5001-7 Guaranteed Loan Borrower Status

Form RD
5001-7 (00-00)

UNITED STATES DEPARTMENT OF AGRICULTURE
RURAL DEVELOPMENT

FORM APPROVED
OMB NO. 0572-0155

GUARANTEED LOAN BORROWER STATUS
INSTRUCTION TO LENDER - COMPLETE PART B AS APPLICABLE
COMPLETING AS: SEMI-ANNUAL STATUS REPORT as of June 30th _________

December 31st _______

PART A - IDENTIFYING INFORMATION
2. GLS Borrower ID:

1. Borrower Name:

3. Unique Entity Identifier:

5. Original Loan Amount:

4. Agency Program Type:
___Community Facilities

___Water and Waste Disposal

___ Business and Industry

___ Rural Energy for America Program

6. Date of Loan:

PART B - TO BE COMPLETED BY LENDER
7. Lender Name and Address:

12. Unpaid Principal

8. Lender Tax ID:

9. Lender Branch:

10. Lender Loan Number:

11. Date of Last Status Update:

13. Unpaid Interest:

15. Payment Status Code: __________
A = Borrower Ahead of Schedule
B = Borrower Behind Schedule
C = Borrower Current

16. Amount Ahead or Behind
Schedule:

14. Amount Advanced During
During the Current Reporting
Period:

17. Has there been any material change in Borrower’s general financial conditions since the date of the last Guaranteed Loan Borrower Status
Report?
Yes _____

No _____

If yes, please explain

18. Has there been any discrimination complaints of lawsuits fi led against the Borrower since the last Guaranteed Loan Borrower Status Report?
Yes _____

No ______

If yes, please explain

__________________________________________
Lender’s Name

____________________________________
Date

By:_______________________________________
Officer Signature

____________________________________
Officer Title

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 currently
valid OMB control number. The valid OMB control number for this collection is 0572-0155. The time required to complete this information collection is estimated to average 2 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.
Responses to this collection of information are mandatory (7 CFR 5001). Send comments on the agency's need for this information, the accuracy of the provided burden estimates, and any
suggested methods for minimizing respondent burden, including through the use of automated collection techniques to InnovationCenterRegulations@usda.gov. Include the OMB control
number in any correspondence. Do not send the completed form to this address.