FSA-440-13 Report of Lien Search - Attorney/Agent

FORMS MANUAL INSERT

FORM FSA-440-13

Used by Agency official or
other searcher to annotate
type and period of liens
against property being offered
as security.

(SEE REVERSE)

PROCEDURE FOR PREPARATION

:

FSA Transferred Instruction 1941-B

PREPARED BY

:

Agency Official, Attorney or Representative.

NUMBER OF COPIES

:

Original and 1 copy.

SIGNATURE REQUIRED

:

Person completing the lien search.

DISTRIBUTION OF COPIES

:

Original to case file and copy to person completing lien search.

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

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FORM FSA-440-13

INSTRUCTIONS FOR PREPARATION
FSA Authorized Official will complete Items 1 through 9 and Item 17. FSA
Authorized Official or other Searcher will complete Items 10 through 16.
Items 1 - 9 to be completed by FSA.
Fld Name /
Item No.
1
FSA Office
Name and
Address
2
Name of
Applicant
3
Name of CoApplicant
4
Address of
Applicant
5
Name of
County
6
Records
Searched For
7
Types of Lien
and Period of
Search
8
Date Lien
Search
Requested
9
Requested By

Instruction
Enter the name and address of the FSA office requesting lien search.

Item 2A. Enter the name of the applicant.
Item 2B. Enter alias or other names used.
(Search all individuals or entity members pledging security for the
loan).
Item 3A. Enter the name of the co-applicant.
Item 3B. Enter alias or other names used.
Enter the complete mailing address of the applicant including zip
code.
Enter the County of the applicant's residence.
Enter either the name of the County or State depending on the type of
search being conducted. (ie., County – liens, mortgages or State UCC).
Items A – K. Enter an “X” in the appropriate box(es) to indicate the
type of lien for which records are being searched and annotate the
number of years to be searched.
Enter the date the search must be completed.

Enter the name of the Agency Official requesting the lien search.

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

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FORM FSA-440-13

Items 10 - 16 to be completed by FSA or Searcher.
Fld Name /
Item No.
10A
Type of Lien
or Instrument
10B
Date Filed
10C
File or Book
and Page
Number
10D
Amount
10E
Due Date
10F
To Whom
Given or
Assigned
10G
Description of
Property
11A
Signature
11B
Title
11C
Date
11D
Hour
12
Continuation
of Lien
Search
13A
Signature
13B
Title

Instruction
Enter the document relating to the lien search specified in Item 7.
Enter the filing date of document in Item 10A.
Enter the File or Book and Page Number listed on the recorded
document.
Enter the dollar amount on the document listed in Item 10A, if shown
on the instrument.
Enter the maturity or due date on the document in Item 10A, if shown.
Enter the name and address of the assignee of the instrument
(mortgagee, beneficiary, etc.) in Item 10A.
Enter the description of the property offered as security on the
instrument listed in Item 10A.
Enter the signature of the person conducting the search.
Enter the title of the person conducting the search.
Enter the date form is completed. (MM-DD-YYYY)
Enter the time the search is completed. (i.e., 3:15 pm)
Items 12A through 12G are used to update a previous search from the
date and time annotated in Items 11C and 11D above. (Complete only
if this is a subsequent search).
Enter the signature of the person conducting the search.
Enter the title of the person conducting the search.

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

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Fld Name /
Item No.
13C
Date
13D
Hour
14
Continuation
of Lien
Search
15A
Signature
15B
Title
15C
Date
15D
Hour
16
Remarks

FORM FSA-440-13
Instruction

Enter the date form is completed. (MM-DD-YYYY)
Enter the time the search is completed. (i.e., 3:15 pm)
Items 14A through 14G are used to complete a subsequent update of a
previous search from the date and time annotated in Items 13C and
13D above.
Enter the signature of the person conducting the search.
Enter the title of the person conducting the search.
Enter the date form is completed. (MM-DD-YYYY)
Enter the time the search is completed. (i.e., 3:15 pm)
Enter any remarks or comments.

Item 17 to be completed by FSA.
17
Name

Enter the name of the FSA official requesting the lien search.

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

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FORMS MANUAL INSERT

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

FORM FSA-440-13

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