Form ISR10 Interest Subsidy Report

IA Form ISR10
Revised XX 202X

OMB Control No. 1076-0020
Expires: XX/XX/202X

Indian Affairs Interest Subsidy Report
(Using this form is optional, but it complies with 25 CFR § 103.23)
Lender: ________________________________
Address: ________________________________
________________________________
Borrower: ______________________________
Address: ________________________________
________________________________
1.
This Interest Subsidy Report (“Report”) covers the period from _____________, 20__ to _____________,
20__ (“Reporting Period”).
2.
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.
3.
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.
4.
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:____________
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,
1001 Indian School Road NW, Suite 229, Albuquerque, New Mexico 87104.
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.

IA Form ISR10
Revised XX 202X

OMB Control No. 1076-0020
Expires: XX/XX/202X

Exhibit A
Calculation Page
Lender:___________________________________________________
Reporting Period: _____________, 20____ to _____________, 20____
Loan Guarantee Certificate No.: ___________________________
Loan Insurance Agreement No.: ___________________________
Date of Loan:_______________, 20___.
Date of IA insurance approval:_______________, 20___.
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: ___________________________
1
List the total accrued interest paid on the Loan during the Reporting Period: $____________
2
In Box A below, list the Treasury/IFA interest rate established for the Loan. Please use decimals; e.g., 5.5%
= .055.
3
In Box B below, list the Lender’s interest rate in effect on the date interest subsidy was approved. Again,
please use decimals; e.g., 8.75% = .0875. If there is an adjustable interest rate which changed during the Reporting
Period, only use the interest rate in effect on the day interest subsidy was approved.
4
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.
5
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. 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.)
6
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.

A
Treasury Indian
Financing Act
Rate

B
Lender’s Interest Rate

C
Subsidy Factor (BA)/B

D
Accrued Interest
Paid on Loan
$

E
Subsidy Due from
DOI
$

TOTAL: $________________