Lender's Guaranteed Loan Payment to USDA

FORM APPROVED
OMB NO. 0575-0137

UNITED STATES DEPARTMENT OF AGRICULTURE
FORM RD 1980-43
(Rev.4-00)

LENDER'S GUARANTEED LOAN PAYMENT TO USDA
TRANSACTION 4036

INSTRUCTIONS-TYPE IN SPACES MARKED
Complete all items. See reverse.
1. CASE NO. (5), (6), (7)
BORROWER'S ID
ST
CO

2. LENDER ID NO. (3419)
(IRS Tax No.)

3. LOAN NO.( 6)

4. BRANCH NO. (4334)

5. BORROWER NAME

6. LENDER NAME

7. RECEIVABLE NO. (4801)

8. DATE INTEREST PAID THROUGH
TO USDA
MO
DA
YR

8A. DATE PRINCIPAL PAID
(F.O. USE ONLY)
MO

9. AMOUNT OF PRINCIPAL PAYMENT (4378)

1 0. AMOUNT OF INTEREST PAYMENT (4379)

11. TOTAL REMITTANCE

12. DATE OF DEPOSIT (642)

(Item 9 + Item 10)
13. PAYMENT CODE

01 = Regular Payment
02 = Deferred Payment

MO

DA

YR

14. SERVICING FEE CODE

DA

YR

(To be completed by USDA)

01 = Accrued Interest
02 = Servicing Fee
(To be completed by Finance Office)

15. AUTHORIZED LENDER'S SIGNATURE

16. TITLE

17. DATE

This report contains information which must be furnished by the lender in order to fulfill requirements and retain the benefit of a USDA loan guarantee. This statement
is furnished pursuant to P.L. 96-511.
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 O575-0137. The time required to complete this information collection is estimated to average 30 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.

FINANCE OFFICE

SERVICING OFFICE

LENDER

RD 1980-43
(Rev. 4-00)