FSA-2570 Offer to Convey Survey

Form Approved - OMB No. 0560-XXXX

This form is available electronically.

FSA-2570

U.S. DEPARTMENT OF AGRICULTURE
Farm Service Agency

(Proposal 3)

Position 1 (Chattels)
Position 5 (Real estate)

OFFER TO CONVEY SECURITY
PART A - BORROWER OFFER TO CONVEY SECURITY

(1) I/We,
(borrower), hereby offer to convey to the United States, U.S. Department of Agriculture, acting through the Farm Service Agency
(Government), the property covered by mortgages, deeds of trust, or other security instruments held by the Government.
(2) Borrower requests:
(a)

full satisfaction of the debt

(b)

a credit equal to the value of the property as determined by the Government, less prior liens, if any, secured or
described in such instruments and any obligations incurred on borrower's behalf, as authorized in Item 4 (c), in
connection with the conveyance of satisfactory title to the Government.

(3) Borrower agrees to remove at own expense all prior and junior liens (except Government liens), and all other encumbrances and
title defects (now known or hereafter disclosed) except those approved by the Government in writing.
(4) Borrower agrees to pay the following items, or request the items be paid by the Government and charged to their account, as
indicated below:

Item

Paid by borrower

May be paid by Government

(a) Expenses necessary or incidental to such conveyance (including but not
limited to expenses to title examination, survey, revenue stamps, notary and
recording fees).
(b) Cost of keeping insurance in force on the property in accordance with the
provisions of the security instruments until the deed to FSA is recorded.
(c) Cost of title insurance if required by FSA.
(d) Taxes and assessments, and any liens approved by FSA for which payment
is necessary to clear title.

(5) Borrower hereby assigns to the Government the following:
(a) all rights, title and interest in all insurance premiums paid by the Government and charged to the account and all unpaid
claims arising from insurance policies in effect at any time on any buildings on the property;
(b) all rights, title and interest in all abstract of title, title insurance policies or other title evidence, and in all outstanding leases to
which the property is subject, including oil and gas and other types of mineral leases; and
(c) funds now on deposit, including borrower and Government funds in a construction, supervised, or other account under
agreement with the Government and
(bank);
(d) all rights, title and interest in all contract rights, inventories, equipment, furnishings, accounts, general intangibles, gross
receipts, gifts, pledges, income, and revenue as described in security instruments held by the Government.
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, disability, and where applicable, sex, marital status,
familial status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part of an individual's income is derived from any public assistance program. (Not
all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact USDA's
TARGET Center at (202) 720-2600 (voice and TDD). To file a complaint of discrimination, write to USDA, Director, Office of Civil Rights, 1400 Independence Avenue, S.W., Washington, D.C.
20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.

FSA-2570 (Proposal 3) Page 2

(6) If cash proceeds are received by the Government before title to the property passes to the Government, the proceeds shall be
applied to the debt.
(7) Borrower agrees to deliver possession of the property to Government when notified by the Government of acceptance of offer.
(8) Borrower understands that the Government may accept or reject this offer at any time by providing a copy of this offer to the
borrower. Borrower understands that borrower may withdraw this offer by written notice to the Government at any time prior to
its acceptance by the Government.

(9A) Borrower's Name

(9B) Signature

(9C) Date

(10A) Borrower's Name

(10B) Signature

(10C) Date

(11A) Borrower's Name

(11B) Signature

(11C) Date

(12A) Borrower's Name

(12B) Signature

(12C) Date

PART B - FSA RECOMMENDATION/APPROVAL
(1) Borrower's offer to convey security is

(a) recommended

(b) not recommended

(2) Date

(3) Justification:

(4A) Authorized Agency Official Name

(5) Borrower's offer to convey security is

(4B) Signature

(a) accepted

(4C) Title

(b) rejected

(6) Date

(7) Justification:

(8A) Authorized Agency Official Name

NOTE:

(8B) Signature

(8C) Title

The following statements are made in accordance with the Privacy Act of 1974 (5 USC 552a): the Farm Service Agency (FSA) is authorized by the Consolidated Farm and Rural
Development Act, as amended (7 USC 1921 et seq.), or other Acts, and the regulations promulgated thereunder, to solicit the information requested on its application forms. The
information requested is necessary for FSA to determine eligibility for credit or other financial assistance, service the loan, and conduct statistical analyses. Supplied information may be
furnished to other Department of Agriculture agencies, the Internal Revenue Service, the Department of Justice or other law enforcement agencies, the Department of Defense, the
Department of Housing and Urban Development, the Department of Labor, the United States Postal Service, or other Federal, State, or local agencies as required or permitted by law. In
addition, information may be referred to interested parties under the Freedom of Information Act, to financial consultants, advisors, lending institutions, packagers, agents, and private or
commercial credit sources, to collection or servicing contractors, to credit reporting agencies, to private attorneys under contract with FSA or the Department of Justice, to business firms
in the trade area that buy chattel or crops or sell them for commission, to Members of Congress or Congressional staff members, or to courts or adjudicative bodies. Disclosure of the
information requested is voluntary. However, failure to disclose certain items of information requested, including Social Security Number or Federal Tax Identification Number, may result
in a delay in the processing of an application or its rejection.
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid
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