FSA-2476 Transfer of real estate security/transferee

This form is available electronically. Form Approved – OMB No. 0560-0236

(See Page 2 for Privacy Act and Public Burden Statements).

FSA-2476 U.S. DEPARTMENT OF AGRICULTURE Position 5 Farm Service Agency TRANSFER OF REAL ESTATE SECURITY
PART A - GENERAL
1. Name of Transferor(s)      						2. Name of Transferees      
3A. Real Estate to be Transferred      						3B. Current Value $     
4A. Other property, besides Real Estate Security, to be transferred      							4B. Current Value $     
5. Reasons for Transfer      
6. Amount in Supervised Bank Account $     			7. Planned Disposition of Funds in Supervised Bank Account      
8. Development to be Completed, Estimated Cost, and Source of Funds      
9A. Prior Lien $     				9B. Is Consent of Prior Lienholder Required?						YES	NO
										 	 
10A. Junior Lien $     				10B. Is Consent of Junior Lienholder Required?						 	 
11. Taxes and Assessments Due and Payable $     		12. Date Transfer to be Complete      						13. Transferee Operating/Occupying Property. If “NO” expected Date:      		 	 
14. If Property is Operated, Occupied, or Leased by other than Transferee, provide terms and conditions of occupancy or lease:      
15. Direct Debts owed FSA to be transferred:
A. Loan Number	B. Amount				C. Current Security				D. Comment
     	$      				     				     
     	$      				     				     
     	$      				     				     
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its program 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, SW., Washington, DC 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.

FSA-2476 (12-31-07) Page 2 of 2

PART B – AGREEMENTS BETWEEN TRANSFERORS AND TRANSFEREES
Transferor and transferee certify that the agreements reached for the transfer of security are made between transferor and transferee and the information provided herein is correct and fully understood by each.
1. Total consideration for transfer of security is											$      
2. Payment or assumption of prior liens:			     
3. Payment or assumption of Junior Liens:				     
4. Payment of Taxes (Including current year's taxes):					     
5. Assignment of Property Insurance and Paid unearned premiums:						     
6. Distribution of income from rentals, easements, mineral leases, etc.:							     
7. Disposition of existing abstracts of Title, Owner's Title Insurance Policy or other Title Evidence:      
8. Expenses to be paid by Transferor:		     
9. Expenses to be paid by Transferee:		     
10. TRANSFEREE WILL: (a) ASSUME AN INDEBTEDNESS TO FSA OF										AMOUNT
										$      
(b) ASSUME INDEBTEDNESS TO										$      
(c) ASSUME INDEBTEDNESS TO										$      
(d) PAY TRANSFEROR (AS EQUITY) (Part B, Item 1 minus, Items 10(a), 10(b), and 10(c))										$      
PART C - SIGNATURES
1A. Transferor Signature									1B. Date      
2A. Transferee Signature									2B. Date      
3A. Authorized Agency Official Name      								3B. Date      
3C. Signature								3D. Date      
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, (7 USC 1921 et seq.), and the regulations promulgated thereunder, to solicit the information requested on this form. The information requested is necessary for FSA to determine eligibility for financial assistance, service your loan, and conduct statistical analyses. Supplied information maybe furnished to other Department of Agriculture agencies, the Department of the Treasury, 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 your Social Security Number or Federal Tax Identification Number, may result in a delay in the processing of this request 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 0560-0236. The time required to complete this information collection is estimated to average 15 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.