RD Form Listing
Form TITLE REV DATE DISTRIBUTION FMI DATE
0021-09 Directive Clearance 12-16-75 W 12-75-75
0021-51 Form Control Record 9-60 W&FO
0021-54 Form Reorder 11-96 W & FO
0033-01 Notice of Miscellaneous Obligation 6-5-75 WS
0102-01 * Request for Check Delivery 8-60 WSL
0104-01 Public Information Transmittal and/or Receipt
6-99 WSAL 7-7-99
0110-02 Office Hours Sign (County) 2-4-69 WSL
0110-04 Office Hours Sign (Part-time) 12-84 WSL
0110-41 Proposal and Acceptance (Office Space) 9-14-79 WSL
0120-40 Voucher or Invoice Transmittal 5-89 W 7-19-89
0140-04 * Transmittal of Documents 2-98 WSAL 3-18-98
0141-01 Pamphlet Transmittal (State and County) 7-6-67 WSL 7-20-77
0142-01 Correspondence Referral 3-30-70 W
0142-46 Routing Sheet--Daily Reading File 6-94 W
0152-43 File Folder Routing Record 10-89 W
0212-01 Change in Position Description 3-18-68 P
0212-03 Position Classification Criteria 6-3-69 P
(05-27-09) PN 429 Page 1 of 29
*Forms shared with FSA
Form TITLE REV DATE DISTRIBUTION FMI DATE
0245-01 Notice of Rating 8-14-80 W
0263-01 Record of Length-of-Service Award 4-61 P
0263-03 Certificate of Appreciation 2-98 WS
0263-04 Certificate of Merit 2-98 WS
0263-04A Certificate of Merit Citation: FARM FAMILY OF THE YEAR
WS
0263-05 Certificate For Outstanding Accomplishment
2-98 WS
0263-05A Certificate For Outstanding Accomplishment Citation: FARM FAMILY OF THE YEAR
WS
0281-02 Safety Inspection Close-out Summary 11-11-77 WS
0281-03 Inspection Monitoring Record 11-11-77 WS
0295-01 Information to Separated Employees 11-25-74 P
0336 * Continuation Sheet 8-87 WSAL 9/4/87
0370-46 Direct Payment Coupon (2X) 9-85 FC
0370-46A Direct Payment Coupon (2A) 9-85 FC
0400-01 * Equal Opportunity Agreement 5-00 WSAL 6-14-00
0400-03 * Notice to Contractors and Applicants 2-98 WSAL 6-24-98
0400-04 * Assurance Agreement 3-97 WSAL 6-19-97
0400-06 * Compliance Statement 4-00 WSAL 6-14-00
0400-07 * Compliance Review for Recreational Loans to Associations (Rural Development Borrowers)
8-99 WSAL 10-6-99
(05-27-09) PN 429 Page 2 of 29
*Forms shared with FSA
Form TITLE REV DATE DISTRIBUTION FMI DATE
0400-08 * Compliance Review 8-00 WSAL 9-27-00,Pgs.13&14 dated 10-18-00
0400-15 * Security Agreement (Insured Loans to Individuals) (Generic Version)
WSAL
0402-01 * Deposit Agreement 6-02 WSAL 10-30-02
0402-02 * Statement of Deposits and Withdrawals 9-98 WSAL 10-21-98 Pgs.1&2
dated 12-22-99
0402-06 * Termination of Interest in Supervised Bank Account
12-96 WSAL
0410-04 Application for Rural Housing Assistance (NonFarm Tract) Uniform Residential Loan Application
10-06 WSAL 10-25-06
0410-07 * Notification to Applicant on Use of Financial Information from Financial Institution
9-98 WSAL 11-25-98
0410-08 * Applicant Reference Letter 12-08 WSAL 12-17-08
0410-09 * Statement Required by the Privacy Act 8-95 WSAL 8-23-95 Pgs.1&2
dated 10-11-95
0410-10 * Privacy Act Statement to References 11-28-78 WSAL 1-10-79
0426-02 * Property Insurance Mortgage Clause (Without Contribution)
3-14-79 WSL 5-9-79
0426-04 * Notice of Expiration of Insurance 6-5-81 WSAL
0426-06 * Transmittal of Property Insurance Mortgage Clause
3-99 WSAL
0440-04AL Crop Pledge (Lousiana) 6-91 WSC in LA
(05-27-09) PN 429 Page 3 of 29
*Forms shared with FSA
Form TITLE REV DATE DISTRIBUTION FMI DATE
0440-04AS Crops and Chattel Mortgage For America Samoa
3-24-81
0440-04LA Chattel Mortgage and Crop Pledge (Louisiana)
10-86 W;SC in LA
0440-04ND Security Agreement (Chattel Property and Fixtures)
10-93 W;SDC in ND
0440-06CA Severance Agreement W; SC in CA
0440-09 * Supplementary Payment Agreement 11-02 WSAL 11-27-02
0440-11 Estimate of Funds Needed for 30-Day Period Commencing ______________
10-00 WSAL 12-6-00
0440-15 * Security Agreement (Direct Loans to Individuals)
7-98 WSAL 8-5-98
0440-15 * S Chattel Mortgage or Security Agreement (Insured Loans to Individuals)
0440-21 * Appraisal of Chattel Property 4-97 WSAL 10-29-97
0440-22 * Promissory Note (Association or Organization)
6-06 WSAL 6-21-06
0440-24 Position Fidelity Schedule Bond 6-02 WSAL 6-26-02
0440-25 * S Financing Statement
0440-25A * Financing Statement (Crop) 5-96 WSAL
0440-26-O Consent and Subordination Agreement W; SC in OH
0440-29 * Semiannual Labor Compliance Report 5-01 WSAL 6-13-01
0440-34 * Option to Purchase Real Property 02-05 WSAL 02-24-05
0440-47 * Statement of Account 6-26-72 WSL
(05-27-09) PN 429 Page 4 of 29
*Forms shared with FSA
Form TITLE REV DATE DISTRIBUTION FMI DATE
0440-57 Acknowledgment of Obligated Funds/Check Request
1-99 WSAL 12-23-96 Pgs. 1&2 dated 03-
31-99
0440-57A Supplemental Installment Information 1-99 WSAL 4-28-99
0440-58 * Estimate of Settlement Costs 7-05 WSAL 7-13-05
0440-A25 Finance Statement 5-96 W; SC in UCC
12-11-96
0442-02 * Statement of Budget; Income and Equity 9-97 WSAL 11-19-97
0442-03 * Balance Sheet 3-97 WSAL 05-14-97
0442-04 * District Directors' Report 9-97 WSAL 12-17-97
0442-07 * Operating Budget 3-02 WSAL 4-17-02
0442-20 * Right-of-Way Easement 10-96 WSAL 2-26-97
0442-21 * Right-of-Way Certificate 12-95 WSL 4-24-96
0442-22 * Opinion of Counsel Relative to Rights-of-Way
10-96 WSAL 2-26-97
0442-28 Bond Registration Book 10-96 WSAL 2-26-97
0442-30 Water Purchase Contract 10-96 WSL 2-26-97
0443-16 ST Assignment of Income from Real Estate Security
10-86 WSAL 3-19-03
0443-16CA Assignment of Income From Real Estate Security
2-9-83 7-3-74
0449-01 Application for Loan and Guarantee (Business and Industry)
8-97 WSAL 1-29-97 Pgs. 1&2 dated 10-
29-97
0449-02 Statement of Collateral 7-97 WSAL 8-20-97
(05-27-09) PN 429 Page 5 of 29
*Forms shared with FSA
Form TITLE REV DATE DISTRIBUTION FMI DATE
0449-04 Statement of Personal History 9-97 WSAL 10-29-97
0449-13 Denial Letter 11-96 WSL 12-11-96
0449-14 Conditional Commitment For Guarantee 8-99 WSAL 10-6-99
0449-17 Contract of Guarantee 3-31-76 WSL
0449-22 Certification of Non-Relocation and Market and Capacity Information Report
9-97 WSD 11-19-97
0449-30 * Loan Note Guarantee Report of Loss 12-99 WSAL 11-7-07
0449-34 * Loan Note Guarantee 10-95 WSAL 10-13-95
0449-35 Lender's Agreement 7-99 WSAL 12-6-00
0449-36 * Assignment Guarantee Agreement 4-00 WSAL 4-19-00
0450-05 * Application to Move Security Property and Verification of Address
6-98 WSAL 7-15-98
0450-06 * Notice of Transmittal of Form RD 450-5 6-98 WSAL 7-15-98
0450-07 Address Inquiry 6-99 WSAL 7-7-99
0450-10 * Advice of Borrower's Change of Address, Name, Case Number, or Loan Number
11-92 WSL 2-4-93 Supp. dated 1-12-94
0450-11 Detail Analysis of Charges/Credits to Loans Receivable
1-1-70 WSL
0450-12 Bill of Sale (Transfer by Withdrawing Member)
5-98 WSAL 6-24-98
0450-13 * Request for Assignment of Income from Trust Property
4-99 WSAL 4-28-99
0451-01 Acknowledgment of Cash Payment 8-88 WSAL 3-13-85
0451-01A Acknowledgment of Cash Payment (Spanish Version)
11-1-83 12-7-83
(05-27-09) PN 429 Page 6 of 29
*Forms shared with FSA
Form TITLE REV DATE DISTRIBUTION FMI DATE
0451-02 * Schedule of Remittances 11-02 WSAL 11-27-02
0451-03 * Reminder of Payment to be Made 7-98 WSAL 8-5-98
0451-05 Notification of Insured Loan Payment and/or Unpaid Principal
10-6-72 WSL
0451-05A Notification of Insured Loan Annual Payment and Unpaid Principal
1-1-72 W
0451-08 * Journal Voucher for Loan Account Adjustments
8-5-82 WSL 9-22-82
0451-19 Statement Showing Distribution of Payment and Balance on Insurance Contract
1-1-72 W
0451-20 Notice and Acknowledgment of Final Payment
10-85 WSL
0451-26 * Transaction Record 11-02 WSAL 11-27-02
0451-27 * Review of Collection--Only Accounts 8-97 WSAL 10-29-97
0451-38 Statement of Interest Paid 7-29-74 WSL
0452-02 Reamortization Agreement 5-97 WSAL 7-16-97
0455-01* Request for Legal Action 2-87 WSAL 4-15-87
0455-02 * Evidence of Conversion 12-29-78 WSAL 2-7-79
0455-03 * Agreement for Sale by Borrower (Chattels and/or Real Estate)
9-85 WSL 11-1-85
0455-04 * Agreement for Voluntary Liquidation of Chattel Security
9-85 WSAL 11-1-85
0455-04LA Agreement for Voluntary Liquidation of Chattel Security
10-87 WSC in LA
0455-22* Information for Litigation 7-98 WSAL 8-5-98
(05-27-09) PN 429 Page 7 of 29
*Forms shared with FSA
Form TITLE REV DATE DISTRIBUTION FMI DATE
0460-01 Partial Release 1-02 WSAL 2-13-02
0460-01 * S Partial Release 1-02 WSAL 2-13-02
0460-02 Subordination by the Government 1-02 WSAL 10-9-02
0460-02 * S Subordination by the Government
0460-04 Satisfaction 3-02 WSAL 3-20-02
0460-04 * S Satisfaction SDC
0460-10 * New Promise to Pay 7-95 WSAL 9-27-95
0462-12 * Statement of Continuation, Partial Release, Assignment, Etc.
4-99 WSAL 4-28-99
0462-12 * S Continuation of Termination Statement
0465-01 * Application for Partial Release Subordination, or Consent
2-97 WSAL 3-19-03
0465-05 * Transfer of Real Estate Security 11-96 WSL 3-19-03
0465-06LA* Partial Release of Direct Real Estate Mortage
8-30-71 W;SC in LA
0465-12 * S Quitclaim Deed
0471-01HI Assignment of Mortgage WS/CA, C/HI
0471-02HI Assignment of Mortgage to United States as Trustee
7-21-65
0471-07 * Notice and Acknowledgment of Sale of Insured or Guaranteed Loan
1-8-74 WSL 12-17-75
0838-B * Invoice - Receipt Certification 8-05 WSAL 8-31-05
1007 * Square Foot Appraisal Form 1991 WSAL
(05-27-09) PN 429 Page 8 of 29
*Forms shared with FSA
Form TITLE REV DATE DISTRIBUTION FMI DATE
1040-76 Equal Employment Opportunity Contract Compliance Notices
WSAL
1902-07 * Financial Institution Summary For CBS 5-88 WSAL 7-12-88
1910-05 * Request for Verification of Employment 12-08 WSAL 12-17-08
1910-11 * Applicant Certification Federal Collection Policies For Consumer Or Commercial Debts
9-02 WSAL 09-18-02
1922-07 Appraisal Report for Multi-Unit Housing 7-90 WSAL 9-5-90
1922-08 * Uniform Residential Appraisal Report 6-93 WSAL 1-12-94
1922-12 * Nonfarm Tract Comparable Sales Data 7-98 WSAL 9-27-06
1922-13 Reviewer's Appraisal Analysis 9-27-82 WS 12-1-82
1922-14 * Residential Appraisal Review For Single Family Housing
6-99 WSAL 9-27-06
1922-15 * Administrative Appraisal Review for Single Family Housing
10-08 WSAL 12-17-08
1924-01 * Development Plan 1-00 WSAL 2-23-00
1924-02 * Description of Materials 7-99 WSAL 10-6-99
1924-03 * Service Building Specifications 8-93 WSL 5-12-87
1924-04 Documentation of Construction Complaint/Request for Compensation for Construction Defects
10-90 WSAL 9-13-91
1924-05 * Invitation for Bid (Construction Contract) 8-93 WSL 5-12-87
1924-06 * Construction Contract 8-93 WSL 5-12-87
1924-07 * Contract Change Order 2-97 WSL 4-9-97
(05-27-09) PN 429 Page 9 of 29
*Forms shared with FSA
Form TITLE REV DATE DISTRIBUTION FMI DATE
1924-09 * Certificate of Contractor's Release 1-98 WSAL 3-18-98
1924-10 * Release by Claimants 1-98 WSAL 3-18-98
1924-11 * Statement of Labor Performed 1-98 WSAL 3-18-98
1924-12 * Inspection Report 1-00 WSAL 2-16-00
1924-13 * Estimate and Certificate of Actual Cost 12-98 WSAL 5-12-99,Pgs.1&2 dated 6-9-99
1924-15 Report of Claims for Construction Defects 6-97 WSAL 8-20-97
1924-16 * Record of Pre-Construction Conference 7-07 WSAL 8-1-07
1924-18 * Partial Payment Estimate 6-97 WSL 8-20-97
1924-19 * Builder's Warranty 1-00 WSAL 1-23-03
1924-21 * Notice of Expiration of First Year of Warranty
1-00 WSAL 2-16-00
1924-25 * Plan Certification 7-99 WSAL 8-18-99
1924-26 * Cost Certification Worksheet 3-94 WSD 3-16-94
1927-01 * S Real Estate Mortgage or Deed of Trust for (State)________
8-97 WS
1927-04 * Transmittal of Title Information 6-06 WSAL 6-21-06
1927-05 * Affidavit Regarding Work of Improvement 11-99 WSAL 12-22-99
1927-07 S Real Estate Mortgage or Deed of Trust for __________ (Rural Housing)
WS
1927-08 * Agreement with Prior Lienholder United States Department of Agriculture
4-06 WSAL 12-19-07
1927-09 * Preliminary Title Opinion 9-99 WSAL 10-6-99
(05-27-09) PN 429 Page 10 of 29
*Forms shared with FSA
Form TITLE REV DATE DISTRIBUTION FMI DATE
1927-10 * Final Title Opinion 7-98 WSAL 8-19-98
1927-11 * S Warranty Deed ( ) WS
1927-12 * S Warranty Deed
1927-15 * Loan Closing Instructions and Loan Closing Statement
7-03 WSAL 8-20-03
1927-19 * Certification of Attorney 11-99 WSAL 12-22-99
1927-20 * Certification of Title Insurance Company 3-98 WSAL 4-22-98
1940-01 * Request for Obligation of Funds 7-08 WSAL 1-26-05; pages 9 thru
14 revised 5-3-06; Pages 1 &
2, 13 & 14 revised 9-3-08
1940-03 Request for Obligation of Funds Guaranteed Loans
7-08 WSAL 1-26-05; pages 3&4 revised 5-3-
06; 1&2 and 9&10 revised
9-3-08
1940-10 * Cancellation of U.S. Treasury Check and/or Obligation
10-94 WSAL 12-14-94 Pgs 1&2 dated 6-
19-97
1940-16 Promissory Note 7-05 WSAL 1-25-06
1940-16CA Promissory Note 4-93
1940-20 * Request for Environmental Information 4-06 WSAL 4-26-06
1940-21 * Environmental Assessment for Class I Action
6-88 WSAL 10-19-88
(05-27-09) PN 429 Page 11 of 29
*Forms shared with FSA
Form TITLE REV DATE DISTRIBUTION FMI DATE
1940-22 * Environmental Checklist for Categorical Exclusions
6-88 WSAL 10-19-88 Pgs 1&2 dated 11-
02-94
1940-25A * Financing Statement for Real Estate and UCC Filing
1-92 ND
1940-25ND Financing Statement 1-92
1940-38 * Request for Lender's Verification of Loan Application
4-7-93 WSAL 4-7-93
1940-41 Truth in Lending Statement 7-05 WSAL 7-13-05
1940-43 Notice of Right to Cancel 8-00 WSAL 10-18-00
1940-59 * Settlement Statement 10-96 WSL 12-23-96
1940-62 Recipient Outreach Activity Report
1940-63 Subrecipient and Ultimate Recipient Compliance Review Report
1940-65 Post Award Compliance Review
1942-08 Resolution of Members or Stockholders 2-98 WSAL 3-18-98
1942-09 Loan Resolution Security Agreement 10-96 WSL 12-11-96
1942-19 Agreement for Engineering Services 10-96 WSL 2-26-97
1942-39 Processing Checklist (Other Than Public Bodies)
2-98 WSAL 3-18-98
1942-40 Processing Checklist (Public Bodies) 6-97 WSAL 7-16-97
1942-46 * Letter Of Intent To Meet Conditions 6-98 WSAL 8-5-98
1942-47 Loan Resolution (Public Bodies) 12-97 WSAL 2-18-98
1942-52 Cash Flow Projection 9-96 WSD 10-30-96
(05-27-09) PN 429 Page 12 of 29
*Forms shared with FSA
Form TITLE REV DATE DISTRIBUTION FMI DATE
1942-53 Cash Flow Report 4-97 WSD 6-11-97
1942-54 Applicant's Feasibility Report 10-96 WSD 10-30-96
1943-02 * Small Farmer Outreach Training and Technical Assistance Program (Evaluation)
11-94 WSAL 12-27-94
1944-01 Interest Credit Agreement Renewal 1-03 WSAL 1-23-03
1944-02 Single Family Housing Fund Analysis 1-03 WSAL 1-23-03
1944-03 * Budget and/or Financial Statement 6-97 WSAL 8-20-97
1944-04 Certification of Disability or Handicap 10-99 WSAL 11-10-99
1944-05 Rural Development Manufactured Housing Dealer-Contractor Application
12-98 WSAL 2-17-99
1944-06 Interest Credit Agreement 3-97 WSAL 05-14-97
1944-06A Interest Credit Agreement 3-97 FO 5-14-97
1944-0B6 Deferred Payment Computation 6-97 WSAL 8-20-97
1944-11 Conditional Commitment 11-99 WSAL 12-22-99
1944-12 Rural Housing Loan Application Package 4-99 WSAL 4-28-99
1944-14 Payment Assistance/Deferred Mortgage Agreement
5-08 WSAL 7-16-08
1944-36 Application for Conditional Commitment 12-05 WSAL 12-7-05
1944-37 Previous Participation Certification 6-00 WSAL 7-12-00
1944-54 Multi-Family Housing Change Borrower Name/ Address/Case Number/ Project Number/ Loan Number
5-98 WSAL 6-24-98
(05-27-09) PN 429 Page 13 of 29
*Forms shared with FSA
Form TITLE REV DATE DISTRIBUTION FMI DATE
1944-57 Multi-Family Housing Acknowledgment of Obligated Funds/Check Request
4-85 WSAL 2-21-91
1944-57A Multi-Family Housing Supplemental Installment Information
5-98 WSAL 6-24-98
1944-59 Certificate of Eligibility 4-07 WSAL 4-18-07
1944-60 Landlord's Verification 12-08 WSAL 12-17-08
1944-61 Credit History Worksheet 2-07 WSAL 2-14-07
1944-62 Request for Verification of Deposit 12-08 WSAL 12-17-08
1950-08 Double Postcard 2-99 WSAL 2-24-99
1950-09 * Address Information Request 12-98 WSAL 4-28-99
1951-04 Report of IRP/RDLF Lending Activity 12-04 WSAL 12-22-04
1951-05 Intermediary Relending Program/Rural Development Loan Fund Field Visit
2-02 WSAL 5-8-02
1951-06 * Borrower Account Description Flag 1-97 WSAL 1-23-03
1951-07 * Request For Change In Application 11-88 WSAL 5-3-89
1951-09 * Annual Statement of Loan Account 12-90 WSAL 1-29-97
1951-10 Workout agreement negotiated between a delinquent Community Programs borrower and the Agency
04-05 WSAL 4-20-05
1951-12 * Correction of Loan Account 5-98 WSAL 6-24-98
1951-13 * Change in Interest Rate 11-98 WSAL 2-17-99
1951-15 * Community Programs Assumption Agreement
1-00 WSAL 1-26-00
1951-23 Moratorium on Payment 5-97 WSAL 7-16-97
(05-27-09) PN 429 Page 14 of 29
*Forms shared with FSA
Form TITLE REV DATE DISTRIBUTION FMI DATE
1951-24 Results of Borrower Graduation Review 8-98 WSAL 9-30-98
1951-26 Substitute Payment Coupon For Single Family Housing Loans
11-96 WSAL 1-23-03
1951-27 Substitute Payment Coupon For Single Family Housing Loans
10-94 WSAL 11-02-94
1951-33 * Reamortization Request 7-05 WSAL 7-13-05
1951-34 Direct Payment Plan Change 6-97 WSAL 7-16-97
1951-37 Delinquency Workout Agreement 5-97 WSAL 7-16-97
1951-43 * Adjustment of Accounts Referred for IRS Offset
11-90 WSAL 12-19-90
1951-44 * Annual Review of District/County Collection Activities Concentration Banking System
4-91 WSAL 6-19-91
1951-46 * Concentration Banking Uncollectible Item 8-91 WSAL 9-11-91
1951-48 * Concentration Banking Daily Activity Report
6-92 WSAL 9-30-92
1951-49 * Register Of Collections 12-05 WSAL 12-7-05
1951-57 * Request for Loan Summary Statement 3-87 WSAL 4-9-87
1951-60 * Field Office Remittance Reconciliation Report ( - - )
10-03 WSAL 10-28-03
1951-61 * Control Of Problem Case Correspondence
8-98 WSAL 9-30-98
1951-62 * Explanation Of Problem Case 1-97 WSAL 3-26-97
1951-63 * Delinquency Audit Worksheet 1-91 WSAL 3-20-91
1955-01 * Offer to Convey Security 6-97 WSAL 8-20-97
(05-27-09) PN 429 Page 15 of 29
*Forms shared with FSA
Form TITLE REV DATE DISTRIBUTION FMI DATE
1955-02 * Report on Real Estate Problem Case 7-98 WSAL 8-5-98
1955-03A * Acquired Property-Maintenance 10-87 WSAL 2-4-93
1955-40 * Notice of Real Property For Sale 8-99 WSAL 10-6-99
1955-41 * Notice of Sale 1-97 WSAL 3-26-97
1955-42 * Open Real Property Master Listing Agreement
6-97 WSAL 8-20-97
1955-43 Notice of Real Property for Sale (Single Family Housing)
6-97 WSAL 6-18-97
1955-44 Notice of Residential Occupancy Restriction
2-98 WSAL 3-18-98
1955-45 * Standard Sales Contract - Sale of Real Property By The United States
11-06 WSAL 11-29-06
1955-46 * Invitation, Bid, and Acceptance Sale of Real Property by the United States
6-97 WSAL 8-20-97
1955-47 * Bill of Sale "A" 10-98 WSAL 2-17-99
1955-49 * Quitclaim Deed 1-02 WSAL 2-13-02
1955-49IN Quitclaim Deed 5-89
1955-49LA Quitclaim Deed 10-85
1955-50A Acquired Property Sold WSAL Automation Supplement
dated 6-28-95
1955-50B Advice of Inventory Property Sold WSAL Automation Supplement
dated 6-28-95
1955-62 * Request for Contract Services for Custodial /Inventory Property or Program Services
1-97 WSAL 3-26-97
(05-27-09) PN 429 Page 16 of 29
*Forms shared with FSA
Form TITLE REV DATE DISTRIBUTION FMI DATE
1956-01 * Application For Settlement of Indebtedness
2-94 WSAL 3-16-94
1956-02 Cancellation or Charge-Off Indebtedness 10-96 WSAL 12-23-96
1962-12ND Statement of Continuation Partial Release Assignment Etc
5-99 WSAL
1962-20 * Notice of Judgment 01-03 WSAL 1-23-03
1965-08 * Release from Personal Liability 1-02 WSAL 2-13-02
1965-11 * Accelerated Repayment Agreement 11-02 WSAL 11-27-02
1965-14 * Proof of Claim of The United States of America (Individual)
8-98 WSAL 9-30-98
1980-04 Guaranteed Loan Status Update Adjustment
3/89 WSAL 11-15-89
1980-07 Notification of Transfer and Assumption of a Guaranteed Loan
10-94 WSAL 11-30-94
1980-11 Guaranteed Rural Housing Lender Record Change
7-00 WSAL 8-16-00; pgs.1&2 dated
10-19-01
1980-12 Master Interest Assistance and Shared Equity Agreement With Promisory Note
1-03 WSAL 1-29-03
1980-13 Annual Interest Assistance AgreementGuaranteed RH Loans
5-95 WSAL 6-21-95
1980-14 Interest Assistance Shared Equity Determination
5-95 WSAL 6-21-95
1980-16 Agreement for Participation in Single Family Housing Guaranteed/Insured Loan Programs of the United States Government
6-06 WSAL 6-21-06
1980-17 Loan Note Guarantee 1-98 WSAL 3-18-98
(05-27-09) PN 429 Page 17 of 29
*Forms shared with FSA
Form TITLE REV DATE DISTRIBUTION FMI DATE
1980-18 Conditional Commitment For Single Family Housing Loan Guarantee
12-97 WSAL 2-18-98
1980-19 * Guaranteed Loan Closing Report 2-02 WSAL 2-13-02
1980-20 Rural Housing Guarantee Report of Loss 7-99 WSAL 8-18-99
1980-21 Request for Single Family Housing Loan Guarantee
6-06 WSAL 6-21-06
1980-24 Request Interest Assistance/Interest Rate Buydown/SubsidyPayment to Guaranteed Loan Lender
6-99 WSAL 7-7-99
1980-37 FmHA Purchase of Guaranteed Loan Portion
10-94 WSAL 11-30-94
1980-41 Guaranteed Loan Status Report 12-99 WSAL 4-19-00
1980-42 * Notice of Substitution of Lender 11-89 WSAL 12-18-98; pgs. 1&2 dated 10-
19-01
1980-43 * Lender's Guaranteed Loan Payment To USDA
4-00 WSAL 4-19-00
1980-44 Guaranteed Loan Borrower Default Status 12-99 WSAL 1-26-00
1980-45 * Notice of Liquidation Responsibility 11-96 WSAL 12-23-96
1980-46 * Report of Liquidation Expense 10-94 WSAL 12-23-96
1980-47 * Guaranteed Loan Borrower Adjustments 11-98 WSAL 11-25-98
1980-50 * Add; Delete or Change Guaranteed Loan Borrower Information
11-92 WSAL 2-4-93
1980-51 * Add; Change or Delete Guaranteed Loan Record
2-90 WSAL 3-26-90 Pgs.1&2
dated 6-21-95
1980-52 * Report Request 10-94 WSAL 11-30-94
(05-27-09) PN 429 Page 18 of 29
*Forms shared with FSA
Form TITLE REV DATE DISTRIBUTION FMI DATE
1980-56 * Guaranteed Loan Borrower Deferment 4-98 WSAL 5-13-98
1980-57 * Reverse Guaranteed Loan Borrower Deferment
11-98 WSAL 2-17-99
1980-68 Lender's Agreement / Drought and Disaster Guaranteed Loan (Interest Not Guaranteed)
11-88 WSAL 1-3-89
1980-69 Loan Note Guarantee / Drought and Disaster Guaranteed Loan (Interest Not Guaranteed)
11-88 WSAL 1-3-89
1980-70 Assignment Guarantee Agreement / Drought and Disaster Guaranteed Loan (Interest Not Guaranteed)
11-88 WSAL 1-3-89
1980-71 Lender's Agreement/Disaster Assistance For Rural Business Enterprise (DARBE) Guaranteed Loans
11-89 WSAL 1-3-90
1980-72 Loan Note Guarantee Disaster Assistance For Rural Business Enterprise (DARBE) Guaranteed Loans
11-89 WSAL 1-3-90
1980-73 Assignment Guarantee Agreement Disaster Assistance For Rural Business Enterprise (DARBE) Guaranteed Loan
11-89 WSAL 1-3-90
1980-80 Guaranteed Rural Housing Loan Status Report
12-00 WSAL 01-31-01
1980-81 Guaranteed Rural Housing Borrower Default Status
12-00 WSAL 01-31-01
1980-84 Modification of New Contract Relating to Farm Credit Programs Guaranteed Loan/Line of Credit
10-95 WSAL 10-13-95
1980-85 Modification of Existing Contract Relating to Farm Credit Programs Guaranteed Loan/Line of Credit
10-95 WSAL 10-13-95
(05-27-09) PN 429 Page 19 of 29
*Forms shared with FSA
Form TITLE REV DATE DISTRIBUTION FMI DATE
1980-86 Request for Reservation of Funds 12-05 WSAL 12-21-05
1980-87 Shared Equity Payment 5-95 WSAL 6-21-95
1992-06 * Acquisition or Abandonment of Secured Property
1-98 WSAL 3-18-98
2006-03 * Instruction and Form Justification 11-99 WSAL 11-10-99
2006-06 Clearance And Routing of Rural Development Issuance
1-98 W 6-24-98
2006-08 * Procedure Notice Material 4-91 W
2006-15 * Request for Automation 3-97 WSAL 6-18-97
2006-17 Request For Approval of Documentation and Software - APDS
8-85 W&FO
2006-18 Request for Approval of Documentation and Software AFMS
8-85 W&FO
2006-21 * Information Systems Management (ISM) Request for Changes to User Documentation
9-93 WSAL 10-12-94
2006-25 * Production Problem Report 3-97 WSAL 6-18-97
2006-38 Civil Rights Impact Analysis Certification 12-94 WSAL 3-1-95
2006-46 Procedure Notice 1-98 W
2006-58 Request for Reproduction and Distribution of Material
4-2-81 W
2009-42 Allotment Advice 3-87 W 5-27-87
2018-01 Vehicle Commitment and Authorization Form
3-97 WSAL 4-9-97
2021-06 * FmHA/RDA Field Office Mail Change 7-94 WS 7-27-94
(05-27-09) PN 429 Page 20 of 29
*Forms shared with FSA
Form TITLE REV DATE DISTRIBUTION FMI DATE
2024-04 Requisition for Forms/Supplies/Pamphlets Listed in Rural Development Supply
02-98 WSAL 05-13-98
2024-06 Notice of Transmittal and Receipt 10-88 WSAL 11-23-88
2024-09 Request for Forms, Supplies, Equipment, or Services
10-98 WSAL 11-25-98
2024-13 Consignment Notice 4-91 W
2024-18 Designation of Contracting Officer's Representative
9-89 WSAL 11-29-89
2024-2 PROPOSED (JEANNE JACOBS - 03/28/06) Request for Borrower Name and Address Labels
2024-3 PROPOSED (JEANNE J. - 03/28/06) Centralized Servicing Center Label Request for Direct Single Family Housing Borrowers
2024-30 Non-Contractual Program Loan Cost (PLCE) Expense Certification
8-05 WSAL 8-31-05
2030-01 Controlled Correspondence 6-87 W 9-23-87
2030-03 RUSH 6-87 W 9-23-87
2030-06 * Record of Telephone Call or Office Visit 2-98 WSAL 6-24-98
2030-08 Facsimile Transmission 12-97 WSAL 3-18-98
2033-01* X/Reference Card 3-98 WSAL 4-22-98
2033-02 Out Card 3-98 WSAL 4-22-98
2033-03 Correspondence Charge And Routing Slip 2-98 WSAL 4-22-98
2033-05 * Request For Future Delivery Of File(s) And/ Or Establishing A Follow Up
8-13-84 WSAL 9-26-84
(05-27-09) PN 429 Page 21 of 29
*Forms shared with FSA
Form TITLE REV DATE DISTRIBUTION FMI DATE
2033-33 Management System Card - Community Programs
2-99 WSAL 2-17-99
2033-34 Management System Card - Business and Industry
9-98 WS 11-25-98
2033-42 Multi-Family Housing Information Status Tracking and Retrieval System
3-98 WSAL 6-24-98
2036-03 Request for Travel Authorization or Amendment
9-00 WSAL 9-27-00
2039-02 Information for Household Goods Shipment Via GBL
8-00 WSAL 9-6-00
2045-01 Monthly Employment Report Supp 8-19-88 Aut. 8-19-88
2045-03 Selection Certificate 9-98 P 2-12-99
2045-11 USDA Pre-Tax Parking Application 4-02 WSAL 6-26-02
2051-01 Application for Change in Tour of Duty 3-98 WSAL 4-22-98
2051-05 Record of FLSA Travel Time 4-05 WSAL 4-20-05
2051-06 Request for Overtime 5-10-84 WSAL 6-20-84
2057-09 * Executive/Management/Supervisory (E/M/S) Individual Development Plan
8-85 WSAL 11-27-85
2057-10 * Executive/Management/Supervisory (EMS) Development Accomplishments And Planning Report
3-87 WSAL 5-13-87
2057-11 Individual Development Plan ADP Coordinator/ADPC Assistant
2-88 WS 6-1-88
2057-13 * Individual Development Plan 9-00 WSAL 10-18-00
2057-14 Request to Earn Credit Hours
3550-01 Authorization to Release Information 12-05 WSAL 12-7-05
(05-27-09) PN 429 Page 22 of 29
*Forms shared with FSA
Form TITLE REV DATE DISTRIBUTION FMI DATE
3550-02 Request for Verification of Gift/Gift Letter 12-08 WSAL 12-17-08
3550-04 Employment Certification/Payment Assistance
02-05 WSAL 2-16-05
3550-06 Notice of Special Flood Hazards, Flood Insurance Purchase Requirements, and Availability of Federal Disaster Relief...
8-00 WSAL 10-18-00
3550-07 Mortgage Loan Commitment 4-07 WSAL 12-19-07
3550-09 Initial Escrow Account Disclosure Statement
10-06 WSAL 10-25-06
3550-10 Condominium Rider 8-00 WSAL 10-18-00
3550-11 Planned Unit Development Rider 8-00 WSAL 10-18-00
3550-12 Subsidy Repayment Agreement 9-06 WSAL 9-27-06
3550-14 ST Mortages/Deeds of Trust WSAL
3550-15 Tax Information 6-06 WSAL 6-21-06
3550-16 Release from Personal Liability 10-96 WSAL 12-23-96
3550-17 Funds Transmittal Report 6-06 WSAL 1-30-09
3550-18 Reamortization Agreement 9-99 WSAL 12-22-99
3550-19 Transmittal - Closing Documents 5-08 WSAL 6-25-09
3550-20 Application for Settlement of Indebtedness
10-96 WSAL 12-23-96
3550-21 Payment Subidy Renewal Certification 3-06 WSAL 3-15-06
3550-22 Assumption Agreement - Single Family Housing
8-99 WSAL 12-7-05
3550-23 Applicant Orientation Guide 4-07 WSAL 4-18-07
(05-27-09) PN 429 Page 23 of 29
*Forms shared with FSA
Form TITLE REV DATE DISTRIBUTION FMI DATE
3550-24 Grant Agreement 8-00 WSAL 8-8-08
3550-25 Loan Closing Instructions and Loan Closing Statement
12-08 WSAL 1-30-09
3550-27 Substitute Payment Coupon 10-96 WSAL 11-7-07
3550-28 Authorization Agreement for Preauthorized Payments
5-05 WSAL 5-18-05
3550-29 Document Errors and Omissions Agreement
11-06 WSAL 11-29-06
3550-30 Verification of Debt Proposed for Refinancing
12-08 WSAL 12-17-08
3560-01 Application for Partial Release, Subordination, or Consent
2-05 WSAL 2-24-05
3560-07 Multiple Family Housing Project Budget/Utility Allowance
5-06 WSAL 5-3-06
3560-07A On-Farm Labor Housing Project Budget 2-05 WSAL 2-24-05
3560-08 Tenant Certification 4-06 WSAL 4-26-06
3560-09 Multiple Family Housing Interest Credit and Rental Assistance Agreement
2-05 WSAL 2-24-05
3560-10 Multi-Family Housing Borrower Balance Sheet
2-05 WSAL 2-24-05
3560-11 Multi-Family Housing Physical Inspection Report
5-08 WSAL 7-16-08
3560-12 Request for Authorization to Withdraw Reserve Funds
2-05 WSAL 2-24-05
3560-13 Multi-Family Project Owner's/Management Agent's Management Certification
12-08 WSAL 1-30-09
3560-15 Reamortization Request 2-05 WSAL 2-24-05
(05-27-09) PN 429 Page 24 of 29
*Forms shared with FSA
Form TITLE REV DATE DISTRIBUTION FMI DATE
3560-16 Multi-Family Housing Reamortization Agreement
2-05 WSAL 2-24-05
3560-17 Multi-Family Housing Note Consolidation 2-05 WSAL 2-24-05
3560-17A Multi-Family Housing Consolidation of Projects/Loan Agreement/Resolutions
2-05 WSAL 2-24-05
3560-18 Multi-Family Housing Release from Personal Liability
2-05 WSAL 2-24-05
3560-20 Multi-Family Housing Transfer and Assumption Review and Recommendation
2-05 WSAL 2-24-05
3560-21 Multi-Family Housing Assumption Agreement
2-05 WSAL 2-24-05
3560-22 Offer to Convey Security 2-05 WSAL 2-24-05
3560-25 Initial Request for Rental Assistance or Operating Assistance
2-05 WSAL 2-24-05
3560-27 Rental Assistance Agreement 2-05 WSAL 2-24-05
3560-27A Operating Assistance Agreement 2-05 WSAL 2-24-05
3560-28 Multi-Family Housiing Exception to Late Fees
2-05 WSAL 2-24-05
3560-29 Notice of Payment Due Report 2-05 WSAL 2-24-05
3560-30 Certification of No Identity Of Interest (IOI)
2-05 WSAL 2-24-05
3560-31 Identity Of Interest (IOI) Disclosure/Qualification Certificate
2-05 WSAL 2-24-05
3560-33 Loan Agreement 2-05 WSAL 2-24-05
3560-33A Consolidated Loan Agreement 2-05 WSAL 2-24-05
(05-27-09) PN 429 Page 25 of 29
*Forms shared with FSA
Form TITLE REV DATE DISTRIBUTION FMI DATE
3560-34 Loan Agreement 2-05 WSAL 2-24-05
3560-34A Consolidated RRH Loan Agreement 2-05 WSAL 2-24-05
3560-35 Loan Resolution 2-05 WSAL 2-24-05
3560-35A Consolidated Loan Resolution 2-05 WSAL 2-24-05
3560-38 Application for Cooperative Housing Membership
2-05 WSAL 2-24-05
3560-39 Loan Resolution (LH Insured Loan to Nonprofit Corporation)
2-05 WSAL 2-24-05
3560-40 Loan Agreement (LH Insured Loan to Individual)
2-05 WSAL 2-24-05
3560-41 Loan and Grant Resolution (Labor Housing Loan and Grant to a Nonprofit Corporation)
2-05 WSAL 2-24-05
3560-42 Labor Housing Grant Agreement 2-05 WSAL 2-24-05
3560-43 Verification of Occupancy of Domestic Farm Laborer
2-05 WSAL 2-24-05
3560-44 Farm Labor Housing Technical Assistance Grant Agreement
2-05 WSAL 2-24-05
3560-50 Multi-Family Housing Conversion Agreement
2-05 WSAL 2-24-05
3560-51 Multi-Family Housing Obligation - Fund Analysis
2-05 WSAL 2-24-05
3560-52 Promissory Note 2-05 WSAL 2-24-05
3560-54 Multiple Family Housing Annual Statement of Loan Account As Of _________
8-05 WSAL 8-17-05
3560-55 Multiple Family Housing Transfer of Rental Assistance
2-05 WSAL 2-24-05
(05-27-09) PN 429 Page 26 of 29
*Forms shared with FSA
Form TITLE REV DATE DISTRIBUTION FMI DATE
3560-57 Application for Settlement of Indebtedness
2-05 WSAL 2-24-05
3560-58 Satisfaction of Lien 2-05 WSAL 2-24-05
3560-64 MFH Payment Certification and Discrepancy Monitoring Log
2-05 WSAL 2-24-05
3565-01 Application for Loan and Guarantee 6-98 WSAL 12-18-98
3565-02 Conditional Commitment 2-05 WSAL 2-18-05
3565-03 Lender's Agreement 2-05 WSAL 2-18-05
3565-04 Loan Note Guarantee 02-05 WSAL 02-18-05
3565-05 Assignment Guarantee Agreement 2-05 WSAL 2-18-05
3570-01 Project Selection Priorities 5-99 WSAL 7-19-99
3570-02 Worksheet for Computing Maxium Grant Assistance
5-99 WSAL 7-19-99
3570-03 Agreement for Administrative Requirements for Community Facilities Grants
5-99 WSAL 7-19-99
3575-01 Application for Loan and Guarantee 6-00 WSAL 7-12-00
4274-01 Application for Loan (Intermediary Relending Program)
7-99 WSAL 10-6-99
4274-02 IRP Project Summary 1-98 WSAL 2-6-98
4274-03 Intermediary Relending Program Promissory Note
9-97 WSAL 2-6-98
4274-04 Intermediary Relending Program Loan Agreement
9-97 WSAL 2-6-98
4274-05 Intermediary Relending Program Supplemental Loan Agreement
9-97 WSAL 2-6-98
(05-27-09) PN 429 Page 27 of 29
*Forms shared with FSA
Form TITLE REV DATE DISTRIBUTION FMI DATE
4279-01 Application for Loan Guarantee (Business and Industry)
10-08 WSAL 1-30-09
4279-01A Application for Loan Guarantee (Business and Industry Short Form-One-Doc)
10-08 WSAL 1-30-09
4279-02 Certification of Non-Relocation and Market and Capacity Information Report
9-97 WSAL 12-23-96 Pgs. 1&2 dated 6-
11-97
4279-03 Conditional Commitment (Business and Industry)
7-08 WSAL 9-3-08
4279-04 Lender's Agreement Business and Industry Guaranteed Loan Program
11-06 WSAL 11-29-06
4279-05 Loan Note Guarantee (Business and Industry)
10-96 WSAL 7-18-05
4279-06 Assignment Guarantee Agreement (Business and Industry)
4-97 WSAL 10-3-05
4279-07 Certificate of Incumbency and Signature (Business and Industry)
2-01 WSAL 7-18-05
4279-08 Certified Lender - Business and Industry Program
4-97 WSAL 6-11-97
4279-14 Unconditional Guarantee 11-06 WSAL 11-29-06
4279-15 Business and Industry Visit Review Report (Field Visit Review)
10-96 WSAL 7-18-05
4279-16 Quarterly Problem/Delinquent Loan Report (Business and Industry)
10-96 WSAL 7-18-05
4280-01 Survey of Recipients of Rural Economic Development Loan and Grant Program
6-07 WSAL 6-29-07
4280-02 Renewable Energy/Energy Efficiency Grant Agreement Renewable Energy Systems and Energy Efficiency Improvements Grant
7-05 WSAL 12-7-05
(05-27-09) PN 429 Page 28 of 29
*Forms shared with FSA
Form TITLE REV DATE DISTRIBUTION FMI DATE
4280-03 Rural Economic Development Grant Agreement
6-07 WSAL 6-29-07
4280-04 Rural Economic Development Grant Letter of Conditions
06-07 WSAL 6-29-07
4280-05 Rural Economic Development Loan Agreement
06-07 WSAL 6-29-07
4280-06 Rural Economic Development Loan Letter of Conditions
06-07 WSAL 6-29-07
4280-07 Promissory Note 06-07 WSAL 6-29-07
(05-27-09) PN 429 Page 29 of 29
*Forms shared with FSA