Submit the original of the completed form in hard copy or facsimile to the appropriate USDA office. Customers who have established electronic access credentials with USDA may electronically transmit this form to the USDA office, provided that the customer submitting the form is the only person required to sign the transaction.
Features for transmitting the form electronically are available to those customers with access credentials only. If you would like to establish online access credentials with USDA, follow the instructions provided at the USDA eForms web site.
Fld Name /
|
Instruction |
1 Applicant’s Name |
Enter the applicant’s full legal name.
|
2 Address of Property |
Enter the address of the property taken as security. |
3 County |
Enter the county in which the property is located. |
4 Title Examination |
Please read. |
5(a) Instrument |
Enter the date the examination period commenced. |
5(b) Date |
Enter the date the instrument was filed for recordation. |
5 (c) Hour |
Enter the time, then check AM or PM to indicate the hour the instrument was filed for recordation. |
Fld Name /
|
Instruction |
5(d) Date |
Enter the ending date of the time period the examination covered. |
5(e) Time |
Enter the ending time, then check AM or PM to indicate the time period the examination covered. |
6 Names |
Enter the names in which title is vested, exactly as they appear on the legal documents. |
7 Encumbrances |
Enter any encumbrances, exceptions, and reservations that appear on the deed that will prevent FSA from obtaining a first lien position. |
8 Names |
Enter the names of any parties in addition to the applicant who must execute the security instrument. |
9 General Information |
Please read. |
10(a) Signature |
Enter the attorney’s or title agent’s signature.
If faxing or mailing the form, print the form and manually enter your signature. If this form is approved for electronic transmission and you have established credentials with USDA to submit forms electronically, use the buttons provided on the form for transmitting the form to the USDA office. Electronic submission may only be completed if you are the only person required to sign this form. |
10(b) Date |
Enter the date the form is signed. |
Page
File Type | application/msword |
File Title | Template Users: Select the text for each of the instruction components below and type over it without changing the font type, |
Author | Preferred Customer |
Last Modified By | Linda.Baker |
File Modified | 2007-05-10 |
File Created | 2006-03-01 |