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•® <br />• USDA-FmHA <br />Form FmHA 19401 REQUEST FOR OBLIGATION OF FUNL_ <br />( Rev. 2.86) <br />e z <br />s iiiS1P#�t."1`I+Qt IYP1fNCAII.rC,Afklxp�fr�b�YlIf+x+stw�ltilC�t�;tl.l,,(�t; <br />:iilliE:ICfI'71^►fk4�IbIMflMMsl!11Y�tlt}:11f#�11fN!....;.,..::` <br />�:...5.;.. .. .:r <br />1. CASE NO. <br />ffit%YfEAss. r <br />St Co Borrower's ID <br />0 9 0 3 1 0 0 0 1 2 0 0 4 7 7 <br />ONlre ti€1�`',; ' {l�tra� lintYi ,: <br />3. NO. NAME FIELDS <br />2. BORROWER NAME <br />I N D IIIA N R I V E R B D 10,Fl 1 (1) <br />2 (1, 2, ora from Item 2) <br />4. STATE NAME <br />C O U N T Y C O M M I Isis I O N S 1 1(2) <br />F L O R Y D A <br />5. COUNTY NAME <br />-A 111111111 111 111, 1 (3) <br />I N D I I I I V E R <br />A I Ny�p <br />/ f <br />lKSRp�}}s�j��gy tt ��yy}9�q y ya�g <br />qR <br />„ <br />f �67tAJH1YR/l4 R ��►{1S ..�' . <br />5. RACE/ETHNIC CLASSIFICATION <br />. . <br />7. SEX CODE 1 = Male 4 - Organization. Male Owned <br />2 = Female 5 = Organization Female Owned <br />1 - White 2 = Black 3 - AVAN 4= Hispanic 5 = A/PI <br />fi 3 = Family Unit 6 = Public Body <br />8. MARITAL STATUS <br />9. VETERAN CODE <br />10. CREDIT REPORT <br />11. DIRECT PAYMENT <br />1 - Married 3 = Unmarried <br />1 = County Office 3 = No <br />2 = Separated <br />11= Yes 2 = No <br />21 1 = Yes 2 = No <br />3 2 = F Inance Office <br />12. TYPE OF PAYMENT <br />13. FEE INSPECTION <br />14. INTEREST CREDIT <br />15. COMMUNITY SIZE <br />1 = Monthly 3 = Semiannual <br />1 = yes <br />1 = 10,000 or less (SF11 & AIFH <br />2 2 =Annually 4 = Quarterly <br />2 1 -yes 2 = No <br />(SPH & MEll Only) <br />12=N. <br />Only) <br />2 =Over 10,000 <br />i <br />^ <br />lCO: P� ETE FOR-:7Gu <br />s� <br />014 0T.. �� , <br />16. TYPE OF ASSISTANCE <br />17. PURPOSE CODE <br />YPE OF FUNDS <br />Gueran tool no Interest Rate Buydown <br />Insured <br />(�2 <br />Guaranteed - with Interest Rate Buydownaranteed <br />Interest Rate Buydown Only <br />19. PERCENT OF LOAN <br />19A. TERM OF INTEREST <br />20. TYPE OF ACTION - <br />GUARANTEED <br />RATE BUYDOWN <br />(Complete 1/)fent IB <br />1 = Obligation Only <br />2 _ Obligation/Check Request <br />Equals 1, 3 or 9i <br />1 = 1 Year 2 = 2 Years 3 = 3 Years <br />3 = Correction of Obligation <br />21. TYPE OF SUBMISSION <br />22. AMOUNT OF LOAN <br />23. AMOUNT OF GRANT <br />1 Initial (Enter Code. 2 If subsequent loan associated <br />$ <br />S <br />21 2= Subsequent reith Credit Sale or Assumption) <br />41 51 3 01 01000,01 <br />0 0 0 1. <br />24. AMOUNT OF IMMEDIATE 25. DATE OF APPROVAL <br />28. INTEREST RATE 27. REPAYMENT TERMS <br />$ ADVANCE <br />MO OA YR <br />1000101 - - <br />713,7.5. 0 (%) 1Nn. of Yaare) <br />COMPLETE FOR $INQIX <br />FAMILY HOUSING ONLY <br />28. INCOME CATEGORY CODES <br />29. LOW INCOME LIMIT -MAX. <br />20. ADJUSTED FAMILY <br />1 - Very Low 3 = Moderate <br />$ <br />S INCOME <br />2= Low 4= Above Moderate <br />90101 <br />0 0 0 <br />31. R. E. INSURANCE <br />32. R. E. TAXES - 1st YEAR <br />33. R. E. TAXES - 2nd YEAR <br />34. NOTE INSTALLMENT <br />$ <br />$ <br />$ <br />$ INELIGIBLE <br />00101 <br />1.00101 <br />00101 <br />Ji00 <br />35. TYPE OF UNIT <br />36. DWELLING CODE <br />1 = Farm Tract <br />1 - Build 3 = Purchase Old 5 = Repair 7 Refinance Repair <br />2 -Non Farm Tract <br />2 Purchase Now 4 = Refinance 6 - Purchase Old Repair <br />-(COMPLETE FOR COMMUNITY <br />PROGRAM ANT) <br />CERTAIN MULTIPLE -FAMILY MOUSING LOANS <br />37 TYPE OF APPLICANT <br />38. PROFIT TYPE <br />1 = Individual 3 Corporation 5 = Assn. of Farmers 7 = Other <br />2 Partnership 4 = Public Body 6 - Organ. of Farm Workers <br />i Full Profit 2 Limited Profit 3 Non -Profit <br />:..: _ �COftiii'LETlE ICOR NSONLY <br />°COMPLETE FOR CREpiT SALE/ASSUMPTIONS ONLY <br />39. DISASTER DESIGNATION NUMBER <br />40. TYPE OF SALE <br />1 • Credit Sale Only 3 Credit Sale/Subsoquent Loan <br />(See /'All) <br />2 - Assumption Only 4 Assumption/Subsequent Loan <br />ORIGINAL - Borrower's Case Folder <br />Position 2 <br />N <br />FmHA 19401 (Rev. 2-86) <br />C <br />