Form RD 5001-19 RD 5001-19 Lender's Guaranteed Loan Payment to USDA

UNITED STATES DEPARTMENT OF AGRICULTURE
FORM RD 5001-19
(00-00)

FORM APPROVED
OMB NO. 0000-0000

LENDER’S GUARANTEED LOAN PAYMENT TO USDA
TRANSACTION 4036

INSTRUCTIONS Complete all items.
1. CASE NO.

2. LENDER TAX ID NO.

3. LOAN NO.

4. BRANCH NO.

5. BORROWER NAME

6. LENDER NAME

7. RECEIVABLE NO.

8. DATE INTEREST PAID THROUGH
TO USDA
MO
DA
YR

9. AMOUNT OF PRINCIPAL PAYMENT

10. AMOUNT OF INTEREST PAYMENT

$

8A. DATE PRINCIPAL PAID
(F.O. USE ONLY)
MO
DA
YR

$

11. TOTAL REMITTANCE

12. DATE OF DEPOSIT
(Item 9 + Item 10)

MO

DA

YR

(To be completed by USDA)

$
13. PAYMENT CODE

01 = Regular Payment
02 = Deferred Payment

14. SERVICING FEE CODE

01 = Accrued Interest
02 = Servicing Fee
(To be completed by Finance Office)

15. AUTHORIZED LENDER’S SIGNATURE

16. TITLE

17. DATE

This report contains information which must be furnished by the lender in order to fulfill requirements and retain the benefit of a USDA loan guarantee. This statement is
furnished pursuant to P.L. 96-511.
According to the Paperwork Reduction Act of 1995, no persons are 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 0000-0000. The time required to complete this information collection is estimated to average 1 hour 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.

Form RD 5001-19 Page 1 of 2

INSTRUCTIONS FOR PREPARATION
To transmit any funds due USDA when USDA has purchased a part or all of the guaranteed portion of the loan, including USDA’s pro-rata share of any payments received from the
borrower or any funds received by the lender in the process of liquidation. The distribution of the funds between interest and principal should be in the same proportion as the
lender’s application to the borrower’s account, however, the lender’s application to the borrower’s account should have been applied to interest first and any remaining balance to
principal.
Item 1.

Enter the Borrower’s Case Number. Show the state and county code and the Borrower’s Social Security or Internal Revenue Service Tax Identification Number.

Item 2.

Enter the Lender’s Internal Revenue Service Tax Identification Number. Fill all leading zeros.

Item 3.

Enter the USDA assigned Loan Number.

Item 4.

Enter the USDA assigned Branch Number.

Item 5.

Enter the Borrower’s Name - Abbreviate when necessary.

Item 6.

Enter the Lender’s Name - Abbreviate when necessary.

Item 7.

Enter the applicable Receivable Number. (Assigned by Finance Office at time of purchase.)

Item 8.

Enter the date through which the accompanying payment pays accrued interest on USDA held portion of loan.

Item 8A.

Finance Office will enter date principal paid.

Item 9.

Enter USDA’s pro-rata share of funds received and applied to principal on the borrower’s loan (e.g. payments from the borrower or proceeds from rents, escrow balances,
sale of collateral, etc.)

Item l0.

Enter USDA’s pro-rata share of funds received and applied to the interest on the borrower’s loan (e.g. payments from the borrower or proceeds from rents, escrow balances,
sale of collateral, etc.)

Item 11.

Enter the total of items 9 and 10.

Item 12.

Finance Office or field office will enter the date the check was deposited.

Item 13.

Enter the applicable payment code. Code 01 is used when the loan payment is to be applied toward the regular balance of principal and/or interest. Code 02 is used when
the loan payment is to be applied toward the deferred principal and/or interest balance based on an approved agreement between USDA, the lender, and the borrower.

Item 14.

Finance Office will insert servicing fee code and verify the servicing fee amount authorized.

Items 15-17.

Self-explanatory.

Form RD 5001-19 Page 2 of 2