5001-7 Guaranteed Loan Borrower Status

Form RD
5001-7 (00-00)

UNITED STATES DEPARTMENT OF AGRICULTURE
RURAL DEVELOPMENT

FORM APPROVED
OMB NO. 0000-0000

GUARANTEED LOAN BORROWER STATUS
INSTRUCTION TO LENDER - COMPLETE PART B AS APPLICABLE
COMPLETING AS: SEMI-ANNUAL STATUS REPORT as of June 30th _________

December 31st _______

PART A - IDENTIFYING INFORMATION
2. GLS Borrower ID:

1. Borrower Name:

3. Unique Entity Identifier:

5. Original Loan Amount:

4. Agency Program Type:
___Community Facilities

___Water and Waste Disposal

___ Business and Industry

___ Rural Energy for America Program

6. Date of Loan:

PART B - TO BE COMPLETED BY LENDER
7. Lender Name and Address:

12. Unpaid Principal

8. Lender Tax ID:

9. Lender Branch:

10. Lender Loan Number:

11. Date of Last Status Update:

13. Unpaid Interest:

15. Payment Status Code: __________
A = Borrower Ahead of Schedule
B = Borrower Behind Schedule
C = Borrower Current

16. Amount Ahead or Behind
Schedule:

14. Amount Advanced During
During the Current Reporting
Period:

17. Has there been any material change in Borrower’s general financial conditions since the date of the last Guaranteed Loan Borrower Status
Report?
Yes _____

No _____

If yes, please explain

18. Has there been any discrimination complaints of lawsuits fi led against the Borrower since the last Guaranteed Loan Borrower Status Report?
Yes _____

No ______

If yes, please explain

__________________________________________
Lender’s Name

____________________________________
Date

By:_______________________________________
Officer Signature

____________________________________
Officer Title

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number
for this information collection is ####-####. The time required to complete this information is estimated to average ## hours per response, including the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.