Fsa-2570. Offer To Convey Security

This form is available electronically. Form Approved - OMB No. 0560-0233

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

FSA-2570 U.S. DEPARTMENT OF AGRICULTURE Position 1 (Chattels)

(proposal 1) Farm Service Agency Position 5 (Real estate)

OFFER TO CONVEY SECURITY

PART A - BORROWER OFFER TO CONVEY SECURITY

(1) I/We,			     
(Borrower), hereby offer to convey to the United States, U.S. Department of Agriculture, acting through the Farm Service Agency (Government), the property covered by mortgages, deeds of trust, or other security instruments held by the Government.
(2)	Borrower requests:
	(a)				a credit for the amount of the market value of the property less prior liens and expenses, or the debt, whichever is less. Market value of the property will be determined by the Government. Prior liens, if any, include those secured or described in such instruments. Expenses are any obligations incurred on borrower's behalf, as authorized in Item 4 in connection with the conveyance of satisfactory title to the Government.
	(b)				a credit with the greater of the market value of the security or the Agency’s debt, since I am an American Indian and my loans are secured by real estate located within the boundaries of a Federally recognized Indian reservation.
(3)	Borrower agrees to remove at Borrowers' own expense all prior and junior liens (except Government liens), and all other encumbrances and title defects (now known or hereafter disclosed) except those approved by the Government in writing.
(4)	Borrower agrees to pay the following items, or request the items be paid by the Government and charged to their account, as indicated below. Any items not paid by Borrower may be paid by the Government, at its option, and charged to Borrower's account:
	     
		Item							Paid by Borrower		May be paid by Government
		(a)		Expenses necessary or incidental to such conveyance (including but not limited to expenses to title examination, survey, revenue stamps, notary and recording fees).
		(b)		Cost of keeping insurance in force on the property in accordance with the provisions of the security instruments until the deed to FSA is recorded.
		(c)		Cost of title insurance if required by the Government.
		(d)		Taxes and assessments, and any liens approved by the Government for which payment is necessary to clear title.
(5)		Borrower hereby assigns to the Government the following:
		(a)		all rights, title and interest in all insurance premiums paid by the Government and charged to the account and all unpaid claims arising from insurance policies in effect at any time on any buildings on the property;
		(b)		all rights, title and interest in all abstracts of title, title insurance policies or other title evidence, and in all outstanding leases to which the property is subject, including oil and gas and other types of mineral leases; and
		(c)		funds now on deposit, including Borrower and Government funds in a construction, supervised, or other account under
				agreement with the Government and/or			     
				(bank);
		(d)		all rights, title and interest in all contract rights, inventories, equipment, furnishings, accounts, general intangibles, gross receipts, gifts, pledges, income, and revenue as described in security instruments held by the Government.
In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex, gender identity (including gender expression), sexual orientation, disability, age, marital status, family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all programs). Remedies and complaint filing deadlines vary by program or incident. Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.) should contact the responsible Agency or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English. To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at http://www.ascr.usda.gov/complaint_filing_cust.html and at any USDA office or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: (1) mail: U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue, SW Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email: program.intake@usda.gov. USDA is an equal opportunity provider, employer, and lender.

FSA-2570 (proposal 1) Page 2 of 2
(6)	If cash proceeds from this assignment are received by the Government before title to the property passes to the Government, the proceeds shall be applied to the debt.
(7)	Borrower agrees to deliver possession of the property to Government when notified by the Government of acceptance of this offer to convey security.
(8)	Borrower understands that the Government may accept or reject this offer at any time by completing the form below and returning a copy to the Borrower. Borrower may withdraw this offer by written notice to the Government at any time prior to its acceptance by the Government.
(9A) Borrower's Name				(9B) Signature	(9C) Date (MM-DD-YYYY)
     					     
(10A) Borrower's Name				(10B) Signature	(10C) Date (MM-DD-YYYY)
     					     
(11A) Borrower's Name				(11B) Signature	(11C) Date (MM-DD-YYYY)
     					     
(12A) Borrower's Name				(12B) Signature	(12C) Date (MM-DD-YYYY)
     					     
PART B - FSA RECOMMENDATION/APPROVAL
(1) Borrower's offer to convey security is (a) recommended (b) not recommended					(2) Date      
(3) Justification:
     
(4A) Authorized Agency Official Name				(4B) Signature	(4C) Title
     					     
(5) Borrower's offer to convey security is (a) accepted (b) rejected					(6) Date      
(7) Justification:
     
(8A) Authorized Agency Official Name				(8B) Signature	(8C) Title
     					     
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, as amended (7 USC 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 the 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 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 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 0560-0233. 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 THE LOCAL FSA OFFICE.