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• • IT- mm 02505811 74 (5 U.S.C. 552a - as NOTE: The following uthori statement is made equesting the accordance nformation identified on this form is the Consolidated amended). The authority The information will be used Farm and Rural Development Act, as amended (7 U.S.C. 1921 et. seq.). to determine eligibility and feasibility for loans and loan and servthericing ofral ans and and local loan guarantees. The information collected on this form may be disclosed to vernmental tgovernment the agencies, ual oragencies, and and/or as described in ities that have been authorized access the applicable Routine Uses identified to the information by statuteregulationApplicant/Borrower. Providing the requested in the System of Records Notice for USDA/FSA-14, orinformationloans is voluntary. Hee and servicing of loans and loan guaranteeever, failure to furnish the requested s. The prmation ovisions of crimy result in a inal nal for and loan guarantees, to the information provided. and civil fraud, privacy, and other statutes may be applicable According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, ncollection for this nformataon collection f informtion unless it a,0516050237,id ThOe time B control number. The valid OMB control umber required to complete this information collection is estimated to average 30 minutesresponse, nse, including the time for reviewing instructions, searching existing data sources, gathering maintaining the data needed, and completing and FSA reviewing the collection of information. RETURN THIS COMPLETED FORM The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, disability,nformathon�polpticarbel eft, reprisale, sex, ll�oatus, r becauserlial all or part of antus, status, religion, sexual orientation, genetic all n rams.) individual's income is derived from any public assistance program. (Not all prohibited bases apply programs.) Persons with disabilities who require alternative means for communication of program information (Braille,e large print, audiotape, etc.) should contact USDA's TARGET Center at (202) 720-2600 Office oice andof TDD).eToAssistant 'Secretary complaint of discrimination, write to USDA, Assistant Secretary for Civil Rights, for Civil Rights, 1400 Independence Avenue, S.W., Stop 9410, Washington, DC 20250-9410, or call toll -free at (866) 632-9992 (English) or (800) 877-8339 (TDD) or (866) 77r and employer Federal -relay) or (800) 845-6136 o (Spanish Federal -relay). USDA is an equal opportunity 6 Initial IV ADate2T FSA-2029 NE (05-02-24) Page 8