FSA-2037 Farrm Business Plan - Balance Sheet

This form is available electronically. Form Approved – OMB No. 0560-0238

(See Page 3 for Privacy Act and Public Burden Statements.)

FSA-2037 U.S. DEPARTMENT OF AGRICULTURE Position 3 (11-04-10) Farm Service Agency FARM BUSINESS PLAN WORKSHEET Balance Sheet
1. NAME      								2. Date of Balance Sheet      
A – CURRENT ASSETS					B – CURRENT LIABILITIES
1A. Cash and Equivalents				$ Value	2A. Accounts Payable						$ Amount
     				     	     						     
     				     	     						     
1B. Marketable Bonds and Securities					     						     
     				     	     						     
     				     	     						     
1C. Accounts Receivable					2B. Income Taxes Payable						     
     				     	     						     
     				     	2C. Real Estate Taxes Payable						     
1D. Crop Inventory	1E. Measure	1F. # Units	1G. $/Unit	$ Value	     						     
     	     	     	     	     	Notes Payable Due Within 12 Months
     	     	     	     	     	2D. Creditor					2E. Purpose
     	     	     	     	     		2F. Interest Rate	2G. Accrued Interest		2H. Payment Amount	2I. Next Payment Date	2J. Principal Balance
     	     	     	     	     	(1)      					     
1H. Growing Crops		1I. # Acres	1J. Cost/Acre	$ Value		     	     		     	     	     
     		     	     	     	(2)      					     
     		     	     	     		     	     		     	     	     
     		     	     	     	(3)      					     
     		     	     	     		     	     		     	     	     
1K. Market Livestock-Poultry	1L. # Head	1M. Weight	1N. $/Unit	$ Value	(4)      					     
     	     	     	     	     		     	     		     	     	     
     	     	     	     	     	2K. Accrued Interest On:						$ Amount
     	     	     	     	     	(1) Current Liabilities						     
     	     	     	     	     	(2) Intermediate Liabilities						     
     	     	     	     	     	(3) Long Term Liabilities						     
1O. Livestock Products	1P. Measure	1Q. # Units	1R. $/Unit	$ Value	2L. Current Portion of Principal Due On:
     	     	     	     	     	(1) Intermediate Liabilities						     
     	     	     	     	     	(2) Long Term Liabilities						     
1S. Prepaid Expenses and Supplies					2M. Other Current Liabilities
     				     	     						     
     				     	     						     
1T. Other Current Assets					     						     
     				     	     						     
1U. TOTAL CURRENT ASSETS (Items 1A through 1T)				     	2N. TOTAL CURRENT LIABILITIES (Items 2A through 2M)						     

FSA-2037 (11-04-10) Page 2 of 4

C – INTERMEDIATE ASSETS

E – INTERMEDIATE LIABILITIES

3A. Machinery & Equipment/Farm Vehicles (Entered on Page 4)

5A. Creditor

5B. Purpose

3B. Breeding Stock

3C. Raised/Purch

3D. # Head

3E. $/Head

$ Value

5C. Interest Rate

5D. Accrued Interest

5E. Payment Amount

5F. Next Payment Date

5G. Principal Balance

     

     

     

     

     

(1)      

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

(2)      

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

(3)      

     

     

     

     

     

     

     

     

     

     

     

3F. Notes Receivable

(4)      

     

     

     

     

     

     

     

     

     

     

(5)      

     

3G. Not Readily Marketable Bonds and Securities

     

     

     

     

     

     

     

(6)      

     

     

     

     

     

     

     

     

3H. Other Intermediate Assets

(7)      

     

     

     

     

     

     

     

     

     

     

3I. TOTAL INTERMEDIATE ASSETS (Items 3A through 3H)

     

5H. TOTAL INTERMEDIATE LIABILITIES (Item 5G (1 through 7))

     

D – LONG TERM ASSETS

F – LONG TERM LIABILITIES

4A. Building and Improvements

$ Value

6A. Creditor

6B. Purpose

     

     

6C. Interest Rate

6D. Accrued Interest

6E. Payment Amount

6F. Next Payment Date

6G. Principal Balance

     

     

(1)      

     

     

     

     

     

     

     

     

     

     

(2)      

     

4B. Real Estate-Land

4C. Total Acres

4D. Crop Acres

4E. %Owned

4F. $/Acre

     

     

     

     

     

     

     

     

     

     

     

(3)      

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

(4)      

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

(5)      

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

(6)      

     

     

     

     

     

     

     

     

     

     

     

     

4G. Other Long Term Assets

$ Value

(7)      

     

     

     

     

     

     

     

     

     

     

4H. TOTAL LONG TERM ASSETS (Items 4A through 4G)

     

6H. TOTAL LONG TERM LIABILITIES (Item 6GA (1 through 7))

     

4I. TOTAL FARM ASSETS (From Items 1U, 3I and 4H)

     

6I. TOTAL FARM LIABILITIES (From Items 2N, 5H, and 6H)

     

6J. TOTAL FARM EQUITY (Item 4I minus Item 6I)

     

FSA-2037 (11-04-10) Page 3 of 4

G – PERSONAL ASSETS			H – PERSONAL LIABILITIES
		$ Value	8A. Creditor					8B. Purpose
7A. Cash and Equivalents		     		8C. Interest Rate	8D. Accrued Interest	8E. Payment Amount		8F. Next Payment Date	8G. Principal Balance
7B. Stocks, Bonds		     	(1)      					     
7C. Cash Value Life Insurance		     		     	     	     		     	     
7D. Other Current Assets		     	(2)      					     
7E. Household Goods		     		     	     	     		     	     
7F. Car, Recreational Vehicle, Etc.		     	(3)      					     
7G. Other Intermediate Assets		     		     	     	     		     	     
7H. Retirement Accounts		     	(4)      					     
7I. Non-Farm Business		     		     	     	     		     	     
7J. Non-Farm Real Estate		     	8H. Other Liabilities						     
7K. Other Long Term Assets		     	     						     
7L. TOTAL PERSONAL ASSETS (Items 7A through 7K)		     	8I. TOTAL PERSONAL LIABILITIES						     
7M. TOTAL ASSETS (Item 4I and Item 7L)		     	8J. TOTAL LIABILITIES (Item 6I and Item 8I)						     
			8K. TOTAL EQUITY (Item 7M minus Item 8J)						     
I - WARNING
I certify that the information provided is true, complete, and correct to the best of my knowledge and is provided in good faith. (Warning: Section 1001 of Title 18, United States Code, provides for criminal penalties to those who provide false statements. If any information is found to be false or incomplete, such finding may be grounds for denial of the requested action.)
9A. SIGNATURE							9B. DATE      
10. COMMENTS      
NOTE:	The following statement 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 0560-0238. The time required to complete this information collection is estimated to average 1.25 hours 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.
The U.S. Department of Agriculture (USDA) prohibits discrimination in all of 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, political beliefs, genetic information, 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, Assistant Secretary for Civil Rights, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, S.W., Stop 9410, Washington, DC  20250-9410, or call toll-free at (866) 632-9992 (English) or (800) 877-8339 (TDD) or (866) 377-8642 (English Federal-relay) or (800) 845-6136 (Spanish Federal-relay).  USDA is an equal opportunity provider and employer.

FSA-2037 (11-04-10) Page 4 of 4

J – MACHINERY AND EQUIPMENT
11A. Qty.	11B. Description	11C. Manufacturer	11D. Size/Type	11E. Condition	11F. Year	11G. Serial Number	11H. $ Value
     	     	     	     	     	    	     	     
     	     	     	     	     	    	     	     
     	     	     	     	     	    	     	     
     	     	     	     	     	    	     	     
     	     	     	     	     	    	     	    
     	     	     	     	     	    	     	     
     	     	     	     	     	    	     	     
     	     	     	     	     	    	     	     
     	     	     	     	     	    	     	     
     	     	     	     	     	    	     	     
     	     	     	     	     	    	     	     
     	     	     	     	     	    	     	     
     	     	     	     	     	    	     	     
     	     	     	     	     	    	     	     
     	     	     	     	     	    	     	     
     	     	     	     	     	    	     	     
     	     	     	     	     	    	     	     
     	     	     	     	     	    	     	     
     	     	     	     	     	    	     	     
     	     	     	     	     	    	     	     
     	     	     	     	     	    	     	     
     	     	     	     	     	    	     	     
     	     	     	     	     	    	     	     
11I TOTAL $ VALUE OF (ITEM 1H)							     
K – FARM VEHICLES
12A. Qty.	12B. Description	12C. Manufacturer	12D. Size/Type	12E. Condition	12F. Year	12G. Serial Number/VIN	12H. $ Value
     	     	     	     	     	    	     	     
     	     	     	     	     	    	     	     
     	     	     	     	     	    	     	     
     	     	     	     	     	    	     	     
     	     	     	     	     	    	     	     
     	     	     	     	     	    	     	     
     	     	     	     	     	    	     	     
     	     	     	     	     	    	     	     
     	     	     	     	     	    	     	     
     	     	     	     	     	    	     	     
12I. TOTAL $ VALUE OF (12H)							     
12J. TOTAL $ VALUE OF (ITEMS 11I AND 12I) TRANSFER TO ITEM 3A)