FSA-2044 Assignment of Income from RE Security

Form Approved – OMB No. 0560-0237

(See Page 2 for Privacy Act and Public Burden Statements)

FSA-2044 (12-31-07)	U. S. DEPARTMENT OF AGRICULTURE Farm Service Agency ASSIGNMENT OF INCOME FROM REAL ESTATE SECURITY	Position 5
PART A - AGREEMENT

1. The United States, acting through the U.S. Department of Agriculture, Farm Service Agency (FSA), is the

holder of a loan in the sum of (a)			     
     					dollars (b) ($)		     			,
made to (c)		     						, (Borrower);
of (d)	     			County, State of (e)		     			.

2. Therefore, in consideration of the FSA’s making the loan or permitting the Borrower to execute the lease or other instrument described below, the Borrower sells, assigns, transfers, and conveys to the FSA

(a)

     

percent (b) (

     

%) of any and all

rents, royalties, bonuses, payments, delay monies, damages, and other income which may now be or later become owing to the Borrower under the terms of this instrument, which is described as follows:

(c) Instrument Title:	     
(d) Date of Instrument:		     
(e) Name of Parties:	     
(f) Recording Information, if any:			     

The instrument described above indicates an interest in the following described property situated in the State
of (g)		     		, County or Counties of
(h)	     		; more particularly described as follows:
(i)	[Legal Description of Property]

or of any renewal or extension of the instrument or of any other lease or agreement supplementary to it which may be entered into between the Borrower and the Lessee or other interested party (third party). The Borrower covenants that the Borrower has made no other assignment or encumbrance of such income.

3. The third party, heirs, executors, administrators, successors, and assigns of the third party are directed to pay to FSA the above listed percentage of all sums now owing or to become owing to the Borrower under the instruments by checks payable to:

	the Farm Service Agency, for the account of (a)			     		.
	(b)	     			and the Farm Service
Agency, to be remitted to FSA at (c)			     
     

or to such other person as may be designated in writing by FSA, until notified in writing by FSA of the termination of this assignment.

4. This assignment shall terminate when the above listed indebtedness of the Borrower is paid in full, provided however, that the third party shall not be liable to the Borrower for any payment to FSA which the third party may have made after the Borrower’s indebtedness was paid in full, unless the third party received, prior to any such payment, written notice from the FSA that the Borrower’s indebtedness has been paid in full.

5. FSA assumes no responsibility under any of the provisions of the instrument described above, or of any other agreements between the Borrower and the third party.

6. Each amount received by the FSA under this assignment shall be used in accordance with the regulations of the FSA in effect when such amount is received.

7. IN WITNESS WHEREOF, the Borrower has signed and sealed this assignment on

     

.

8A. Borrower’s Name	8B. Signature	8C. Date
    		     
9A. Borrower’s Name	9B. Signature	9C. Date
     		     
10A. Borrower’s Name	10B. Signature	10C. Date
     		     
11A. Borrower’s Name	11B. Signature	11C. Date
     		     

PART B – THIRD PARTY ACKNOWLEDGMENT

The undersigned third party recognizes the foregoing assignment, and agrees to remit to FSA the percentage of income in the manner and amount specified in this assignment.

1. Name and Address of Third Party	2. Authorized Officer of Third Party Name and Title
     	    
3. Date	4. Signature
     

NOTE: 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,

(7 USC 1921 et seq.), and the regulations promulgated thereunder, to solicit the information requested on this form. The information requested is necessary for FSA to determine eligibility for financial

assistance and conduct statistical analyses. Supplied information may be furnished to other Department of Agriculture agencies, the Department of the Treasury, 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 (FOIA), 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 your Social Security Number or Federal Tax Identification

Number, may result in a delay in the processing of this form 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 OMB control

number. The valid OMB control number for this information collection is 0560-0237. The time required to complete this information collection is estimated to average 20 minutes 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. RETURN THIS

COMPLETED FORM TO YOUR LOCAL FSA OFFICE.

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.

PART C – RELEASE OF MORTGAGE INTEREST

The FSA’s interest in the property described in this instrument ceased as of (1)

     

and the FSA shall have no interest in such property thereafter.

2A. Authorized Agency Official Name	2B. Signature	2C. Title