This form is available electronically

Status: Original and derived artifacts are available for this document.

Download: docx | pdf | html

                                                                                                                                                      Position 2                                                                                                           Form Approved - OMB No. 0560-0155
OMB Expiration Date: xx-xx-xxxx
FSA-2241
(xx-xx-xx)
U.S. DEPT OF AGRICULTURE
    Farm Service Agency

(2) Borrower’s FSA ID Number
(3) Borrower's Name




     
     
GUARANTEED FARM LOAN STATUS REPORT



(4) Lender's FSA ID Number 
(5) Lender's Branch Number

     
     

(6) Lender's Name
    (1) As of 
     

     



(7)
Lender's Loan Number

(8)
FSA Loan
Number
(9)
Original Loan Amount
(10)
Loan Type
(11)
Unpaid Principal as of Date in (1)
(12)
Unpaid 
Accrued 
Interest as of Date in (1)
(13)
Unpaid
Emergency Advances as of Date in (1)
(14)
Interest Rate Guaranteed
(16)
Interest Rate
Nonguaranteed
(18)
Amount Advanced
During the Current
Reporting Period
(20)
Payment Status Code
A-Borr Ahead of
Schedule
B-Borr Behind Schedule
C-Borr Current
(22)
Terminate Guar
(Y/N)
(23)
Loan Sold
(Y/N)







(15)
Fixed/Variable
(F/V)
(17)
Fixed/Variable
(F/V)
(19)
Date of Last Advance
(21)
Amount Ahead/Behind


     
     
$     
     
$     
$     
$     
     %
     %
$     
 
 
 







 
 
     
$     


     
     
$     
     
$     
$     
$     
     %
     %
$     
 
 
 







 
 
     
$     


     
     
$     
     
$     
$     
$     
     %
     %
$     
 
 
 







 
 
     
$     


     
     
$     
     
$     
$     
$     
     %
     %
$     
 
 
 







 
 
     
$     


     
     
$     
     
$     
$     
$     
     %
     %
$     
 
 
 







 
 
     
$     


     
     
$     
     
$     
$     
$     
     %
     %
$     
 
 
 







 
 
     
$     


     
     
$     
     
$     
$     
$     
     %
     %
$     
 
 
 







 
 
     
$     


(24) Authorized Lender's Signature
(25) Title
(26) Date
(27) Lender’s Name and Address Changes

     
     
     

FSA-2241 (xx-xx-xx)                                                                                                                                                                                                                                                 Page 2 of 2
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 20 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.