FSA-2371 Agreement to complete training

Form Approved – OMB No. 0560-0237

This form is available electronically.

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

FSA-2371 (12-31-07)

U.S. DEPARTMENT OF AGRICULTURE Farm Service Agency

Position 3

AGREEMENT TO COMPLETE TRAINING

PART A - AGREEMENT

1.

In consideration for receiving a direct loan , I agree to complete the following approved courses in

(a)

production and/or (b)

financial management:

     

2.

I understand payment for all required courses is my responsibility.

3.

I must complete training as follows:

(a)

within 2 years of the date this agreement is signed, unless I am granted an extension by the Farm Service Agency;

(b)

financial management training, if required, within one year of the date the one time 2-year OL term limit extension is signed.

4.

I understand that if I fail to complete this training as agreed, I will be ineligible for future direct loans.

5A. Name      

5B. Signature

5C. Dat e

     

PART B – FSA USE ONLY

1.

The borrower completed the training course on (a)

     

as per attached documentation.

The borrower (b) has

(c) has not met the borrower training requirements.

(d) Name of Agency Official      

(e) Title of Agency Official      

(f) Signature of Agency Official

(g) Date

     

FSA-2371 (12-31-07) Page 2

Note:

The following statements are made in accordance with the Privacy Act of 1974 (5 U.S.C. 552(a)). The Farm Service Agency (FSA) is authorized by the Consolidated Farm and Rural Development Act, as amended (7 U.S.C. 1921 et seq.) or other Acts, and the regulations promulgated thereunder, to solicit the information requested on its application forms. The information requested is necessary for FSA to determine eligibility for credit or other financial assistance, service your loan, and conduct statistical analyses. Supplied information may be furnished to other Department of Agriculture agencies, the Internal Revenue Service, 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 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 Social Security Number or Federal Tax Identification Number, may result in a delay in the processing of an application 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 0560-0237. 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.

The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs 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, S.W., Washington, D.C. 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.