Form Ccc 185 – Fill Out and Use This PDF

This form is available electronically.

(See Page 2 for Privacy Act and Paperwork Reduction Act Statements)

2A. Name and Address of Loan Applicant (Including ZIP Code)		2B. Tax Identification No.	2C. Telephone No.
		(last 4 digits)	(Including Area Code)
		3A. Requested Loan Amount	3B. Requested Loan Term
	$

4.Purpose of Loan (For example, loan to purchase, construct, erect, install or remodel the farm storage facility.)

5.Facility Equipment described in Item 4 needed for the storage, drying, or handling of the estimated production of the listed commodities on the farm.

A.		B.		C.		D.	E.
Farm Number		Commodities		Acres		Yield Per Acre	Total Production for Each
							Commodity
							(Item 5C times Item 5D = Item 5E)
				X		=
				X		=
				X		=
				X		=
				X		=
				X		=
				F. Total Production from Item 5E.
				G. Total Estimated Production Times Applicable Years
						H. Existing Capacity
					I. Additional Capacity Needed
		J. Capacity of Proposed Storage Structure Described in Item 4.
			K. Eligibility and Proration Indicator (Item 5Iminus Item 5J)
6. Date Facility Equipment Purchased or Tentative Purchase				7. Name of Company Where Facility Equipment			Was Purchased
Date (MM-DD-YYYY)
8. Date Facility Equipment Erected or Installed or Tentative				9. Name of Company That Erected or Installed the Facility Equipment
Date to Erect or Install (MM-DD-YYYY)
10. Date Facility Equipment Was/Will Be Delivered to the Farm				11. Location of Real Estate on Which Facility Equipment Was/Will Be
(MM-DD-YYYY)				Erected or installed
12A. Name of Owner of Real Estate in Item 11				12B. Lien Information (Name of Person Having a Lien or Interest in the
(If Other than Applicant)				Real Estate)

13. APPLICANT'S CERTIFICATION

The Applicant certifies that the statements made on this application are true, complete and correct to the best of the applicant's knowledge and belief, and made in good faith to obtain a loan. Section 1001 of Title 18, United States Code provides for criminal penalties to those who provide false statements on loan applications. Applicants are aware that credit reports will be requested on all applicants and co-applicants. By signing below, I acknowledge that, as a condition for the FSFL, I am required annually to provide proof of payment of real estate taxes, crop insurance or NAP; and all-peril and flood insurance, if required.

Are you or any co-applicant delinquent on any Federal non-tax debt? (If “YES”, provide details in the remarks)		YES		NO
A. Signature of Applicant (By)	B. Title/Relationship of the Individual if Signing in a			C. Date of Application
	Representative Capacity			(MM-DD-YYYY)
D. Signature of Co-applicant (By)	E. Title/Relationship of the Individual if Signing in a			F. Date of Application
	Representative Capacity			(MM-DD-YYYY)

CCC-185 (02-12-13)

Page 2 of 2

14. CCC APPROVAL

A loan is approved by CCC for the approximate amount shown in Item 14A below, but not to exceed the amount authorized in the program regulations. Such loan shall be repayable in the number of equal annual installments shown in Item 14B. This approval shall become null and void 6 months after the date hereof unless the loan funds have been disbursed or this approval has been extended in writing by the State or County Committee. Loan funds will not be disbursed until property has been erected or installed and inspected and approved in accordance with program regulations.

A. Loan Amount Approved By	B. Number of Loan Installments	C. Final Loan Approval	D. Date CCC Contacted Loan
CCC Pending Funding		Expiration Date (MM-DD-YYYY)	Applicant of Final Expiration
			Date (MM-DD-YYYY)
$
15A. Signature of CCC Representative		15B. Date (MM-DD-YYYY)
16A. FSA County Office Name and Address (Including ZIP Code)		17. Security Required: When loan approved, enter type of security
		that approving committee is requiring (UCC or chattel mortgage
		or 1st lien. Enter size of tract covered by lien, if required).
16B. Telephone Number (Including Area Code)
18. Remarks

NOTE: The following statement is made in accordance with the Privacy Act of 1974 (5 USC 552a - as amended). The authority for requesting the information identified on this form is 7 CFR Part 1436, the Commodity Credit Corporation Charter Act (15 U.S.C. 714 et seq.), and the Food, Conservation, and Energy Act of 2008 (Pub. L. 110-246). The information will be used to determine eligibility for CCC financing for farm storage and drying equipment. The i nformation collected on this form may be disclosed to other Federal, State, Local government agencies, Tribal agencies, and nongovernmental entities that have been authorized access to the information by statute or regulation and/or as described in applicable Routine Uses identified in the System of Records Notice for USDA/FSA-14, Applicant/Borrower. Providing the requested information is voluntary. However, failure to furnish the requested information will result in a determination of ineligibility for CCC financing under the Farm Storage Facility Loan Program.

This information collection is exempted from the Paperwork Reduction Act as it is required for the administration of the Food, Conservation, and Energy Act of 2008 (see Pub. L. 110-246, Title I, Subtitle F-Administration). The provisions of criminal and civil fraud, privacy and other statutes may be applicable to the information provided. RETURN THIS COMPLETED FORM TO YOUR COUNTY FSA OFFICE.

The U.S. Department of Agriculture (USDA) prohibits discrimination against its customers, employees, and applicants for employment on the bases of race, color, national origin, age, disability, sex, gender identity, religion, reprisal, and where applicable, political beliefs, marital status, familial or parental status, sexual orientation, or all or part of an individual's income is derived from any public assistance program, or protected genetic information in employment or in any program or activity conducted or funded by the Department. (Not all pr ohibited bases will apply to all programs and/or employment activities.)

If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, found online at http://www.ascr.usda.gov/complaint_filing_cust.html , or at any USDA office, or call (866) 632-9992 to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter to us by mail at U.S. Department of Agriculture, Director, Office of Adjudication, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, by fax (202) 690-7442 or e- mail at program.intake@usda.gov.

Individuals who are deaf, hard of hearing, or have speech disabilities and wish to file either an EEO or program complaint, pl ease contact USDA through the Federal Relay Service at (800) 877- 8339 or (800) 845- 6136 (in Spanish). Persons with disabilities, who wish to file a program complaint, please see information above on how to contact us by mail directly or by email. If you require alternative means of communication

for program information (e.g., Braille, large print, audiotape, etc.) please contact USDA’s TARGET Center at (202) 720-2600 (voice and TDD).