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	  OMB No. 0560-0155
                                                                                                                                  OMB Expiration Date: XX/XX/XXXX
FSA-2236	U.S. DEPARTMENT OF AGRICULTURE	  Position 2
(XX-XX-XX)	Farm Service Agency

LOAN CLOSING REPORT AND
LENDER CERTIFICATION

PART A - CLOSING INFORMATION

1. BORROWER’S NAME AND ADDRESS (Last, First, and M.I.)
     
    2.  2. FSA ACCOUNT NUMBER 


   ST CODE

    
   CO CODE

    
  BORROWER ID

     

    3.  3.  LENDER NAME AND ADDRESS
     
    4.  4.  LENDER ID NO.
     
    5.  5.   LENDER STATUS
     

       
    6. SERVICING OFFICE (MAIL CODE)
     

    7. EFFECTIVE DATE OF LENDER’S AGREEMENT 
      
    8. EXPIRATION DATE OF LENDER’S AGREEMENT  
     
    9.  LENDER LOAN NUMBER
     

    10.  AMOUNT OF
	 GUARANTEE FEE
	 PAID

$      

    11.  GUARANTEE FEE PURPOSE 	 CODE

    3-Initial Closing Fee  
    5-Consolidation
    7-Initial Closing-No Fee
    12. AMOUNT OF LOAN
 LINE OF CREDIT

$      

    13. ADVANCE AMOUNT TO
	DATE

$      


    14.  LOAN CLOSING
	DATE
     
    15.  LOAN MATURITY
		DATE
     
    16. TERM OF INTEREST
	ASSISTANCE YEARS 
	(IF APPLICABLE) 
     
    17. PERCENT OF LOAN
	GUARANTEE
         %

    18. LENDER’S NOTE INTEREST RATE
	ON GUARANTEED PORTION


     %

  Fixed
  Variable

    19. LENDER’S NOTE INTEREST
	RATE ON NON-GUARANTEED PORTION 

     %

  Fixed
  Variable

20.  INTEREST ASSISTANCE RATE (IF 
        APPLICABLE)


     %



    20. ADVANCE PERIOD OF
	OPERATING LINE OF CREDIT

     
    21. INTEREST RATE BASIS
	(CHOOSE BASIS BELOW)

  360        365         ACTUAL
23.   ANNUAL REVIEW DATE 
       (FOR IA LOANS ONLY)

     

PAD INFORMATION (To be completed if guaranteed loan fee is not paid by check)

24. ROUTING NUMBER
     
25.  ACCOUNT NUMBER
     
26.  ACCOUNT TYPE
     

PART B - LENDER CERTIFICATION

27.  The undersigned lender certifies that the following requirements have been or will be met on the guaranteed loan closed on the above 
         stated date.

        a. No major changes have been made in the lender’s loan or line of credit conditions and requirements since submission of the application (except those approved in the interim by the Agency in writing).
        b. All insurance requirements are in effect.
        c. Truth in lending requirements have been met.
        d. All equal employment opportunity and equal credit and nondiscrimination requirements have been or will be met at the appropriate time.
        e. The loan or line of credit has been properly closed, and the required security instruments have been obtained, or will be obtained, on any acquired property that cannot be covered initially under State law.
        f. The borrower has a marketable title to the collateral owned by the borrower, subject to the instrument securing the loan or line of credit to be guaranteed and subject to any other exceptions approved in writing by the Agency. When required, an assignment on all USDA crop and livestock program payments has been obtained.
        g. When required, personal, joint operation, partnership, corporate or other guarantees have been obtained.
        h. Liens have been perfected and priorities are consistent with requirements of the Conditional Commitment.



PART B - LENDER CERTIFICATION, Continued from Page 1

i.   Loan proceeds have been or will be disbursed for purposes and in amounts consistent with the Conditional Commitment and 
     as specified on the loan application. In line of credit cases, if any advances have occurred, they have been disbursed for 
     purposes and in amounts consistent with the Conditional Commitment and Line of Credit Agreements.
j.   There have been no material adverse changes in the borrower's condition, financial or otherwise, since submission of the
     application.
k.  Evaluations or appraisals have been completed which support security values stated in the Conditional Commitment.
l.   All other requirements specified in the Conditional Commitment have been met.
m. If PAD account information is included in Items 24-26, I authorize FSA to pull the guarantee fee for each loan from 
     this account.
PART C - REPRESENTATIONS REGARDING FELONY CONVICTIONS AND TAX DELINQUENT STATUS FOR CORPORATE LENDERS (Note: This section only applies if the lender is a corporation) 
A corporation includes, but is not limited to, any entity that has filed articles of incorporation in one of the 50 States, the District of Columbia, or the various territories of the United States including American Samoa, Federated States of Micronesia, Guam, Midway Islands, Northern Mariana Islands, Puerto Rico, Republic of Palau, Republic of the Marshall Islands, or the U.S. Virgin Islands. Corporations include both for profit and non-profit entities.
28.  If the lender is a corporation the undersigned lender certifies that the following statements are true and accurate at the time of loan closing:
    • The Lender has not been convicted of a felony criminal violation under any Federal law in the 24 months preceding the date of application.          
    • The Lender does not have any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability.
PART D - LENDER SIGNATURE AND CERTIFICATION
29.  I certify that this report accurately describes the subject loan.
A. Name and Title of Lender’s         Representative
     
B.  Signature of Lender’s Representative
C. Date (MM-DD-YYYY)
     
NOTE: Along with this form, submit the following, as appropriate:
        a. Guarantee Fee
        b. Copy of executed promissory note or loan agreement.
        c. Copy of evaluation if Standard Eligible Lender or Micro Lender and not previously submitted.
        d. FSA-2221, Interest Assistance Agreement, if Interest Assistance is included in the loan.
        e. FSA-2201, Lender's Agreement, if a current version has not already been executed.
PART E - AGENCY SIGNATURE AND CERTIFICATION
30.  Guaranteed Loan Number
     
31.  Obligated Loan Number
     
32.  Branch Number
     
33.  Date of Deposit
       (MM-DD-YYYY)
     
34.  I have reviewed this report and the information is consistent with the Conditional Commitment and the supporting documentation provided by the lender.
A. NAME OF AGENCY OFFICIAL (PRINTED)
     
B. TITLE (PRINTED)
     
C. SIGNATURE OF AGENCY OFFICIAL
D. DATE APPROVED (MM-DD-YYYY)
     













Privacy Act Statement: The following statement is made in accordance with the Privacy Act of 1974 (5 U.S.C. 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. 

Public Burden Statement (Paperwork Reduction Act): 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 0560-0155. The time required to complete this information collection is estimated to average 15 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. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden by emailing to: [email protected].  RETURN THIS COMPLETED FORM TO YOUR COUNTY FSA OFFICE.

Non-Discrimination Statement: In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex, disability, age, marital status, family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all programs). Remedies and complaint filing deadlines vary by program or incident.

Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.) should contact the State or local Agency that administers the program or contact USDA through the Telecommunications Relay Service at 711 (voice and TTY). Additionally, program information may be made available in languages other than English.

To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at https://www.usda.gov/oascr/how-to-file-a-program-discrimination-complaint and at any USDA office or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: (1) mail: U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW, Mail Stop 9410, Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email: [email protected]. 

USDA is an equal opportunity provider, employer, and lender.