FSA-440-04A Security Agreement

FORMS MANUAL INSERT

FORM FSA-440-4A
Used by County Offices when
loans are secured by chattel
property.

(SEE REVERSE)

PROCEDURE FOR PREPARATION

:

FSA Transferred Instruction 1941-B and FSA Handbook 1-COR.

PREPARED BY

:

Agency Official.

NUMBER OF COPIES

:

Original and two.

SIGNATURE REQUIRED

:

Borrower signs original; when an entity is involved, refer to the applicable loan making
regulations for additional signature requirements.

DISTRIBUTION OF COPIES

:

Original in locked fire resistant file; work copy in borrower's case file; copy to borrower.

(12-08-04) FSA PN Issue No. 215

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FORM FSA-440-4A

INSTRUCTIONS FOR PREPARATION
The Security Agreement (Chattels and Crops) is completed by FSA for the
debtor(s). The debtor(s) will go to the FSA County Office to review the
form. The debtor(s) MUST READ Items 3 and 4 before the form is signed in
Item 5 on Page 6. A copy of the signed form will be given to the Debtor(s)
for their records. Items 1 through 2D (Completed by FSA County Offices).
Fld Name /
Item No.
1(a)
Month and
Day
1(b)
Year
1(c)
Name of
Debtor
1(d)
Name of
Debtor
1(e)
Mailing
Address
2
Description
of Collateral
2(A)(1)
Farms/Other
Real Estate
2(A)(2)
Approximate
Number of
Acres
2(A)(3)
County and
State
2(A)(4)
Distance
and
Directions

Instruction
Enter the month and day this agreement is signed (i.e. March 10).
Enter the year this agreement is signed (i.e. 2003).
Enter the legal name of the debtor.
Enter the legal name of the second debtor, if applicable.
Enter debtor’s complete mailing address, including Zip code.
Enter a description of the collateral in the space provided.
Enter farm name or landowner name where all crops are or will be
grown.
Enter the approximate number of acres for land listed in Item 2(A)(1).

Enter the County and State where the farm(s) listed in Item 2(A)(1) are
located.
Enter a brief description of approximate distance and directions from
the nearest town or landmark to the farm(s) listed in Item 2(A)(1).

(12-08-04) FSA PN Issue No. 215

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Fld Name /
Item No.
from
Nearest
Town
2(B)
State(s)
Where Farm
and
Equipment
are Located
2(B)(1)
Line
Number
2(B)(2)
Quantity
2(B)(3)
Kind
2(B)(4)
Manufacturer
2(B)(5)
Size and
Type
2(B)(6)
Condition
2(B)(7)
Year of
Manufacture
2(B)(8)
Serial or
Model
Number
2(B)(9)
Fixtures

FORM FSA-440-4A
Instruction

Enter the name of the State(s) where the farm and other equipment
listed in Items 2B(1) through 2B(8) is located.

Enter a line number for each entry. Line numbers must be sequential,
beginning with number 1.
Enter the quantity of each kind of equipment.
Enter the kind of equipment.
Enter the manufacturer for each piece of equipment.
Enter the equipment's size and type.
Enter the condition for each piece of equipment (i.e. Excellent, Good,
Fair or Poor).
Enter the year the equipment was manufactured.

Enter equipment's serial and model number.

Enter description of fixtures and the legal description of the associated
real estate. If more space is needed, insert an additional page. This
page should be initialed by the debtor.

(12-08-04) FSA PN Issue No. 215

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2(C)
State(s)
Where
Livestock
and Other
Farm
Products
Are Located
2(C)(1)
Line
Number
2(C)(2)
Quantity
2(C)(3)
Kind-Sex
2(C)(4)
Breed
2(C)(5)
Color
2(C)(6)
Weight
2(C)(7)
Age
2(C)(8)
Brands or
Other
Identification
2(D)
All
Accounts

FORM FSA-440-4A

Enter the State(s) where the livestock or farm products listed in Items
2C(1) through 2C(8) are located.

Enter a line number for each entry. Line numbers must be sequential,
beginning with number 1.
Enter the quantity of each kind of livestock listed.
Enter the kind/sex for the animals listed.
Enter the breed for the animals listed.
Enter the color for the animals listed.
Enter the approximate average weight for the animals listed.
Enter the age or age range for the animals listed.
Note any brands or other identifying marks for the animals listed.

List all accounts, deposit accounts, goods, supplies, inventories, etc.,
that may serve as security.

The Debtor(s) MUST READ ITEMS 3 and 4 before signing the form in Item 5.
5
Debtor(s)
Signature

Enter legal signature(s) and date(s) of the debtor(s).
NOTE: If applicable, the debtor(s) will affix their Seal to the form
above their signature(s).

Space provided for additional signatures.

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FORM FSA-440-4A

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FORM FSA-440-4A

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(12-08-04) FSA PN Issue No. 215

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(12-08-04) FSA PN Issue No. 215

FORM FSA-440-4A

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