RD 5001-10 Guaranteed Loan Report of Loss

USDA
Form RD 5001-10
(00-00)

GUARANTEED LOAN REPORT OF LOSS

FORM APPROVED
OMB NO. 0000-0000

TRANSACTION 4041

INSTRUCTIONS—TYPE IN CAPITALIZED ELITE TYPE IN SPACES MARKED (____)

Complete Items 1-6, 10-13, 16-35,

36-41, and 47-54 when report type is 1. Complete items 1-6, 10-16, 31-35, and 36-54 when report type is 2.
1. CASE NO.
ST
CO

2A. AGENCY
LOAN NO.

2B. LOAN TYPE

4. BORROWER NAME

5. LENDER ID NO.
(IRS Tax No.)

6. AGENCY’S LENDER
BRANCH NO.

7. CHECK ISSUE CODE

8. DATE MANUAL CHECK
MO
DA
YR ISSUED

9. DATE OF DEPOSIT

10. LIQUIDATION PLAN APPROVAL DATE

11. DATE OF SETTLEMENT

BORROWER’S ID

MO
(F.O. only)

GUARANTEED LOAN ITEMS:

DA

YR
(F.O. only)

$ DOLLARS

MO

DA

3A. REPORT
TYPE CODE

YR

LOSS GUARANTEED:

12. PRINCIPAL BALANCE

32. PERCENT OF LOSS
GUARANTEED

13. ACCRUED INTEREST
OWED

33. AMOUNT TO BE PAID

14. PRINCIPAL BALANCE OWED
ON PROTECTIVE ADVANCES

34. (Sum of Prin. Advance +
Item 13) X Item 32

15. ACCRUED INTEREST ON
PROTECTIVE ADVANCES

35. MAXIMUM LOSS ALLOWED

16. TOTAL (Add Items 12 - 15)

PRIOR LIEN AMOUNTS OWED TO SETTLEMENT DATE:

3B. IS THE FINAL ESTIMATED
LOSS PAYMENT UNDER THE
TYPE CODE CHECKED?
YES
NO
1 = SYSTEM GENERATED
2 = MANUAL CHECK
3 = NO CHECK ISSUED
4 = REFUND
(F.O. only)

MO

DA

YR

$ DOLLARS
(Percent)

(Item 31 X Item 32)

(Lessor of Items 33 or 34)

ADJUSTMENTS TO PROTECTIVE ADVANCES & INTEREST
36. PROTECTIVE ADVANCES PLUS
INTEREST [(Items 14 + 15) X Item 32]

17. REAL ESTATE DEBTS

37. REMAINING BALANCE LOSS
GUARANTEE (Item 35 minus Item 36)

18. PERSONAL PROPERTY DEBTS

38. PERCENT OF GUARANTEED
PORTION HELD BY LENDER

19. UNPAID TAXES, ASSESSMENTS,
GROUND RENTS, ETC.

39. LOSS ON GUARANTEED PORTION
HELD BY LENDER OR HOLDER

20. TOTAL PRIOR LIENS

40. UNPAID ANNUAL/LATE FEES

(Percent)

(Item 37 X Item 38)

(Add Items 17-19)

COLLATERAL:

41. AMOUNT DUE LENDER

21. REAL PROPERTY
VALUE

AMOUNT DUE LENDER OR USDA:

22. CHATTEL PROPERTY
VALUE
23. VALUE OF PERSONAL AND
CORPORATE GUARANTEES

[(Item 36 + Item 39) minus Item 40]

42. PAID ANNUAL/LATE FEES
43. AMOUNT PAID ON
ESTIMATED LOSS
44. BALANCE DUE LENDER
[(Item 41 minus (Items 42 + 43, if positive)]

24. TOTAL (Add Items 21 - 23)
45. INTEREST ON OVERPAYMENT
(Accrued interest due Agency)
25. NET COLLATERAL
(Item 24 minus Item 20)
26. BASIC LOSS
(See Instructions)

46. AMOUNT DUE AGENCY BY LENDER
[(Items 42 + 43) minus (Items 41 + 45)]
47. LENDER LOSS
UNGUARANTEED

ADJUSTMENT TO BASIC LOSS:
27. FUNDS BEING HELD

48. NAME OF LENDER

28. INCOME TO BE APPLIED TO DEBT

49. BY
X
50. TITLE

29. BORROWER’S DEBT PAYMENT
ABILITY - PRESENT VALUE
30. TOTAL DEDUCTIONS
(Add Items 27 - 29)
31. ADJUSTED BASIC LOSS
(Item 26 minus Item 30)

51. DATE

52. TENTATIVE APPROVAL - AGENCY OFFICIAL:
BY
X
53. TITLE
54. DATE

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 0000-0000. The time required to complete this information collection is estimated to average 25 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.

Form RD 5001-10 Page 1 of 3

INSTRUCTIONS FOR PREPARATION
Item 1.

Enter the state and county code and borrower’s random number (borrower ID found in the Guaranteed Loan System (GLS)).

Item 2A.

Enter Agency assigned Loan Number, i.e. 50, 51, etc.

Item 2B.

Enter loan type. (2nd field Item 2) BP = Business Programs; CF = Community Facilities; and WW = Water & Waste Disposal.

Item 3A.

Enter applicable Report Type Code.
1 - Estimated Loss - (Liquidation)
2 - Final Loss - (Liquidation)
4 - Recovery Received after Final Loss (Liquidation)

5 - Loss - Bankruptcy Reorganization
8 - Interest Loss Payment
13 - Voluntary Payment to Agency on Secured Debt

Item 3B.

If this is the final estimated loss payment under the type code entered in Item 3A, check Yes; otherwise , No.

Item 4.

Enter Borrower’s Name – abbreviate when necessary.

Item 5.

Enter the Lender’s Identification Number.

Item 6.

Enter the Lender’s Branch number that has been assigned by the Agency.

Items 7. - 9.

To be completed by the Finance Office only.

Item 10.

Enter the Liquidation Plan Approval Date (MO DA YR). Under no circumstances will the Agency pay more than 90 days of additional
accrued interest once the liquidation plan is approved.

Item 11.

Enter the date the Report of Loss is prepared. If the Lender was overpaid on an estimated loss claim, this date is the date the Lender's
refund of an overpayment plus interest was approved by an authorized Agency representative.

Item 12.

Enter unpaid principal balance on loan.

Item 13 - 15.

Lender must provide, as an attachment, its calculation of unpaid accrued interest showing advances, payments, periods of time, interest
rate and amount. Items 14 & 15 should not be completed on an estimated loss claim.

Item 16.

Enter total of items 12 thru 15.

Items 17 - 19.

Include principal and interest, or other items for which lien priority exists. Item 19 shows only the amount not paid by the borrower and
not included in the Protective Advances. Do not include improvement assessments to be paid periodically in the future.

Item 20.

Enter total of items 17, 18 and 19. If zero, enter 0.00.

Items 21 - 23.

Enter appropriate amounts. If zero, enter 0.00.

Item 24.

Enter the total of items 21 thru 23. If zero, enter 0.00.

Item 25.

Enter the amount of net collateral. Item 24 minus Item 20. If negative, enter 0.00.

Item 26.

Subtract Item 25 from Item 16 and enter result in Item 26. When a final loss is prepared, insert figure in Item 16 in Item 26.

Items 27-29.

Enter the appropriate amounts. Items 27, 28, and 29 include amount(s) of other assets of the borrower which have not been pledged as
security for the loan from which collections can readily be made.

Item 30.

Enter the total of items 27 thru 29. If zero, enter 0.00).

Item 31.

Enter the adjusted basic loss. (Item 26 minus Item 30). For interest loss payments carry the figure from Item 13 to this column.

Item 32.

Enter applicable percentage of guarantee.

Item 33.

Enter the amount of Item 31 X Item 32.

Item 34.

[Enter the total principal advanced plus unpaid accrued interest (Item 13)] X Item 32. If a line of credit, enter the maximum allowed
balance plus unpaid accrued interest (Item 13) X Item 32.

Item 35.

Enter the amount of the maximum loss to be paid (Lesser of Item 33 or 34).

Item 36.

For final loss claims only add item 14 and 15 and multiply the sum by the percentage in item 32. If estimated loss claim, enter 0.00.

Form RD 5001-10 Page 2 of 3

Item 37.

Enter the difference remaining from Item 35 less item 36.

Item 38.

Enter the percentage of the Guaranteed portion held by the lender that has not been purchased from the secondary market holder by the
Agency. If the Agency has purchased the entire guaranteed portion of the loan from the holder, then enter 0. If the Agency purchased less
than the entire guaranteed portion of loan from the holder, enter the percentage of the guaranteed portion that the lender still holds. If the
loan was not sold or the lender will forward the holder or holders their pro-rata share of any loss payment received, then enter 100.

Item 39.

Multiply Item 37 by the percentage in Item 38.

Item 40.

Enter any unpaid annual/late fees when paying an estimated loss, final loss, bankruptcy reorganization or interest loss payment.

Item 41.

Enter the amount due lender. (Item 39 plus item 40.)

NOTE:

COMPLETE ITEMS 42-47 FOR A REPORT OF FINAL LOSS ONLY.

Item 42.

Enter any paid annual/late fees listed as Unpaid Annual/Late Fees on estimated loss, bankruptcy reorganization, or interest loss
payment previously paid.

Item 43.

If an estimated loss claim was filed, enter the total amount paid to lender on the estimated loss claim. If zero, enter 0.00.

Item 44.

Enter Balance Payable to the Lender. If zero, enter 0.00. [Item 41 minus (item 42 plus item 43, if positive)] The Agency will verify this
amount and issue payment.

Item 45.

When the estimated loss payment made by USDA exceeds the actual loss, USDA is entitled to interest on the overpayment. Interest will
be charged on the amount of overpayment at the note rate from the check date of the estimated loss payment by USDA to the final date
of settlement as shown in item 11.

Item 46.

Enter Amount Due to the Agency. If zero, enter 0.00. [(Item 42 + Item 43) minus (Item 41 + Item 45)]

NOTE: WHEN THE REPORT TYPE CODE = 04 OR 13, ENTER AMOUNT DUE TO USDA FROM A RECOVERY (04) OR VOLUNTARY
PAYMENT TO THE AGENCY ON A SECURED DEBT (13) BY THE LENDER AFTER THE FINAL LOSS CLAIM PAYMENT OR INTEREST LOSS PAYMENT HAS BEEN MADE. LENDERS CHECK FOR THIS AMOUNT SHOULD ACCOMPANY REPORT AND BE
DELIVERED TO A USDA AUTHORIZED REPRESENTATIVE.
Item 47.

Lender is to insert the amount of any loss it incurred on the unguaranteed portion of the loan.

Items 48 - 54.

Self-explanatory.

Form RD 5001-10 Page 3 of 3