Form RD 1980-13 RD 1980-13 Annual Interest Assistance Agreement

ANNUAL INTEREST ASSISTANCE AGREEMENT
Guaranteed RH Loans

Form RD 1980-13
(Rev. 5-95)
Date of Note

Amount of Note

Type of Agreement

Note Rate

Floor Rate

1
New 2
Case Number

%
Loan Number

Corrected

FORM APPROVED
OMB NO. 0575-0078

Mid-Term Revision

3

4

Cancellation

Effective Date

%
Lender Identification Number

Branch Number

I. This agreement between the United States of America, acting through the Rural Housing Service and Community Development Service pursuant to
Title V of the Housing Act of 1949, (called ''the Government") and the borrower whose name appears below (called ''Borrower'') supplements the Master
Interest Assistance and Shared Equity Agreement with Promissory Note dated
(called Master Agreement whether one or more).
II. TO BE COMPLETED BY BORROWER (If additional space is needed, attach additional sheets)
A. Complete the following for borrower, co-borrower,
Planned Income
and all adult members of the household who will
Next 12 Months
receive income.
Name
Age
Wages
Other
Names and addresses of employer or source of income
1.
2.
3.
B. Number of dependents (not including foster children) residing in the dwelling

SIGNATURES OF BORROWERS. I (we) certify that this information is correct to the best of my (our) knowledge and have read and understand the
requirements and conditions on the Master Agreement.
WARNING: Section 1001 of Title 18, United States Code, provides: ''Whoever, in any matter within the jurisdiction of any department or agency of

the United States knowingly and willfully falsifies, conceals or covers up by any trick, scheme, or device ... a material fact, or makes any false,
fictitious or fraudulent statements or representations, or makes or uses any false writing or document knowing the same to contain any false, fictitious
or fraudulent statement or entry, shall be fined under this title or imprisoned not more than 5 years, or both.''

(Borrower)

(Co-Borrower)

(Date)

III. TO BE COMPLETED BY THE LENDER

Complete this column for each Loan Note

1. Annual Income

4. Installment (@ Note Rate)
5. Installment (@ Note Rate)
6. Difference

2. Deductions

7. Interest Assistance Monthly
Overpayment to be Offset

3. Adjusted Annual Income
(1 minus 2)
Low-Income Limit - Maximum

Total Amount
Monthly Amount

IV. MONTHLY INSTALLMENT NOTE: Subject to the provisions of this agreement, the borrower will pay
dollars per month for 12 months
beginning
(not including any amounts required for taxes and insurance escrow accounts). This agreement may be revised or
cancelled as provided by the conditions listed on the Master Agreement.
Prepared by (Authorized Lender Signature & Title)
UNITED STATES DEPARTMENT OF AGRICULTURE Rural Housing and
Community Development Service (Authorized Signature & Title)
Date

Date

V. The Government's share of payments made under this agreement are reduced by
dollars per month for
which the Government and Borrower agree represents an overpayment of assistance for the
months to offset the amount of
to
.
period
VI. TO BE COMPLETED BY RHS SERVICING OFFICE ONLY: The lender is entitled to a processing fee for the preparation of this agreement.
Enter 1 for system generated check, 2 for manual check (Finance Office Only), or 3 for no check issued.
Date of Processing Fee
(Finance Office Only)
VII. FINANCE OFFICE USE ONLY
Check Issue Code
Manual Check (Interest Assistance)

...............................................

(Date)

(Amount)

Information provided on this form is used by RHCDS to calculate the amount of interest subsidy the borrower will receive and the amount of loan
installment the borrower will pay in the ensuing year. Information collected is necessary to receive the subsidy benefits.
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 0575-0078. 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.

Position 2