Report of Loss

USDA
FORM APPROVED
GUARANTEED LOAN REPORT OF LOSS
Form RD 449-30
OMB NO. 0575-0137
TRANSACTION 4041
(Rev. 08-09)
INSTRUCTIONS-TYPE IN CAPITALIZED ELITE TYPE IN SPACES MARKED
Complete items 1-6, 10-12, 15-34, 36-41 and 48-55 when report type is 1 (estimated loss). Complete items 1-6, 10-15, 25, 30-34, and 36-55 when report type is 2 (final loss) or 5
for (bankruptcy reorganization with no collateral). Complete item s 1-6, 10-34, 36-41, 48-55 when the report type is 5 (bankruptcy reorganization with collateral). Complete
items 1-6, 10, 12, 25, 30-34, 36-41, and 48-55 when the report type is 8 (interest loss payment). Complete item 1-6, 10, 46, 48-55 when the report type is 4 (recovery) or 13
(voluntary payment).
2A. AGENCY
2B. LOAN TYPE
3B. IS THE FINAL ESTIMATED
1. CASE NO.
3A. REPORT
BORROWER'S ID
LOSS PAYMENT UNDER THE
ST CO
LOAN NO.
TYPE CODE
TYPE CODE CHECKED?
YES

5. LENDER ID NO.

4. BORROWER NAME
7. CHECK ISSUE CODE
1 = SYSTEM GENERATED
2 = MANUAL CHECK
3 = NO CHECK ISSUED
4 = REFUND

(IRS No)

(F.O.
Only)

GUARANTEED LOAN ITEMS:

8. DATE MANUAL CHECK
YR ISSUED
MO
DA
(F.O.

DA

YR

Only)

(F.O.
Only)

LOSS GUARANTEED:

$ DOLLARS

11. PRINCIPAL BALANCE

31. PERCENT OF LOSS
GUARANTEED

12. ACCRUED INTEREST
OWED

32. AMOUNT TO BE PAID

13. PRINCIPAL BALANCE OWED ON
PROTECTIVE ADVANCES

33. (Sum of Prin. Advance +

14. ACCRUED INTEREST ON
PROTECTIVE ADVANCES

34. MAXIMUM LOSS ALLOWED

15. TOTAL (Add items 11 - 14)

10. DATE OF SETTLEMENT

9. DATE OF DEPOSIT
MO

NO

6. AGENCY'S LENDER
BRANCH NO.

MO

DA

YR

$ DOLLARS
(Percent)

(item 30 X item 31)

item 12) X item 31)

(Lessor of items 32 or 33)

$0.00

35. ALLOWANCES TO LENDER
LIQUIDATION COST

(F.O.
Only)

PRIOR LIEN AMOUNTS OWED TO SETTLEMENT DATE:

ADJUSTMENTS TO PROTECTIVE ADVANCES & INTEREST

16. REAL ESTATE DEBTS

36. PROTECTIVE ADVANCES PLUS
INTEREST (Items 13 + 14) X item 31)

17. PERSONAL PROPERTY DEBTS

GUARANTEE (Item 34 minus item 36)

18. UNPAID TAXES, ASSESSMENTS,
GROUND RENTS, ETC.

$0.00
(Percent)

38. PERCENT OF GUARANTEED
PORTION HELD BY LENDER

19. TOTAL PRIOR LIENS
(Add items 16-18)

$0.00

37. REMAINING BALANCE LOSS

$0.00

39. LOSS ON GUARANTEED PORTION
HELD BY LENDER OR HOLDER

$0.00

(Item 37 X item 38)

COLLATERAL:

40. UNPAID ANNUAL/LATE FEES

20. REAL PROPERTY
VALUE

41. AMOUNT DUE LENDER

21. CHATTEL PROPERTY
VALUE

AMOUNT DUE LENDER OR USDA: (If Applicable)
42. PAID ON ANNUAL/LATE FEES

22. VALUE OF PERSONAL AND
CORPORATE GUARANTEES

43. AMOUNT PAID ON ESTIMATED LOSS

23. TOTAL (Add items 20 - 22)

44. BALANCE DUE LENDER

$0.00
24. NET COLLATERAL
(Item 23 minus item 19)

25. BASIC LOSS
(See Reverse for Instructions)

$0.00

(Item 36 + item 39 minus Item 40)

[(Item 41 minus Item 42 + item 43, (If positive)]

45. INTEREST ON OVERPAYMENT

$0.00

(Accrued interest due USDA)

46. AMOUNT DUE USDA BY LENDER

$0.00

$0.00

[(Item 42 + Item 43) minus ( Item 41 + Item 45)]

47. LENDER LOSS UNGUARANTEED

ADJUSTMENT TO BASIC LOSS:
26. FUNDS BEING HELD

48. NAME OF LENDER

27. INCOME TO BE APPLIED TO DEBT

49. BY
50. TITLE

28. BORROWER'S DEBT PAYMENT
ABILITY - PRESENT VALUE

51. DATE

52. TENTATIVE APPROVAL-USDA OFFICIAL

29. TOTAL DEDUCTIONS
(Add items 26 - 28)

$0.00

54. TITLE

30. ADJUSTED BASIC LOSS
(Item 25 minus item 29)

53. SIGNATURE
55. DATE

$0.00

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