Request for Obligation of Funds

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USDA
Form RD 1940-1
(Rev. 06-10)

FORM APPROVED
OMB No. 0570-0062

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.

ST

FISCAL YEAR

LOAN NUMBER

1. CASE NUMBER

)

CO BORROWER ID

3. NUMBER NAME FIELDS

2. BORROWER NAME

(1, 2, or 3 from Item 2)

4. STATE NAME
5. COUNTY NAME
GENERAL BORROWER/LOAN INFORMATION
8. COLLATERAL CODE

6. RACE/ETHNIC
CLASSIFICATION

7. TYPE OF APPLICANT

4 - HISPANIC
5 - A/PI

1 - WHITE
2 - BLACK
3 - AI/AN

10. SEX CODE
1 - MALE
2 -FEMALE

1 - INDIVIDUAL
2 - PARTNERSHIP
3 - CORPORATION
4 - PUBLIC BODY
5 - ASSOC. OF
FARMERS

3 - FAMILY UNIT
4 - ORGAN. MALE OWNED
5 - ORGAN FEMALE OWNED
6 - PUBLIC BODY

14. DIRECT PAYMENT

6 - ORG. OF FARMERS
7 - NONPROFIT-SECULAR
8 - NONPROFIT-FAITH BASED
9 - INDIAN TRIBE
10-PUBLIC COLLEGE/UNIVERSITY
11-OTHER

1 - EMPLOYEE
2 - MEMBER OF FAMILY
3 - CLOSE RELATIVE
4 - ASSOC.

13. CREDIT REPORT
1 -YES
2 -NO

16. FEE INSPECTION
1 -YES
2 - NO

18. USE OF FUNDS CODE

17. COMMUNITY SIZE
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

9. EMPLOYEE
RELATIONSHIP CODE

1 -YES
2 -NO

1 - MARRIED
3 - UNMARRIED (INCLUDES
2 - SEPARATED
WIDOWED/DIVORCED)

15. TYPE OF PAYMENT

4 - MACHINERY ONLY
5 - LIVESTOCK ONLY
6 - CROPS ONLY
7 - SECURED BY
BONDS
8 - RLF ACCT

12. VETERAN CODE

11. MARITAL STATUS

1 - MONTHLY 3 - SEMI-ANNUALLY
2 - ANNUALLY 4 - QUARTERLY

(See FMI)

1- REAL ESTATE
SECURED
2-REAL ESTATE
AND CHATTEL
3 - NOTE ONLY OR
CHATTEL ONLY

22. TYPE OF ACTION
1 -OBLIGATION ONLY
2 - OBLIGATION/CHECK REQUEST
3 - CORRECTION OF OBLIGATION

(See FMI)

23. TYPE OF SUBMISSION

24. AMOUNT OF LOAN

25. AMOUNT OF GRANT

1 - INITIAL
2 -SUBSEQUENT

26. AMOUNT OF
IMMEDIATE ADVANCE

27. DATE OF
APPROVAL
MO

DAY

28. INTEREST RATE

29. REPAYMENT TERMS

YR

%
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

COMPLETE FOR CREDIT SALE-ASSUMPTION
32. TYPE OF SALE

(See FMI)

1 -CREDIT SALE ONLY

FINANCE OFFICE USE ONLY
33. OBLIGATION DATE
MO

DA

2 - ASSUMPTION ONLY
3 -CREDIT SALE WITH SUBSEQUENT LOAN

4 -ASSUMPTION WITH
SUBSEQUENT LOAN

COMPLETE FOR FP LOANS ONLY
34. BEGINNING FARMER/RANCHER

YR
(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.

Position 2

ORIGINAL - Borrower's Case Folder

COPY 1 - Finance Office

COPY 2 - Applicant/Lender

COPY 3 - State Office

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 0570-0062. 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.

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CERTIFICATION APPROVAL
EM, OL, FO, and SW Loans

For All Farmers Programs

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-working-day 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)

Typed or Printed Name:
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.
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