FSA-2028 Date of Modification 12-31-07
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					Fld Name / | Instruction | 
| 1(a) Month and Day | Enter the month and day and year this agreement is signed (i.e. March 10, 2006). | 
| 1(b) Name of Debtor | Enter the legal name of the debtor(s). | 
| 1(c) Mailing Address | Enter debtor’s complete mailing address, including zip code. | 
| 2(a) Description of Collateral | Enter a description of the collateral in the space provided. | 
| 2(b)(1) Farms/Other Real Estate Owner | Enter farm name or landowner name where all crops are or will be grown. | 
| 2(b)(2) Approximate Number of Acres | Enter the approximate number of acres for land listed in Item 2(b)(1). | 
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					Fld Name / | Instruction | 
| 2(b)(3) County and State | Enter the County and State where the farm(s) listed in Item 2(b)(1) are located. | 
| 2(b)(4) Distance and Directions from Nearest Town | Enter a brief description of approximate distance and directions from the nearest town or landmark to the farm(s) listed in Item 2(b)(1). | 
| 2(c)(1) State(s) Where Farm… | Enter the name of the State(s) where the farm and other equipment listed in Items 2(c)(2) through 2(c)(9) is located. | 
| 2(c)(2) Line Number | Enter a line number for each entry. Line numbers must be sequential, beginning with number 1. | 
| 2(c)(3) Quantity | Enter the quantity of each kind of equipment. | 
| 2(c)(4) Kind | Enter the kind of equipment. | 
| 2(c)(5) Manufacturer | Enter the manufacturer for each piece of equipment. | 
| 2(c)(6) Size and Type | Enter the equipment's size and type. | 
| 2(c)(7) Condition | Enter the condition for each piece of equipment (i.e. Excellent, Good, Fair or Poor). | 
| 2(c)(8) Year of Manufacture | Enter the year the equipment was manufactured. | 
| 2(c)(9) Serial or Model No. | Enter equipment serial and model number. | 
| 2(c)(10) Fixtures | Enter description of fixtures and the legal description of the associated real estate. If more space is needed, insert an additional page. This page should be initialed by the debtor. | 
| 2(d)(1) State(s) Where Livestock… | Enter the State(s) where the livestock or farm products listed in Items 2(d)(2) through 2(d)(9) are located. | 
| 2(d)(2) Line Number | Enter a line number for each entry. Line numbers must be sequential, beginning with number 1. | 
| 2(d)(3) Quantity | Enter the quantity of each kind of livestock listed. | 
| 2(d)(4) Kind-Sex | Enter the kind or sex for the animals listed. | 
| 2(d)(5) Breed | Enter the breed for the animals listed. | 
| 2(d)(6) Color | Enter the color for the animals listed. | 
| 2(d)(7) Weight | Enter the approximate average weight for the animals listed. | 
| 2(d)(8) Age | Enter the age or age range for the animals listed. | 
| 2(d)(9) Brands or Other Identifi- cation | Enter description of any brands or other identifying marks for the animals listed. | 
| 2(e) List All Accounts | List all accounts, deposit accounts, goods, supplies, inventories, investment property, etc., that may serve as security. | 
| 5 Certification | Read Items 3 and 4 and the certification before signing the form. | 
| 6A Debtor Signature | Enter legal signature and date the document is executed. 
 NOTE: If applicable, the debtor(s) will affix their Seal to the form above their signature(s). | 
| 6B Debtor Signature | Enter legal signature and date the document is executed. 
 NOTE: If applicable, the debtor(s) will affix their Seal to the form above their signature(s). | 
Space provided for additional signatures.
	Page 
| File Type | application/msword | 
| File Title | INSTRUCTIONS FOR PREPARATION | 
| Author | cquayle | 
| Last Modified By | maryann.ball | 
| File Modified | 2010-07-01 | 
| File Created | 2010-07-01 |