FSA-2341 Date of Modification 12-31-07
	
	
| CERTIFICATION OF ATTORNEY | |
| INSTRUCTIONS FOR PREPARATION | |
| Purpose: This form is used to notify an attorney of his selection to handle a loan closing and for him to certify to his status as a practicing attorney and his liability and fidelity bond coverage. | |
| Handbook Reference: 3-FLP | Number of Copies: Original and One | 
| Signatures Required: Authorized Agency Official and Attorney. | |
| Distribution of Copies: Original in case file and copy to Attorney. | |
| 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): N/A | |
Parts A, B, and D completed by FSA.
Part C must be completed by the Attorney.
| 
					Fld Name / | Instruction | 
| A1 Attorney | Enter the name and address of the attorney/title company selected by the applicant to perform legal services and close the loan. | 
| A 2 FSA Office | Enter the name and address of the FSA Office. | 
| B1(a) Name of Applicant | Enter the full legal name of applicant. | 
| B1(b) Address | Enter the address of the applicant. | 
| B2A Agency Offical’s Name | Enter the name of the Agency Official signing this form. | 
| B2B Agency Official’s Title | Enter the title of the Agency Official signing this form. | 
| B2C Agency Official’s Signature 
 | Enter the signature of the Agency Official signing this form. | 
| 
				 Fld Name/ Item No. | Instruction | 
| B2D Date of Signature | Enter the date the form is signed by the Agency Official. | 
| C1(b)(c) State | Enter the Name of the State in which the Attorney is a member of the bar. | 
| C2(a)&(b) Method of Providing Clearance | Enter a check mark to indicate the appropriate type of clearance: (a) Title Opinion or (b) Title Insurance Policy. | 
| C3(a) Amount of Insurance | Enter the dollar amount of professional liability insurance per occurrence. | 
| C3(b) Insurance Company Name | Enter the name of the Attorney’s liability insurance company. | 
| C3(c) Insurance Company Address | Enter the address of the Attorney’s liability insurance company. | 
| C3(d) Deductible Amount | Enter the dollar amount of the policy deductible. | 
| C3(e) Policy Number | Enter the policy number. | 
| C3(f) Expiration Date | Enter the policy expiration date. 
 
 | 
| C 3(g) Fidelity Bond Coverage | Enter the amount of fidelity bond coverage for employees and associates having access to FSA loan funds. | 
| C4A Signature | Enter the Attorney’s Signature. 
 | 
| C4B Date | Enter the date the attorney or his representative signed the form. | 
| 
				 
 
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| 
				 Fld Name/ Item No. | Instruction | 
| 
				 FOR FSA’S USE ONLY. PART D – FSA APPROVAL. 
 | |
| D1 FSA’s Decision | Mark checkbox to indicate FSA’s decision to approve or disapprove the selected attorney. | 
| D2A Approval Official’s Name | Name of Approval Official. 
 
 | 
| D2B Approval Official’s Signature | Enter the signature of the Approval Official. | 
| D2C Date Signed | Enter the date the Approval Official signed the form. | 
	Page 
| File Type | application/msword | 
| File Title | Template Users: Select the text for each of the instruction components below and type over it without changing the font type, | 
| Author | Preferred Customer | 
| Last Modified By | maryann.ball | 
| File Modified | 2010-07-12 | 
| File Created | 2010-07-12 |