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By signing below, Borrower accepts and agrees to the terms and covenants contained in this instrument and in any rider executed by Borrower and
<br />recorded ith this instrument.
<br />Thomas Vern Chapman
<br />STATE OF KANSAS
<br />COUNTY OF Smith
<br />Ja nu a ry ro p'2e0
<br />(SEAL)
<br />ACKNOWLEDGMENTS
<br />1 ss. (Individual)
<br />NOTARY PUBLIC - State of Kansas
<br />KAREN PA 1— N I a1H
<br />MyAppt. Exp 9
<br />Note: Page 6 of 6 applies to entities only and will not be recorded for individuals.
<br />2017071SO
<br />NOTARY PUBLIC
<br />(SEAL)
<br />485
<br />On this 5th day of October, 2017 , before me personally appeared Thomas Vern Chapman, a single
<br />person , to be known to me to be the same person(s) whose name is subscribed to the foregoing instrument, and
<br />acknowledged that (he or she) signed and delivered the instrument as (his or her) free and voluntary act, for the uses and purposes set forth.
<br />NOTE: The following statements are made in accordance with the Privacy Act of 1974 (5 U.S.C. 552a): the Farm Service Agency (FSA) is
<br />authorized by the Consolidated Farm and Rural Development Act, as amended (7 U.S.C. 1921 gL sea.), or other Acts, and the regulations
<br />promulgated thereunder, to solicit the information requested on its application forms. The information requested is necessary for FSA to
<br />determine eligibility for credit or other financial assistance, service your loan, and conduct statistical analyses. Supplied information may be
<br />fumished to other Department of Agriculture agencies, the Internal Revenue Service, the Department of Justice or other law enforcement
<br />agencies, the Department of Defense, the Department of Housing and Urban Development, the Department of Labor, the United States
<br />Postal Service, or other Federal, State, or local agencies as required or permitted by law. In addition, information may be referred to
<br />interested parties under the Freedom of Information Act, to financial consultants, advisors, lending institutions, packagers, agents, and
<br />private or commercial credit sources, to collection or servicing contractors, to credit reporting agencies, to private attomeys under contract
<br />with FSA or the Department of Justice, to business firms in the trade area that buy chattel or crops or sell them for commission, to Members
<br />of Congress or Congressional staff members, or to courts or adjudicative bodies. Disclosure of the information requested is voluntary.
<br />However, failure to disclose certain items of information requested, including Social Security Number or Federal Tax Identification Number,
<br />may result in a delay in the processing of an application or its rejection.
<br />According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a
<br />collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is
<br />0560 -0237. The time required to complete this information collection is estimated to average 30 minutes per response, including the time
<br />for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the
<br />collection of information.
<br />The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age,
<br />disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs,
<br />reprisal, or because all or part of an individual's income is derived from any public assistance program. (Not all prohibited bases apply to all programs.)
<br />Persons with disabilities who require altemative means for communication of program information (Braille, large print, audiotape, etc.) should contact
<br />USDA's TARGET Center at (202) 720 -2600 (voice and TDD). To file a complaint of discrimination, write to USDA, Director, Office of Civil Rights, 1400
<br />Independence Avenue, S.W., Washington, D.C. 20250 -9410, or call (800) 795 -3272 (voice) or (202) 720 -6382 (TDD). USDA is an equal opportunity
<br />provider and employer.
<br />FSA -2029 KS (11- 04 -08) Page 5 of 6
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