Intermediairy Relending Program

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0570-0021 can be found here:

Documents and Forms

Document Name Document Type
Form 400-4 Intermediairy Relending Program Form
RD 4274-5 Intermediary Relending Program Supplemental Loan Agreeme 4274-05.pdf Form
RD 4274-1 Application for Loan 4274-01.pdf Form
RD 4274-3 Intermediary Relending Program Promissory Note 4274-03.pdf Form
RD 4273-4 Intermediary Relending Program Loan Agreement 4274-04.pdf Form
1940-20 Request for Environmental Information (approved under 05 1940-20.pdf Form
1951-4 Report of IRP/RDLF Lending Activity (approved under 0570 1951-04.pdf Form
400-4 Assurance Agreement (approved under 0570-0018) 0400-04.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Intermediairy Relending Program	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 7 CFR 4274

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	400-4	Assurance Agreement (approved under 0570-0018)	0400-04.pdf	Yes	Yes	Fillable Printable
Form	RD 4274-5	Intermediary Relending Program Supplemental Loan Agreement	4274-05.pdf	Yes	No	Fillable Printable
Form	1940-20	Request for Environmental Information (approved under 0575-0094)	1940-20.pdf	Yes	Yes	Fillable Printable
Form	1951-4	Report of IRP/RDLF Lending Activity (approved under 0570-0015)	1951-04.pdf	Yes	Yes	Fillable Printable
Form	RD 4273-4	Intermediary Relending Program Loan Agreement	4274-04.pdf	Yes	No	Fillable Printable
Form	RD 4274-1	Application for Loan	4274-01.pdf	Yes	No	Fillable Printable
Form	RD 4274-3	Intermediary Relending Program Promissory Note	4274-03.pdf	Yes	No	Fillable Printable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 202	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	2,403	2,403
Annual IC Time Burden (Hours)	17,959	17,959
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.