FSA- 2360 Date of Modification 12-31-07
	
Part A – Items 1 through 7 completed by FSA.
| 
					Fld Name / | Instruction | 
| 1A Name | Enter the applicant’s full legal name. | 
| 1B Known as | Enter any alias or other name used. | 
| 2 Address | Enter the mailing address and physical address if different from mailing address. | 
| 3 County of Residence | Enter the County where residence is located. | 
| 4 Records Searched | Enter the name of the County and State depending on the type of search being conducted for records searched. (ie., County - liens, mortgages or State – UCC). | 
| 5A-5K Types of Lien and Period of Search | Check 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. 
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| 6 Name of Agency Official | Enter the name of the Agency Official requesting the lien search. 
 
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| 7 Date | Enter the date Agency Official signs the form requesting the lien search. | 
| 
					Fld Name / | Instruction | 
| Part B- Items 1 through 19 completed by the attorney or representative. | |
| 1A Type of Lien | Enter the instrument relating to the lien search specified in Item 5. | 
| 1B Date Filed | Enter the filing date of document in Item 1A. | 
| 1C File or Book and Page Number | Enter the File or Book and Page Number where the recorded instrument is located. | 
| 1D Amount | Enter the dollar amount on the instrument listed in Item 1A, if shown on the instrument. | 
| 1E Due Date | Enter the maturity or due date of the instrument in Item 1A, if shown. | 
| 1F To Whom Given | Enter the name and address of the lienholder or assignee of the instrument (mortgagee, beneficiary, etc.). | 
| 1G Description of Property | Enter the description of the property offered as security on the instrument listed in Item 1A. | 
| 2 Name | Enter the person’s name conducting the lien search. | 
| 3 Title | Enter the person’s title conducting the lien search. | 
| 4 Signature | Enter the signature of the person conducting the search. | 
| 5 Date | Enter the date lien search is completed. | 
| 6 Hour | Enter the time the search is completed. (i.e., 3:15) and check the box for AM or PM. | 
| 7 Continuation of Lien Search | Items 7A through 7G are used to update a previous search from the date and time annotated in Items 5 and 6 above. (Complete only if this is a subsequent search). | 
| 8 Name | Enter the person’s name conducting the lien search. | 
| 9 Title | Enter the person’s title conducting the lien search. | 
| 10 Signature | Enter the signature of the person conducting the search. | 
| 11 Date | Enter the date lien search is completed. | 
| 12 Hour | Enter the time the search is completed. (i.e., 3:15) and check the box for AM or PM. | 
| 13 Continuation of Lien Search | Items 13A through 13G are used to complete a subsequent update of a previous search from the date and time annotated in Items 11 and 12 above. | 
| 14 Name | Enter the person’s name conducting the lien search. | 
| 15 Title | Enter the person’s title conducting the lien search. | 
| 16 Signature | Enter the signature of the person conducting the search. 
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| 17 Date | Enter the date lien search is completed. | 
| 18 Hour | Enter the time the search is completed. (i.e., 3:15 ) and check the box for AM or PM. | 
| 19 Remarks | Enter any remarks or comments. | 
| Part B - Item 20 is for FSA use only. | |
| 20 Address 
 | Enter the address where the completed report, other instruments or documents should be returned. | 
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| File Type | application/msword | 
| File Title | Instructions for FSA-441-25 | 
| Author | gg330 | 
| Last Modified By | maryann.ball | 
| File Modified | 2010-07-12 | 
| File Created | 2010-07-12 |