Instructions For FSA 440-32

VERIFICATION OF DEBTS AND ASSETS

This form is used to verify the debts and assets of applicants applying for direct loan assistance or settlement of an unpaid FSA debt.

The loan applicant may submit the form to FSA with at least items 1 and 6 completed and other items as applicable if they have the information available. FSA will send the form to applicable financial institutions. Alternatively, the applicant may request that their financial institution obtain the form directly from the USDA eForms service web site and complete the items that are applicable to the account that the applicant has with that institution.

The lender may submit the original of the completed form in hard copy or facsimile to the appropriate FSA servicing office. Questions on completion of the form may be answered by calling your local Service Center.

Customers who have established electronic access credentials with USDA may electronically transmit this form to the USDA servicing office, provided that (1) the customer submitting the form is the only person required to sign the transaction, or (2) the customer has an approved Power of Attorney (Form FSA-211) on file with USDA to sign for other customers for the program and type of transaction represented by this form.

Features for transmitting the form electronically are available to those customers with access credentials only. If you would like to establish online access credentials with USDA, follow the instructions provided at the USDA eForms web site.

Applicants must complete Items 1, 4A through 8.

FSA completes Items 2 through 3C.

Financial Institutions must complete Items 9 through 30.

Item 1 is completed by Applicant

Fld Name / Item No.	Instruction
Item 1 To: Name and Address of Financial Institution	Enter the complete name and address of the financial institution where a debt is owed or an asset is invested.

Items 2 - 3C are for FSA use only.

Items 4A - 8 are completed by applicant.

	Fld Name / Item No.		Instruction
	Item 4A - 6C Applicant(s)Name, Address, Signature and Date		Items 4A, 5A, and 6A. Enter the complete name(s) and mailing address of the applicant(s). Items 4B, 5B, and 6B. Enter the applicant(s) signature(s). Items 4C, 5C, and 6C. Enter the date when the applicant(s) signed this form. Each applicant must sign in the space provided.
Items 7A - 7D Type(s) of Loans		Items 7A through 7D. Enter the type(s) of loan or account. For example, automobile loan, cattle and or credit cards, etc.
Items 8 Account Number(s)		Items 8 1^st, 2^nd, 3^rd, and 4^th account number or numbers. Enter the type of account(s). For example, checking, savings, money market and mutual funds, etc.

Items 9 - 30 are completed by the financial institution.

Fld Name / Item No.	Instruction
Items 9A - 9D Date of Origination	Enter origination date of loan or account. See columns A, B, C and D to enter dates of origin.
Item 10 Principal Balance	Enter the current principal balance of loan or account.
Item 11 Accrued Interest	Enter the current accrued interest balance.
Item 12 Daily Interest Accrual	Enter the dollar amount of the daily interest accrual.
Item 13 Effective Date of Items 10 and 11	Enter the effective date of Items 10 and 11.
Item 14 Previous 12-Month High Balance	Enter the previous 12-month high balance of the loan or account.
Item 15 Previous 12-Month Low Balance	Enter the previous 12-month low balance of the loan or account.
Item 16 Current Interest Rate applicant is being charged or is earning	Enter the current interest rate the applicant is being charged or is earning.
Item 17 Installment or annuity amount	Enter installment if the account is a loan. Enter annuity amount if the applicant is receiving a payment from the lender.
Item 18 Amount past due	Enter the amount that is currently past due if applicable.
Item 19 Description of collateral	Enter a brief description of the collateral in the case of a loan.
Item 20 Maturity Date or Final Due Date	Enter the maturity or final due date.
Item 21 Rate of Applicant's Repayment Record	Rate the applicant's repayment record in one of the following three checkboxes: Prompt Checkbox. Enter a checkmark in the checkbox if the applicant was prompt. Usually Prompt Checkbox. Enter a checkmark in the checkbox if the applicant was usually prompt. Not Prompt Checkbox. Enter a checkmark in the checkbox if the applicant was not prompt.
Item 22 How many years …	Enter the number of years the applicant has conducted business with your firm.
Item 23 Do your lien …	Check “YES” if lien instruments, if applicable, contain a hereafter acquired clause, if not check “NO.”
Item 24 Do your lien …	Check “YES” if lien instruments, if applicable, contain a future advance clause, if not check “NO.”
Item 25 Does your firm …	Check “YES” if your firm imposes a penalty if the deposit or investment accounts described on this form are withdrawn prior to maturity. If not, check “NO.”
Item 26 Would you extend additional credit?	Check “YES” if you would extend additional credit. If not, check “NO.”
Item 27 Would you extend …	Check “YES” if you would extend additional credit with an FSA Guarantee. If not, check “NO.”
Item 28 Remarks	Enter any remarks you may have about the applicant.
Item 29A Signature of Financial Institution's Representa-tive	Enter the signature of the authorized financial institution representative. If you are mailing or faxing this form, print the form and manually enter your signature. If this form is approved for electronic transmission and you have established credentials with USDA to submit forms electronically, use the buttons provided on the form for transmitting the form to the USDA servicing office.
Item 29B Title	Enter the title of the authorized financial institution representative.
Item 29C Date	Enter the date the authorized financial institution representative signed the form.
Item 30 Telephone Number	Enter the financial institution's complete telephone number, including area code.