FSA-2236 (OMB 0560 Guaranteed Loan Closing Report

Form Approved – OMB No. 0560-0155
(See Page 2 for Privacy Act and Paperwork Reduction Act Statements)

This form is available electronically.

FSA-2236

U.S. DEPARTMENT OF AGRICULTURE
Farm Service Agency

(04-16-13)

Position 2

GUARANTEED LOAN CLOSING REPORT
Transaction 4030
4. LENDER ID NO.

1. FSA ACCOUNT NUMBER
A. STATE CODE

B. COUNTY CODE

5. LENDER STATUS 6. LENDER TYPE
CODE
CODE

C. FSA ID NUMBER
7. CERTIFICATION EFFECTIVE
DATE

8. CERTIFICATION EXPIRATION
DATE

2. BORROWER NAME AND ADDRESS

9. LENDER NAME AND ADDRESS

3. BORROWER TYPE CODE

10. SERVICING OFFICE (State and County Code)

11. SOURCE OF FUNDS

12. GUARANTEE FEE PURPOSE
CODE

13. FEE RATE
$

14. AMOUNT OF GUARANTEE
FEE PAID

15. AMOUNT OF LOAN-LINE OF
CREDIT

$

$

16. ADVANCE AMOUNT TO DATE

17. CLOSING DATE

$

18. MATURITY DATE OF LOAN

19. TERM OF INTEREST
ASSISTANCE YEARS

20. PERCENT OF LOAN
GUARANTEED

21. LENDER’S NOTE
INTEREST RATE
GUARANTEED PORTION

22. LENDER’S NOTE
INTEREST RATE ON
NONGUARANTEED
PORTION
%
26. TYPE OF GUARANTEE

23. INTEREST ASSISTANCE RATE 24. PERIOD OF OPERATING LINE
OF CREDIT

%

%

%
27. INTEREST BASIS
(360 OR 365 DAYS)

1 = LINE OF CREDIT
2 = LOAN NOTE
GUARANTEE

YEARS
28. INTEREST RATE CODE

25. RESERVED

29. BALANCE OWED ON LOAN

1 = SINGLE VARIABLE
2 = SINGLE FIXED

30. DATE GUARANTEE PERIOD 31. DATE GUARANTEE PERIOD
BEGINS
ENDS

3 = MULTI VARIABLE
4 = MULTI FIXED
32. ANNUAL REVIEW DATE

$

33. CERTIFIED LOAN
NO

YES

34. I certify that all conditions of the conditional commitment have been met and that this report accurately describes
the subject loan.
A. SIGNATURE OF AUTHORIZED LENDER REPRESENTATIVE

35. GUARANTEED LOAN
NUMBER

B. TITLE

COMPLETED BY AGENCY SERVICING OFFICE
36. OBLIGATED LOAN
37. BRANCH NUMBER
NUMBER

C. DATE
COMPLETED BY FINANCE OFFICE
38. DATE OF DEPOSIT

39. I have reviewed this report and the information is consistent with the conditional commitment and the supporting
documentation provided by the lender.
A. NAME OF AGENCY OFFICIAL (PRINTED)

B. TITLE (PRINTED)

C. SIGNATURE OF AGENCY OFFICIAL

D. DATE APPROVED

The U.S. Department of Agriculture (USDA) prohibits discrimination against its customers, employees, and applicants for employment on the bases of race, color, national origin, age, disability, sex, gender identity, religion, reprisal, and where
applicable, political beliefs, marital status, familial or parental status, sexual orientation, or all or part of an individual’s income is derived from any public assistance program, or protected genetic information in employment or in any program or
activity conducted or funded by the Department. (Not all prohibited bases will apply to all programs and/or employment activities.) Persons with disabilities, who wish to file a program complaint, write to the ad dress below or if you require
alternative means of communication for program information (e.g., Braille, large print, audiotape, etc.) please contact USDA’ s TARGET Center at (202) 720-2600 (voice and TDD). Individuals who are deaf, hard of hearing, or hav e speech
disabilities and wish to file either an EEO or program complaint, please contact USDA through the Federal Relay Service at (800) 877 -8339 or (800) 845-6136 (in Spanish).
If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, found online at http://www.ascr.usda.gov/complaint_filing_cust.html, or at any USDA office, or call (866) 632 9992 to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter by mail to U.S. Department of Agriculture, Director, Office of Adjudication, 1400
Independence Avenue, S.W., Washington, D.C. 20250 -9410, by fax (202) 690 -7442 or email at [email protected]. USDA is an equal opportunity provider and employer.

FSA-2236 (04-16-13)
NOTE:

Page 2
The following is made in accordance with the Privacy Act of 1974 (5 USC 552a – as amended). The authority for requesting the information
identified on this form is the Consolidated Farm and Rural Development Act, as amended (7 U.S.C. 1921 et. seq.). The information will be used
to determine eligibility and feasibility for loans and loan guarantees, and servicing of loans and loan guarantees. The information collected on
this form may be disclosed to other Federal, State, and local government agencies, Tribal agencies, and nongovernmental entities that have
been authorized access to the information by statute or regulation and/or as described in the applicable Routine Uses identified in the System of
Records Notice for USDA/FSA-14, Applicant/Borrower. Providing the requested information is voluntary. However, failure to furnish the
requested information may result in a denial for loans and loan guarantees, and servicing of loans and loan guarantees. The provisions of
criminal and civil fraud, privacy, and other statutes may be applicable to the information provided.
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
0560-0155. The time required to complete this information collection is estimated to average 1 hour 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 COUNTY FSA OFFICE.