FSA-2044 Assignment of income

Form Approved – OMB No. 0560-0237
Expiration Date: 12/31/2025
(See Page 2 for Privacy Act and Public Burden Statements)

U. S. DEPARTMENT OF AGRICULTURE
Farm Service Agency

FSA-2044
(12-31-07)

PART A - AGREEMENT

Position 5

ASSIGNMENT OF INCOME FROM
REAL ESTATE SECURITY

1. The United States, acting through the U.S. Department of Agriculture, Farm Service Agency (FSA), is the
holder of a loan in the sum of (a)
dollars (b) ($)
made to (c)
, (Borrower);
of (d)
County, State of (e)
2. Therefore, in consideration of the FSA’s making the loan or permitting the Borrower to execute the lease or
other instrument described below, the Borrower sells, assigns, transfers, and conveys to the FSA
(a)
percent (b) (
%) of any and all
rents, royalties, bonuses, payments, delay monies, damages, and other income which may now be or later become
owing to the Borrower under the terms of this instrument, which is described as follows:
(c)
(d)
(e)
(f)

Instrument Title:
Date of Instrument:
Name of Parties:
Recording Information, if any:

The instrument described above indicates an interest in the following described property situated in the State
of (g)
(h )

, County or Counties of
; more particularly described as follows:

(i)

or of any renewal or extension of the instrument or of any other lease or agreement supplementary to it which may
be entered into between the Borrower and the Lessee or other interested party (third party). The Borrower
covenants that the Borrower has made no other assignment or encumbrance of such income.

,
.

FSA-2044 (12-31-07)

Page 2 of 3

3. The third party, heirs, executors, administrators, successors, and assigns of the third party are directed to pay to
FSA the above listed percentage of all sums now owing or to become owing to the Borrower under the instruments
by checks payable to:
the Farm Service Agency, for the account of (a)
(b)
Agency, to be remitted to FSA at (c)

.
and the Farm Service

or to such other person as may be designated in writing by FSA, until notified in writing by
FSA of the termination of this assignment.
4. This assignment shall terminate when the above listed indebtedness of the Borrower is paid in full, provided
however, that the third party shall not be liable to the Borrower for any payment to FSA which the third party may
have made after the Borrower’s indebtedness was paid in full, unless the third party received, prior to any such
payment, written notice from the FSA that the Borrower’s indebtedness has been paid in full.
5. FSA assumes no responsibility under any of the provisions of the instrument described above, or of any other
agreements between the Borrower and the third party.
6. Each amount received by the FSA under this assignment shall be used in accordance with the regulations of the
FSA in effect when such amount is received.
7. IN WITNESS WHEREOF, the Borrower has signed and sealed this assignment on

.

8A. Borrower’s Name

8B. Signature

8C. Date

9A. Borrower’s Name

9B. Signature

9C. Date

10A. Borrower’s Name

10B. Signature

10C. Date

11A. Borrower’s Name

11B. Signature

11C. Date

PART B – THIRD PARTY ACKNOWLEDGMENT
The undersigned third party recognizes the foregoing assignment, and agrees to remit to FSA the percentage of
income in the manner and amount specified in this assignment.
1. Name and Address of Third Party

2 . Authorized Officer of Third Party Name andTitle

3 . Date

4 . Signature

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
and conduct statistical analyses. Supplied information may be 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 0560-0237. The time required to complete this information collection is estimated to average 20 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 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 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 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 (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.

FSA-2044 (12-31-07)

Page 3 of 3

PART C – RELEASE OF MORTGAGE INTEREST
The FSA’s interest in the property described in this instrument ceased as of (1)
and the FSA shall have no interest in such property thereafter.
2A. Authorized Agency Official Name

2B. Signature

2C.Title