Form AG-01324-01 "Application for Disaster Recovery Loan Participation - a 45%/$200,000 Participation Program" - Minnesota

What Is Form AG-01324-01?

This is a legal form that was released by the Minnesota Department of Agriculture - a government authority operating within Minnesota. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 2019;
  • The latest edition provided by the Minnesota Department of Agriculture;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form AG-01324-01 by clicking the link below or browse more documents and templates provided by the Minnesota Department of Agriculture.

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Download Form AG-01324-01 "Application for Disaster Recovery Loan Participation - a 45%/$200,000 Participation Program" - Minnesota

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Rural Finance Authority
FOR RFA USE ONLY:
Minnesota Department of Agriculture
625 Robert Street North
Application
St. Paul, Minnesota 55155-2538
No.:______________________
651-201-6004
Date
Received:____________________
APPLICATION FOR DISASTER RECOVERY LOAN PARTICIPATION
A 45%/$200,000 Participation Program
PART 1:
OFFER: Submission of this application constitutes an offer to sell a participation interest in the
lenders proposed loan described in the application.
Lender Name: ___________________________________________________
MPA #: _________________
Lender Address: _________________________________________________
P.O. Box: _______________
City, State, Zip: _____________________________________________________________________________
Contact Person: _________________________________________________
Phone: _________________
Federal Tax ID: _____________________ State Tax ID: _________________
Fax: ___________________
PART 2:
RECOVERY FINANCING:
Total cost of recovery
$_________________________
Less applicant equity/other
- $_________________________
Total financing requested
$_________________________
Closing costs (if financed)
+ $_________________________
Amount to be financed by lender and RFA
$_________________________
RFA participation amount (__________%)
$_________________________
Loan balance retained by lender **
$_________________________
** (including other financed costs
i.e. stock $____________________)
____________________________________________________________________________________________________________
In accordance with the Americans with Disabilities Act, this information is available in alternative forms of communication upon request by
calling 651-201-6000. TTY users can call the Minnesota Relay Service at 711. The MDA is an equal opportunity employer and provider.
1
Rural Finance Authority
FOR RFA USE ONLY:
Minnesota Department of Agriculture
625 Robert Street North
Application
St. Paul, Minnesota 55155-2538
No.:______________________
651-201-6004
Date
Received:____________________
APPLICATION FOR DISASTER RECOVERY LOAN PARTICIPATION
A 45%/$200,000 Participation Program
PART 1:
OFFER: Submission of this application constitutes an offer to sell a participation interest in the
lenders proposed loan described in the application.
Lender Name: ___________________________________________________
MPA #: _________________
Lender Address: _________________________________________________
P.O. Box: _______________
City, State, Zip: _____________________________________________________________________________
Contact Person: _________________________________________________
Phone: _________________
Federal Tax ID: _____________________ State Tax ID: _________________
Fax: ___________________
PART 2:
RECOVERY FINANCING:
Total cost of recovery
$_________________________
Less applicant equity/other
- $_________________________
Total financing requested
$_________________________
Closing costs (if financed)
+ $_________________________
Amount to be financed by lender and RFA
$_________________________
RFA participation amount (__________%)
$_________________________
Loan balance retained by lender **
$_________________________
** (including other financed costs
i.e. stock $____________________)
____________________________________________________________________________________________________________
In accordance with the Americans with Disabilities Act, this information is available in alternative forms of communication upon request by
calling 651-201-6000. TTY users can call the Minnesota Relay Service at 711. The MDA is an equal opportunity employer and provider.
1
PART 3:
APPLICANT(S):
Name: ___________________________________________________
Phone: _______________________
Name: ___________________________________________________
County: ______________________
Address: _________________________________________________
Zip: _________________________
PART 4:
APPLICANT ELIGIBILITY CRITERIA – ALL APPLICANTS:
Circle either T for true or F for false regarding each of the following. When two or more individuals apply
jointly, the term “I” shall mean “we”, but only one person need fulfill criteria 2 and 6.
A:
GENERAL ELIGIBILITY CRITERIA – ALL APPLICANTS
1.
T
or F
I am a resident of the State of Minnesota or a domestic family farm corporation
or a family farm partnership as defined in Section 500.24, Subdivision 2.
2.
T
or F
I am the principal operator of the farm.
3.
T
or F
I certify that the damage or loss was sustained within a county that was included
in a state or federal disaster declaration, or because of the presence of avian
influenza, due to excessive snowfall, or due to cover the loss of revenue when
the revenue loss is due to an infectious human disease for which the governor
has declared a peacetime emergency under section 12.31.
4.
T
or F
I have received all applicable indemnity claims.
5.
T
or F
At least 50 percent of my average annual gross income was from farming the last
three years.
6.
T
or F
I have a financial need and the ability to repay the loan.
7.
T
or F
I am actively engaged in farming (off-farm income is acceptable).
8.
T
or F
I have never received an RFA participation loan before. If false, enter RFA
participation loan #: _______________________________.
I HEREBY CERTIFY that I have read and circled the eligibility criteria above, that I am eligible for the program
indicated, and have submitted my $50 non-refundable application fee.
______________________________
______________________________
__________________
(Signature)
(Spouse)
(Date)
___________________________________________________________________________________________________
In accordance with the Americans with Disabilities Act, this information is available in alternative forms of communication upon request
_
by calling 651-201-6000. TTY users can call the Minnesota Relay Service at 711. The MDA is an equal opportunity employer and provider.
2
PART 5:
LENDER CERTIFICATION:
I HEREBY CERTIFY that I have reviewed the above criteria with the applicant and believe that the applicant is in
compliance with the statutory intent of the program and the Participation Agreement which we have executed.
______________________________
______________________________
__________________
(Authorized Signature)
(Title)
(Date)
The lender must submit the following documents with this application:
$50 non-refundable application fee; lenders evaluation of collateral; cash flow projection for the next complete
production year; three years of borrower’s income tax statements; loan narrative and risk rating analysis; qualified
financial statement; and RFA Loan Agreement and Note (rough draft).
(Financial information is confidential by law)
PART 6:
FINANCING INFORMATION: Loan proceeds may be used to:
A:
Pay for the cost of clean-up and removal of debris, lost seed or other crop inputs, feed or livestock not
covered by insurance.
B:
Repair existing agricultural buildings to a similar size and capacity
C:
Replace destroyed agricultural buildings with structures of similar capacity and function and to repair
or replace septic and water systems.
D:
Purchase watering systems, irrigation systems, and other drought mitigation systems and practices
when drought is the cause of the purchase.
E:
Replace poultry birds not covered by indemnity payments, make improvements to poultry buildings, or
to cover the loss of revenue if the damage or loss is due to highly pathogenic avian influenza.
F:
Experienced a loss of agriculture revenue due to a human disease.
List the repairs to be done, items to be replaced, or other expenditures relating to this recovery and the
estimated cost of each:
Item:
Cost:
__________________________________________________________
________________________
__________________________________________________________
________________________
__________________________________________________________
________________________
__________________________________________________________
________________________
__________________________________________________________
________________________
Total Cost of Recovery:
$_______________________
_________________________________________________________________________________________
_
In accordance with the Americans with Disabilities Act, this information is available in alternative forms of communication upon request
by calling 651-201-6000. TTY users can call the Minnesota Relay Service at 711. The MDA is an equal opportunity employer and provider.
3
Describe the collateral: ______________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
PART 7:
RFA APPROVAL/DISAPPROVAL OF APPLICATION:
__________ Approved for RFA participation and closing.
__________ Not approved.
Participation has been assigned the following number: _____________________________________________
Comments: ________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
______________________________
______________________________
__________________
(Authorized Signature)
(Title)
(Date)
Note: If not approved, either the applicant or lender may petition for reconsideration. Call the RFA office for further
information.
PART 8:
LENDER CERTIFICATION OF LOAN CLOSING:
This loan was closed on: ________________________________________.
(Date)
______________________________
______________________________
__________________
(Authorized Signature)
(Title)
(Date)
(After closing, forward copies of security documents to the RFA)
_________________________________________________________________________________________
_
In accordance with the Americans with Disabilities Act, this information is available in alternative forms of communication upon request
by calling 651-201-6000. TTY users can call the Minnesota Relay Service at 711. The MDA is an equal opportunity employer and provider.
4
PART 9:
STATEMENT OF EXPERIENCE (By Applicant):
Describe your farming operation and the damages caused by the disaster. (Attach a separate sheet if needed.)
--------------------------------------------------------------------------------------------------------------------------------------------------
FOR STATISTICAL PURPOSES ONLY – NOT USED FOR CREDIT ANALYSIS – PLEASE COMPLETE
--------------------------------------------------------------------------------------------------------------------------------------------------
Age/s:
_______________
Post H.S.:
T
or F
Married:
T
or F
College Degree:
2 yr. or
4 yr.
Children
T
or F
School: __________________________________
H.S. Graduate:
T
or F
Major: ___________________________________
______________________________
______________________________
__________________
(Signature)
(Spouse)
(Date)
_________________________________________________________________________________________
_
In accordance with the Americans with Disabilities Act, this information is available in alternative forms of communication upon request
by calling 651-201-6000. TTY users can call the Minnesota Relay Service at 711. The MDA is an equal opportunity employer and provider.
AG-01324-01 (03/2019)
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