIT REPORT
1 - YES
2 - NO
1 - YES
2 - NO
1 -YES
2 - NO
18. USE OF FUNDS CODE
1 - 10,000 OR LESS (FOR SFH AND
2 - OVER 10,000
HPG ONLY)
(See FMI)
COMPLETE FOR OBLIGATION OF FUNDS
20. PURPOSE CODE
21. SOURCE OF FUNDS
19. TYPE OF
ASSISTANCE
1 - EMPLOYEE
2 - MEMBER OF FAMILY
3 - CLOSE RELATIVE
4 - ASSOC.
16. FEE INSPECTION
1 -MONTHLY 3 - SEMI-ANNUALLY
2 - ANNUALLY 4 - QUARTERLY
17. COMMUNITY SIZE
12. VETERAN CODE
9. EMPLOYEE
RELATIONSHIP CODE
1 - OBLIGATION ONLY
2 - OBLIGATION/CHECK REQUEST
3 - CORRECTION OF OBLIGATION
2
(See FMI)
23. TYPE OF SUBMISSION
22. TYPE OF ACTION
24. AMOUNT OF LOAN
25. AMOUNT OF GRANT
1 - INITAL
2 - SUBSEQUENT
26. AMOUNT OF IMMEDIATE
ADVANCE
,
,
0.0 0
0 .0 0
,
,
,
27. DATE OF
28. INTEREST RATE
APPROVAL
DA
YR
MO
.
–
–
,
.0 0
29. REPAYMENT TERMS
COMPLETE FOR COMMUNITY PROGRAM AND CERTAIN MULTIPLE-FAMILY HOUSING LOANS
30. PROFIT TYPE
1 - FULL PROFIT
2 - LIMITED PROFIT
3 - NONPROFIT
COMPLETE FOR EM LOANS ONLY
31. DISASTER DESIGNATION NUMBER
(See FMI)
COMPLETE FOR CREDIT SALE-ASSUMPTION
32. TYPE OF SALE
1 - CREDIT SALE ONLY
FINANCE OFFICE USE ONLY
33. OBLIGATION DATE
MO
DA
YR
–
–
4 - ASSUMPTION WITH
2. ASSUMPTION ONLY
3 - CREDIT SALE WITH SUBSEQUENT LOAN SUBSEQUENT LOAN
COMPLETE FOR FP LOANS ONLY
34. BEGINNING FARMER/RANCHER
(See FMI)
If the decision contained above in this form results in denial, reduction or cancellation of USDA assistance, you may appeal this decision and have a hearing or you may request a
review in lieu of a hearing. Please use the form we have included for this purpose.
ORIGINAL - Borrower’s Case Folder
Position 2
COPY 1 - Finance Office
COPY 2 - Applicant/Lender
COPY 3 - State Office
CERTIFICATION APPROVAL
For All Farmers Programs
EM, OL, FO, and SW Loans
This loan is approved subject to the availability of funds. If this loan does not close for any reason within 90 days from the date
of approval on this document, the approval official will request updated eligibility information. The undersigned loan applicant agrees that the approval official will have 14 working days to review any updated information prior to submitting this
document for obligation of funds. If there have been significant changes that may affect eligibility, a decision as to eligibility
and feasibility will be made within 30 days from the time the applicant provides the necessary information.
If this is a loan approval for which a lien and/or title search is necessary, the undersigned applicant agrees that the 15-workingday loan closing requirement may be exceeded for the purposes of the applicant’s legal representative completing title work
and completing loan closing.
35.
COMMENTS AND REQUIREMENTS OF CERTIFYING OFFICIAL
36.
I HEREBY CERTIFY that I am unable to obtain sufficient credit elsewhere to finance my actual needs at reasonable rates and
terms, taking into consideration prevailing private and cooperative rates and terms in or near my community for loans for
similar purposes and periods of time. I agree to use the sum specified herein, subject to and in accordance with regulations
applicable to the type of assistance indicated above, and request payment of such sum. I agree to report to USDA any material
adverse changes, financial or otherwise, that occur prior to loan closing. I certify that no part of the sum specified herein has
been received. I have reviewed the loan approval requirements and comments associated with this loan request and agree to
comply with these provisions.
(For FP loans at eligible terms only) If this loan is approved, I elect the interest rate to be charged on my loan to be the
lower of the interest rate in effect at the time of loan approval or loan closing. If I check “NO”, the interest rate charged on my
loan will be the rate specified in Item 28 of this form. __________ YES ______ NO
WARNING:
Date
Whoever, in any matter within the jurisdiction of any department or agency of the United States
knowingly and willfully falsifies, conceals or covers up by any trick, scheme, or device a material
fact, or makes any false, fictitious or fraudulent statements or representations, or makes or
uses any false writing or document knowing the same to contain any false, fictitious or fraudulent
statement or entry, shall be fined under this title or imprisoned not more than five years, or
both.
, 20
(Signature of Applicant)
Date
, 20
(Signature of Co-Applicant)
37.
I HEREBY CERTIFY that all of the committee and administrative determinations and certifications required by regulations
prerequisite to providing assistance of the type indicated above have been made and that evidence thereof is in the docket, and
that all requirements of pertinent regulations have been complied with. I hereby approve the above-described assistance in the
amount set forth above, and by this document, subject to the availability of funds, the Government agrees to advance such
amount to the applicant for the purpose of and subject to the availability prescribed by regulations applicable to this type of
assistance.
(Signature of Approving Official)
Date Approved:
38.
Title:
TO THE APPLICANT: As of this date _____________________ , this is notice that your application for financial assistance
from the USDA has been approved, as indicated above, subject to the availability of funds and other conditions required by the
USDA. If you have any questions contact the appropriate USDA Servicing Office.
File Type | application/pdf |
File Title | 1940-01.pmd |
Author | cheryl.thompson |
File Modified | 2008-10-14 |
File Created | 2008-10-14 |