FSA-2251 Lenders Guaranteed Loan Payment to USDA

Form Approved - OMB No. 0560-0155

This form is available electronically.
U.S. DEPARTMENT OF AGRICULTURE
Farm Service Agency

FSA-2251
(08-18-08)

Position 2

LENDER'S GUARANTEED LOAN PAYMENT TO USDA
Transaction 4035

INSTRUCTIONS: Complete All Items.
1. FSA ACCOUNT NUMBER
STATE CODE

COUNTY CODE

2. LENDER'S ID NUMBER
FSA ID NUMBER

3. FSA LOAN NUMBER

4. FSA ASSIGNED BRANCH NUMBER

5. BORROWER'S NAME

6. LENDER'S NAME

7. RECEIVABLE NUMBER (Assigned by Finance Office)

8A. DATE INTEREST PAID
THROUGH TO FSA

9. AMOUNT OF PRINCIPAL PAYMENT

10. AMOUNT OF INTEREST PAYMENT

$

8B. DATE PRINCIPAL PAID
(Completed by Finance Office)

$

11. TOTAL REMITTANCE (Item 9 + Item 10)

12. DATE OF DEPOSIT (To be completed by Finance Office)

$
(To Be Completed By Finance Office)
14. SERVICING FEE CODE (Insert appropriate code in box below)

13. PAYMENT CODE (Insert appropriate code in box below)
01 = REGULAR PAYMENT

01 = ACCRUED INTEREST

02 = DEFERRED PAYMENT

02 = SERVICING FEE

15. AUTHORIZED LENDER'S SIGNATURE

16. TITLE

17. DATE

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, (7 USC 1921 et seq.) , and the regulations promulgated thereunder, to solicit the information
requested on this form. The information requested is necessary for FSA to determine eligibility for financial assistance, service your loan, and conduct
statistical analyses. Supplied information maybe furnished to other Department of Agriculture agencies, the Department of the Treasury, 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 (FOIA), 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 your Social Security Number or Federal Tax Identification
Number, may result in a delay in the processing of this form 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 0560-0155. 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. RETURN THIS
COMPLETED FORM TO YOUR LOCAL 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.