IA Form ISR10 OMB Control No. 1076-0020
Revised March 2010 Expires: ________________
Indian
Affairs Interest Subsidy Report
(Using
this form is optional, but it complies with 25 CFR §
103.23.)
Paperwork
Reduction Act Notice:
This form is covered by the Paperwork Reduction Act.
It is used to calculate and document the amount of interest
subsidy for which the Federal government may reimburse respondent.
The information is provided by respondents to obtain or
retain a benefit. In compliance with the Paperwork
Reduction Act of 1995, as amended, the collection has been reviewed
by the Office of Management and Budget and assigned a number and an
expiration date. The number and expiration date are
at the top right corner of the form. An agency may
not sponsor or conduct, and a person is not required to respond to,
a request for information collection unless it displays a currently
valid OMB Control Number. The public reporting burden is estimated
to average 2
hours per respondent.
This includes the time needed to understand the
requirements, gather the information, complete the form, and submit
it to the Department. Comments regarding the burden
or other aspects of the form may be directed to the Indian Affairs
Information Collection Clearance Officer, Office of Regulatory
Affairs – Indian Affairs, 1849 C Street, NW, MS-4141,
Washington, DC 20240.
Privacy
Act Statement (5 U.S.C. 552(a)): The
authority for collecting this information is 25 U.S.C. 1511.
The information will be used to administer the Loan
Guarantee, Insurance and Interest Subsidy Program, 25 U.S.C. 1481 et
seq. Disclosures of this information may be made to
track and record payments and unpaid balances and provide
information on payments made for paying interest subsidy, credits
obtained, service loans made, and premiums paid by Lenders, and for
the other routine uses described by system of record notice, BIA-13,
Loan Management and Accounting System.
This
Interest Subsidy Report (“Report”) covers the period
from _____________, 20__ to _____________, 20__
(“Reporting Period”).
The
Lender may include summaries for multiple loans and/or Borrowers in
a single Report, as long as the information concerning each loan
and each Borrower is complete and attached to this Report as a
separate Calculation Page. See,
Exhibit
A,
attached. Blank Exhibits
A
may be reproduced by the Lender as necessary to attach to this
Report.
The
Lender also must attach a printout or duplicate of its loan payment
history for each loan on which interest subsidy is to be paid,
identifying the Lender’s loan number, the Borrower, and the
date and amount of all loan balance activity for the reporting
period.
By
submitting this Report, the official signing for the Lender below
represents that he or she (a) has been given due authority from the
Lender to submit this Report on its behalf, (b) has made diligent
inquiry into the truth and accuracy of the information contained in
this Report, and (c) believes this Report is an appropriate claim
for the payment of interest subsidy under the provisions of the
Loan Guarantee, Insurance and Interest Subsidy Program, 25 U.S.C.
§§ 1481 et
seq.,
1511 et
seq.,
and 25 CFR Part 103.
Lender:_____________________________
ABA No.:___________________________
By:_________________________________
Its:_________________________________
Date
of this Report:______________, 20 __.
Lender:
__________________________________ Address:
__________________________________
Borrower:__________________________________
Address:__________________________________
Exhibit
A Calculation
Page
Lender:___________________________________________________
Reporting Period: _____________, 20____ to _____________, 20____
Loan Guarantee Certificate No.: ___________________________
Loan Insurance Agreement No.: ___________________________
Date
of Loan:_______________, 20___.
Date
of BIA insurance approval:_______________, 20___.
List
the total accrued interest paid on the Loan during the Reporting
Period: $____________
In
Box A below, list the Treasury/IFA interest rate established for
the Loan. Please use decimals; e.g.,
5.5% = .055.
In
Box B below, list the Lender’s interest rate for the
Reporting Period. Again, please use decimals;
e.g.,
8.75% = .0875. If there is an adjustable interest rate which
changed during the Reporting Period, fill out more than one row
and indicate the portion of the Reporting Period during which
the specified interest rate was in effect.
Subtract
the Treasury interest rate (Box A) from the Lender’s
interest rate (Box B), then divide the result by the Lender’s
interest rate. Put the quotient in Box C.
This number is the Subsidy Factor. Using the example
above, if the Treasury/IFA interest rate is 5.5% and the
Lender’s interest rate is 8.75%, the Subsidy Factor is
(.0875.055)/.0875 = .37142.
In
Box D, please list the amount of accrued interest paid on the
Loan during each segment of the Reporting Period for which there
was a different Lender’s interest rate (Box B).
When totaled, the amount(s) listed in Box(es) D should equal the
total accrued interest figure entered in item 1, above.
(Note that if the Loan has a fixed rate of interest, or if it
has an adjustable rate of interest that did not change during
the Reporting Period, the Lender should fill out only one row of
Boxes below.)
Multiply
the Subsidy Factor(s) (Box C) by the corresponding amount(s) of
interest paid (Box D), and enter the product(s) in Box E.
If
there is more than one row filled out below, total the amounts
from Box E in the space provided.
Treasury Indian Financing Act Rate |
B Lender’s Interest Rate (and dates applicable, if less than entire Reporting Period) |
C Subsidy Factor (B-A)/B |
D Accrued Interest Paid on Loan |
E Subsidy Due from DOI |
|
________________
(from__/__/__ to __/__/__)
|
|
$ |
$ |
|
________________
(from__/__/__ to __/__/__)
|
|
$ |
$ |
|
________________
(from__/__/__ to __/__/__)
|
|
$ |
$ |
Original
Loan Principal Amount: $__________________________ (Exclusive of
amounts potentially added pursuant to 25 CFR §§ 103.8,
103.34, or 103.36.)
Lender’s
Internal Loan Number: ___________________________
TOTAL:
$________________
| File Type | text/rtf |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |