FSA2301Ins

Farm Loan Programs - Direct Loan Making

FSA2301Ins

OMB: 0560-0237

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FSA-2301 Date of Modification 11-18-2021


REQUEST FOR YOUTH LOAN

INSTRUCTIONS FOR PREPARATION

Purpose:

This form used by youth loan applicants to apply for direct loan assistance from FSA.

Handbook Reference:

3-FLP

Number of Copies:

Original

Signatures Required:

Applicant, Project Advisor, and Parent/Guardian.

Distribution of Copies:

Retained in the case file.

Automation-Related Transactions: (Instructions for writers: provide only the information required, i.e. ADPS TC 3K. If no automation actions are required, insert N/A FBP, DLS,


Applicants must complete Part A.

Project advisor must complete Part B.

Parent or guardian must complete Part C.

Part D is for FSA use only.

Part A, Items 1-40B are completed by the applicant.

Fld Name /
Item No.

Instruction

1

Exact Full Legal Name

Enter the applicant’s exact full legal name.

2

Address

Enter applicant’s complete mailing address, including physical address if different from mailing address.

3

County of Project

Enter the County where the project will be performed.

4

Email Address

Enter the applicant’s email address.

5

Social Security No.

Enter applicant’s social security number.

6

Birth Date

Enter applicant’s date of birth.

7

Telephone Number

Enter applicant’s contact telephone numbers, including area code.

8

Marital Status

Enter check in the appropriate box for marital status.

9

Amount of Loan Request

Enter the loan amount being requested.

10

Citizenship

Check “YES” if you are a U.S. citizen. Check “NO” if a U.S. non-citizen national or qualified alien and provide appropriate documentation of immigration status.

11

Previous FSA Assistance

Check “YES” if you ever obtained a direct or guaranteed loan from FSA; if not, check “NO”.

12

Delinquent on Federal Debt

Check “YES” if you are delinquent on any federal debt and provide an explanation in Item 18. (Federal debt includes but is not limited to education loans, delinquent taxes, obligations at Natural Resources Conservation Service, etc.) Otherwise check “"NO.”

13

Debt Forgiveness

Check “YES” if the government ever forgave any debt on an FSA direct or guaranteed loan through a write-off, debt settlement, compromise, write-down, charge-off, adjustment, reduction or bankruptcy and provide an explanation in Item 18. If not, check “NO”.

14

Employment Information

Check “YES” if employed and enter the name, mailing address and telephone number of the employer. Also provide the annual income and if employment is full or part time in Item 18. If not employed, check “NO”.

15

Employee Relationship

Check “YES” if you are an employee, related to an employee, or closely associated with an employee of the Farm Service Agency, and provide an explanation in Item 18. If not, check “NO”.

16

Agriculture Related Organization

Check “YES” if you are an active member of FFA, 4-H or other agriculture related organization. Provide the name of the organization that will sponsor you for this project in Item 18. If not, check “NO”.

17

Veteran

Check “YES” if you are a veteran. If not, check “NO”.

18

Additional Answers

Use this space to provide additional answers to questions on this application.

19

Brief Description of Project

Provide a brief description of your proposed project.

20A

Ethnicity

Check the appropriate box indicating the individual applicant’s ethnicity.

20B

Race

Check the appropriate boxes indicating the individual applicant’s race.

20C

Gender

Check the appropriate box indicating the individual applicant’s gender.

21A

Income Description

Enter the description of each projected source of income.

21B

$ Amount

Enter the projected annual dollar amount of income received from each source described.

22

Total

Enter the projected total annual dollar amount of income from all sources listed under Item 21A.

23A

Expense Description

Enter the description for each projected expense.


Fld Name /
Item No.

Instruction

23B

$Amount

Enter the projected annual dollar amount of each expense described.

24

Total

Enter the projected total annual dollar amount of all expenses listed under Item 23A.

25

Annual Total Income

Enter the projected total annual dollar amount of income from Item 22.

26

Annual Total Expenses

Enter the projected total annual dollar amount of all expenses from Item 24.

27

Annual Amount of Payments Due

Enter the estimated annual dollar amount of payments due, including requested loan.

28

Ending Cash Balance

Subtract Item 26 “Annual Total Expenses” and 27 “Annual Amount of Payments Due” from Item 25 “Annual Total Income” to complete Item 28 “Ending Cash Balance”.

29A

Assets

Description

Enter a description of all assets.

29B

$ Amount

Enter the dollar value of each asset described.

30

Total Assets

Enter the total dollar value of all assets described.

31A

Debts Description

Enter a description of all debts.

31B

$ Amount

Enter the dollar amount of each debt described.

32

Total Debts

Enter the total dollar amount of all debts described.

33

Total Assets

Enter the dollar amount of total assets from Item 30.

34

Total Debts

Enter the dollar amount of total debts from Item 32.

35

Net Worth

Enter the net worth by subtracting Item 34 from Item 33.

36

Special Program Information

Please read.

37

General Information

Please read.

38

Certifications

Please read.

39

Warning

Please read.

40A

Signature

Enter the applicant’s signature.

40B

Date

Enter the date applicant signed.

PART B - All items are completed by the project advisor.

41A

Project Advisor Recommendation

Enter a brief description of how you plan to assist the applicant.

41B

Name

Print the project advisor’s name.

41C

Signature

Enter the project advisor’s signature.

41D

Title Within Organization

Enter project advisor’s title within the organization (leader, advisor, teacher, County Extension agent, etc.).

41E

Organizational Affiliation

Enter the name of agricultural organization with which project advisor is associated.

41F

Phone Number

Enter the contact phone number for the project advisor.

41G

Date

Enter the date the project advisor signed.

PART C - All items are completed by the parent or guardian.

42A

Parent or Guardian Recommendation

Enter a brief description of how you plan to assist the applicant.

42B

Name

Print the parent or guardian name.

42C

Signature

Enter the parent or guardian’s signature.

42D

Date

Enter the date the parent or guardian signed.

PART D- All items are completed FSA.

43A

Date Form Received

Enter the date the FSA 2301 received in the Office.

43B

Date Application

Complete

Enter the date the application is considered complete.

43C

Credit Report Fee

Enter the amount of the credit report fee. (For applicants 18 years or older).

43D

Date Received

Enter the date the credit report fee is received.

43E

Agency Official

Enter the name of the Agency Official receiving the application.


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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleInstructions for FSA-2301
Authorcquayle
File Modified0000-00-00
File Created2024-09-16

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