Date _______________________________
(Name of bank) _______________________________
(City or town) _______________________________
(State) _______________________________
Gentlemen: Attached is Draft No. ______, for $______, issued by the ____________ Insurance Company in payment of ______ loss which damage the buildings on the farm of __________________, of ______________ County, State of ______________.
This draft has been endorsed by the undersigned payees who request that you collect these funds and issue cashier's checks to the following payees for the following amounts:
________________, First Mortgage $______
________________, Second Mortgage $______
________________, Third Mortgage $______
The balance only, if any, will be paid to ________________, the owner of the property.
First Mortgagee _______________________________
Second Mortgagee _______________________________
Third Mortgagee _______________________________
Owner _______________________________
7 C.F.R. 1806 app Exhibit A to Subpart A of Part 1806