FSA-2538 Response to Notification of Homestead Protection

Farm Loan Programs - Direct Loan Servicing - Special ( 7 CFR 766)

FSA2538

OMB: 0560-0233

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Form Approved - OMB No. 0560-0233
Position 4

U.S. DEPARTMENT OF AGRICULTURE
Farm Service Agency

FSA-2538
(12-31-07)

RESPONSE TO NOTIFICATION OF CONSIDERATION FOR HOMESTEAD
PROTECTION
FOR BORROWERS WHO RECEIVED FSA-2537

TO:

Farm Service Agency

I have read the Notification of Consideration for Homestead Protection which I received with this response
form. I want to withdraw my request for Homestead Protection.

NOTE: This form must be signed by all parties (entity and individual) that executed the promissory note(s) or
assumption agreement(s), and have not previously been released of liability for the debt. All parties may either
sign one form or duplicates of the form, but all must sign.
1A. Borrower’s Name

1B. Signature

1C. Date

2A. Borrower’s Name

2B. Signature

2C. Date

3A. Borrower’s Name

3B. Signature

3C. Date

4A. Borrower’s Name

4B. Signature

4C. Date

NOTE:

The following statements are made in accordance with the Privacy Act of 1974 (5 USC 552a): the Farm Service Agency (FSA) is authorized
by the Consolidated Farm and Rural Development Act, as amended (7 USC 1921 et seq.), or other Acts, and the regulations promulgated
thereunder, to solicit the information requested on its application forms. The information requested is necessary for FSA to determine
eligibility for credit or other financial assistance, service your loan, and conduct statistical analyses. Supplied information may be furnished
to other Department of Agriculture agencies, the Internal Revenue Service, the Department of Justice or other law enforcement agencies, the
Department of Defense, the Department of Housing and Urban Development, the Department of Labor, the United States Postal Service, or
other Federal, State, or local agencies as required or permitted by law. In addition, information may be referred to interested parties under
the Freedom of Information Act, to financial consultants, advisors, lending institutions, packagers, agents, and private or commercial credit
sources, to collection or servicing contractors, to credit reporting agencies, to private attorneys under contract with FSA or the Department of
Justice, to business firms in the trade area that buy chattel or crops or sell them for commission, to Members of Congress or Congressional
staff members, or to courts or adjudicative bodies. Disclosure of the information requested is voluntary. However, failure to disclose certain
items of information requested, including Social Security Number or Federal Tax Identification Number, may result in a delay in the
processing of an application or its rejection.
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
0560-0233. The time required to complete this information collection is estimated to average 5 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. RETURN THIS COMPLETED FORM TO YOUR LOCAL FSA OFFICE.

The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age,
disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs,
reprisal, or because all or part of an individual's income is derived from any public assistance program. (Not all prohibited bases apply to all programs.)
Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact
USDA's TARGET Center at (202) 720-2600 (voice and TDD). To file a complaint of discrimination, write to USDA, Director, Office of Civil Rights, 1400
Independence Avenue, S.W., Washington, D.C. 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity
provider and employer.

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File Typeapplication/pdf
File TitleFSA2538_071231V01.doc
AuthorLiz.Ashton
File Modified2010-08-30
File Created2007-12-15

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