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APPLICANT <br />Board O$ COI1AtV haus Rives cd1113ty <br />APPROPRIATION <br />R ce (Ethnic Code) <br />Check Oke <br />W ❑1 N ❑2 O ❑3 <br />Al ❑4 S ❑S <br />CASE NUMBER <br />09-3 <br />TYPE OF SUBMISSION <br />❑x 1 -INITIAL ❑2 -SUBSEQUENT <br />NO. 01; INSTALLMENTS FIRST j�1�jST. DUE <br />�1 <br />1115 <br />INTEREST`�RATE <br />TSYP�E 0- ASSISTANCE <br />T <br />REPAYMENTS WITHIN DAYS PRIOR TO THIS LOAN <br />STATE & CO. MAIL CODE <br />09-147 <br />RECEIPT NO. DATE <br />AMOUNT <br />VETERAN: <br />❑ 1 -YES ❑ 2 -NO <br />CHECK DATE AND AMOUNT OF: <br />SCHEDULE NO. $20,639,000-00 <br />THIS SPACE FOR FINANCE <br />OFFICE USE ONLY (EM Loans) <br />IN <br />SF <br />FY <br />NO. ADV. <br />OL INDEBT. <br />I SUB. <br />I HEREBY CERTIFY that I am unable to obtain sufficient credit elsewhere -to finance my actual needs at reasonable rates and terms; <br />taking into consideration prevailing private and cooperative rates and terms in or near my community for loans for similar purposes and <br />periods of time. I agree to use, subject to and in accordance with regulations applicable to the type of assistance indicated above, and <br />request payment of the sum specified herein. I certify that no part of said sum has been received. <br />Bpi OF COUNT% CG " ICI ' IMW7 Fa= COMM <br />' ature pylao¢nt) <br />t\ / Ix, <br />I HEREBY CERTIFY that all of the committee and administrative determinations and certifications required by law or regulations <br />prerequisite to providing assistance of the type indicated above have been made and that evidence thereof is in the docket, and that all <br />requirements of pertinent regulations and laws have been complied with. I hereby approve the above-described assistance in the amount <br />set forth above, and by this document, subject to the availability of funds, the Government agrees to advance such amount to the applicant <br />for the purposes of and subject to the conditions prescribed by the laws and regulations applicable to this type of assistance. <br />Comptete for Operating & Emergency Loans Only BY AUTHORITY OF THE SECRETARY OF AGRICULTURE <br />The County Committee certification for the <br />cropyear ending ........................................ <br />covers this loan. (Signct•ure of Approving Official) <br />Date Title <br />TO THE ABOVE NAMED APPLICANT: This is notice that your application for the above financial assistance from the Farmers Home <br />Administration has been approved, as indicated above, subject to availability of funds and other conditions required by the Farmers <br />Home Administration. If you have any questions contact the County Supervisor. <br />Amount stated above is verified as correct and funds are obligated for payment. <br />Date <br />(Signature of .Authorized Finance Office Official) <br />:t oPo-1972-7152-016/20 FHA 440.1 (Rev. 7-19-72) <br />' position Z <br />90 . <br />