RD 449-2 Statement of Collateral

Position 5
UNITED STATES DEPARTMENT OF AGRICULTURE
RURAL DEVELOPMENT

Form RD 449-2
(Rev. 7-97)

FORM APPROVED
OMB NO. 0570-0014

STATEMENT OF COLLATERAL
OFFERED BY APPLICANT AS SECURITY FOR LOAN AND APPRAISER'S VALUATION REPORT
NAME (Applicant)

EMPLOYER ID NO.

ADDRESS (Include Zip Code)
RD CASE NUMBER

SUMMARY COLLATERAL OFFERED
CLASSIFICATION

Cost

Net Book Value

For Use of
Appraiser
Market Value

1. Land and land improvements
2. Buildings
3. Machinery and Equipment
4. Automotive Equipment
5. Office Furniture and Equipment
6. Other
7. Total Presently Owned Collateral

$0.00

8. Real and personal property liens
(Not to be paid from loan)

XXXX

9. Equity in Collateral

XXXX

10. Collateral to be acquired (Total Cost)

$0.00

11. Total

$0.00

$0.00

XXXX
$0.00

$0.00

$0.00
$0.00

SUMMARY OF COLLATERAL TO BE ACQUIRED
CLASSIFICATION

For Use of
Appraiser
Market Value

Exact Cost

1. Land Acquisition

XXXX

2. New Buildings or Plant Construction

XXXX

3. Acquisition of Machinery and Equipment

XXXX

4. Acquisition of Automotive Equipment

XXXX

5. Acquisition of Office Furniture and Equipment

XXXX

6. Other

XXXX

7. Total (To Item 10 above)

$0.00

XXXX

$0.00

THE APPRAISER CERTIFIES that he has personally and thoroughly inspected the collateral as listed in this Report and has estimated the value of the collateral to be
acquired. Furthermore, as of
the market values shown in the above Summary are fair and reasonable as of that date. Additional comments are
attached to this Report.
Appraiser's Signature
Date of Report
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 0570-0014. The time required to complete this information is estimated to average 5 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.

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REAL ESTATE OWNED
NAME (Applicant)

EMPLOYER ID NO.

ADDRESS (Include Zip Code)
RD Case No.

Parcel number

Title Insurance

Title data:

Address of Realty Offered

Abstract

Other (indicate)
Realty in name of
Recorded: Book

Page

County
1.

Land and land improvements (Do not include buildings-see Sec. 2 below) (Land improvements such as paving, utilities, fences, etc.)
Date acquired

Cost
Legal description (Attach if too long)*

* If available, attach plat survey.

Total Acres:

Date acquired

2. Buildings (Show square footage of each) Cost (If separate from land)

Building description: List each building separately with brief description including size, type of construction, number of stories,
date erected, use, and condition.

Assessed Value
Land
Improvements
Taxes
Rent if Applicable.
Carry Totals to Page 1
(Summary) Lines 1 and 2

Month

Annually

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Lease

Term of Lease

REAL ESTATE TO BE ACQUIRED
NAME (Applicant)

EMPLOYER ID NO.

ADDRESS (Include Zip Code)
RD Case No.

Parcel number

Title data:

Abstract

Other (indicate)

Address of Realty Offered

1.

Title Insurance

Land and land improvements (Do not include buildings-see Sec. 2 below) (Land improvements such as paving, utilities, fences, etc.)
Cost
Legal description (Attach if too long) *

* If available, attach plat survey.

Total Acres:

2. Buildings (Show square footage of each) Cost (If separate from land)

Building description * : List each building separately with brief description including size, type of construction, number of stories,
date erected, use, and condition.

Assessed Value
Land
Improvements
*Identity if existing building or to be constructed
Rent if Applicable.
Carry Totals to Page 1
(Summary) Lines 1 and 2

Taxes
Month

Annually

3 of 6

Lease

Term of Lease

PERSONAL PROPERTY
(And any fixtures not included with Real Estate or Building on Page 2)
The following described property
Name of Applicant
is located or headquartered at
Include zip code
RD Case No.
Location is owned
Leased
Applicants will make an ACTUAL PHYSICAL INVENTORY OF THE PERSONAL PROPERTY being offered as collateral DO
NOT TAKE FROM BOOK RECORDS. List each item in accordance with the classification numbers on page 1, e.g.
*(3) Machinery and Equipment (4) Automotive Equipment (5) Office furniture and equipment (6) Other for example: jigs, dies,
fixtures, airplanes, etc. (List property at different locations on separate pages)
Classification
Item Name-Manufacturer-Make

Date to
be
Acquired

Model

Serial
Number

Carry Totals of Each Classification to Page 1
(Summary) Lines 3, 4, 5, and 6.

New
Used
Rebuilt

Total

For Use of Appraiser
Market
Cond.
Value

NET
BOOK
VALUE

COST

0

0

XXX

BE SURE ALL ITEMS CAN BE READILY INSPECTED BY APPRAISER
1,
(Signature of owner, partner, or corporation officer)

(Title)

of the
(Name of Firm)
I certify that the above machinery and equipment listing represents an actual physical inventory taken on (date)
Mark items (in column 2) with an asterisk if they are subject to conditional bills of sale or liens the balance of which will not be paid off
from a loan. Show total of such items on line 8, page I (Summary).
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0

CONTINUATION OF PERSONAL PROPERTY
(And any fixtures not included with Real Estate or Building on Page 2)
The following described property
Name of Applicant
is located or headquartered at
Include zip code
RD Case No.
Location is owned
Leased
Classification
Item Name-Manufacturer-Make

Date to
be
Acquired

Model

Serial
Number

Carry Totals of Each Classification to Page 1
(Summary) Lines 3, 4, 5, and 6.

New
Used
Rebuilt

Total

COST

0

BE SURE ALL ITEMS CAN BE READILY INSPECTED BY APPRAISER

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For Use of Appraiser
Market
Cond.
Value

NET
BOOK
VALUE

0

XXX

0

PERSONAL PROPERTY TO BE ACQUIRED
(And any fixtures not included with Real Estate or Building on Page 3)
The following described property
Name of Applicant
is located or headquartered at
RD Case No.
Include zip code
Location is owned
Leased
Classification
Item Name-Manufacturer-Make

Date to
be
Acquired

Model

Serial
Number

Carry Totals of Each Classification to Page 1
(Summary) Lines 3, 4, 5, and 6.

New
Used
Rebuilt

Total

COST

0

BE SURE ALL ITEMS CAN BE READILY INSPECTED BY APPRAISER

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For Use of Appraiser
Market
Cond.
Value

NET
BOOK
VALUE

0

XXX

0