FSA-2340 Selection of attorney/title company

This form is available electronically.

FSA-2340
(12-31-07)

U.S. DEPARTMENT OF AGRICULTURE
Farm Service Agency

Form Approved - OMB No. 0560-0237
Expiration Date 12-31-2025
Position 5

SELECTION OF ATTORNEY/TITLE AGENT

1. I select:
(a) Name of Attorney/Title Agent
(b) Address
(c) Telephone Number
to prepare a title opinion/commitment and perform loan closing and other legal services in accordance with instructions
and requirements of the Farm Service Agency.
2. I understand that they will set the fee according to their usual charges for comparable services. I further understand
that the Farm Service Agency does not assume any liability or responsibility for any portion of the fee.

3. Name

4. Signature

5. 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 (FOIA), 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 0560-0237. The time required to complete this
information collection is estimated to average 10 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 COUNTY 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.