Instructions For CCC-296

FARM STORAGE FACILITY LOAN PROGRAM CERTIFICATION OF ATTORNEY

This form is completed by the attorney providing the required certifications.

Submit the original of the completed form in hard copy or facsimile to the FSA County Office when completed by the attorney.

Attorney completes Items (1) through (8) and 6A&B.

Items 1-5B are for FSA use only.

Fld Name / Item No.	Instruction
(1) State	Enter the State you are licensed in.
(2) or (3) Title Clearance	Check the appropriate box indicating if you will provide title clearance through a title opinion or title insurance policy.
(4) – (8) Lawyer’s Professional Liability Insurance	Enter the dollar amount, company, deductible, policy number, and expiration date of your liability insurance.
6A & 6B Signature of Attorney	Attorney signs and dates (MM-DD-YYYY) the certification.

Item 7 through 8B are for FSA use only.