Spreadsheet Summary - Form 36

USDA - RUS		Title of Information Document						OMB No.
		Water and Waste Loan and Grant Program							0572-0121
SUMMARY OF INFORMATION COLLECTION		7 CFR 1780						Date Prepared
								10/27/11 rev
INSTRUCTIONS:				>	(f) TOTAL		(h) TOTAL		(k) TOTAL
Use this form when a single information collection document involves multiple reporting and				>	-	= (e) Average	-	= (g) Average	-	= (j) Average
recordkeeping requirements.				>	(d) TOTAL		(f) TOTAL		(i) TOTAL
IDENTIFICATION OF REPORTING AND RECORDKEEPPING REQUIREMENTS						ANNUAL BURDEN
		FORM			REPORTS				RECORDS
		NO(s)	NO. OF	NO. OF	TOTAL	HOURS	TOTAL	NO. OF	ANNUAL	TOTAL
SECTION OF		(If "none"	RESPON-	RESPONSES	ANNUAL	PER	HOURS	RECORD-	HOURS PER	RECORD-
REGULATIONS	DESCRIPTION	so state)	DENTS	PER	RESPONSES	RESPONSE	(Col. f & g)	KEEPERS	RECORD-	KEEPING
				RESPON-	(Col. d & e)				KEEPER	HOURS
				DENT						(Col. i & j)
(a)	(b)	(c)	(d)	(e)	(f)	(g)	(h)	(i)	(j)	(k)
	NON-FORM BURDEN
1780.1(f)	Relationship or association with RUS employees	Written	829	1	829	0.25	207
	7 CFR 1777-Colonias (0572-0109)		19	1	19	0.25	5
	7 CFR 1778-ECWAG (0572-0110)		4	1	4	0.25	1
1780.7(d)	Statement on availability to obtain credit elsewhere	Written	829	1	829	1.00	829
	7 CFR 1777-Colonias		19	1	19	1.00	19
	7 CFR 1778-ECWAG		4	1	4	1.00	4
1780.11(a)(2)	Notification of service statement	Written	211	1	211	2.00	422
	7 CFR 1777-Colonias		6	1	6	2.00	12
	7 CFR 1778-ECWAG		1	1	1	2.00	2
1780.14(a)(3) & (b)(2)	Liens on real and chattel property	Written	167	1	167	1.00	167
	7 CFR 1777-Colonias		5	1	5	1.00	5
	7 CFR 1778-ECWAG		1	1	1	1.00	1
1780.14(b)(2)	Financing Statement	Written	211	1	211	1.00	211
	7 CFR 1777-Colonias		6	1	6	1.00	6
	7 CFR 1778-ECWAG		1	1	1	1.00	1
1780.19	Public Information	Written	707	1	707	2.00	1,414
	7 CFR 1777-Colonias		19	1	19	2.00	38
	7 CFR 1778-ECWAG		4	1	4	2.00	8
	SUBTOTAL				3,043		3,352	0.00		0.00
	TOTAL OF ALL PAGES				36,678		104,701	14,000		1,120
TOTAL - Columns "F" and "I" = OMB 83I, 13 b; Columns "H" and "K" = OMB 83I, 13c					50,678		105,821
1780.33(b)	Intergovernmental comments	Written	707	1	707	1.00	707
	7 CFR 1777-Colonias		19	1	19	1.00	19
	7 CFR 1778-ECWAG		4	1	4	1.00	4
1780.33(c)	Preliminary engineering report	Written	707	1	707	4.00	2,828
	7 CFR 1777-Colonias		19	1	19	4.00	76
	7 CFR 1778-ECWAG		4	1	4	4.00	16
1780.33(e)	Supporting documentation	Written	707	1	707	6.00	4,242
	7 CFR 1777-Colonias		19	1	19	6.00	114
	7 CFR 1778-ECWAG		4	1	4	6.00	24
1780.33(h)(5)	Certification Regarding Debarment	AD-1047	707	1	707	0.25	177
	7 CFR 1777-Colonias		19	1	19	0.25	5
	7 CFR 1778-ECWAG		4	1	4	0.25	1
1780.33(h)(6)	Certification Regarding Drug-Free Workplace	AD-1049	707	1	707	0.25	177
	7 CFR 1777-Colonias		19	1	19	0.25	5
	7 CFR 1778-ECWAG		4	1	4	0.25	1
1780.39(b)(1) and (2)	Agreements for professional services	Written	707	1	707	4.00	2,828
	7 CFR 1777-Colonias		19	1	19	4.00	76
	7 CFR 1778-ECWAG		4	1	4	4.00	16
1780.39(b)(4)	Contracts for other services	Written	707	1	707	2.00	1,414
	7 CFR 1777-Colonias		19	1	19	2.00	38
	7 CFR 1778-ECWAG		4	1	4	2.00	8
	SUBTOTAL				5,110		12,775
1780.39(c)(5)(i)	Positive programs to encourage connections	Written	89	1	89	3.00	267
	7 CFR 1777-Colonias		7	1	7	3.00	21
	7 CFR 1778-ECWAG		4	1	4	3.00	12
1780.39(c)(3)	User agreement	Written	89	1	89	4.00	356
	7 CFR 1777-Colonias		7	1	7	4.00	28
	7 CFR 1778-ECWAG		4	1	4	4.00	16
1780.39(d)	Interim financing	Written	600	1	600	4.00	2,400
	7 CFR 1777-Colonias		0	1	0	4.00	0
	7 CFR 1778-ECWAG		0	1	0	4.00	0
1780.39(g)(3)	Fidelity or employee dishonesty Bond	Written	707	1	707	4.00	2,828
	7 CFR 1777-Colonias		19	1	19	4.00	76
	7 CFR 1778-ECWAG		4	1	4	4.00	16
1780.39(g)(4)	Property insurance	Written	707	1	707	1.00	707
	7 CFR 1777-Colonias		19	1	19	1.00	19
	7 CFR 1778-ECWAG		4	1	4	1.00	4
1780.39(g)(5)	General Liability Insurance	Written	707	1	707	1.00	707
	7 CFR 1777-Colonias		19	1	19	1.00	19
	7 CFR 1778-ECWAG		4	1	4	1.00	4
1780.39(g)(6)	Flood Insurance	Written	89	1	89	1.00	89
	7 CFR 1777-Colonias		5	1	5	1.00	5
	7 CFR 1778-ECWAG		1	1	1	1.00	1
	SUBTOTAL				3,085		7,575
1780.39(g)7)	Workman's compensation insurance	Written	707	1	707	0.50	354
	7 CFR 1777-Colonias		19	1	19	0.50	10
	7 CFR 1778-ECWAG		4	1	4	0.50	2
1780.44(f)	Evidence of other funds	Written	250	1	250	1.00	250
	7 CFR 1777-Colonias		15	1	15	1.00	15
	7 CFR 1778-ECWAG		4	1	4	1.00	4
1780.44(g)(3)	Water rights	Written	100	1	100	3.00	300
	7 CFR 1777-Colonias		7	1	7	3.00	21
	7 CFR 1778-ECWAG		1	1	1	3.00	3
1780.44(g)	Appraisal Report	Written	42	1	42	2.00	84
	7 CFR 1777-Colonias		3	1	3	1.00	3
	7 CFR 1778-ECWAG		1	1	1	1.00	1
1780.44(g)(1)(ii)	User Connections	Written	25	1	25	3.00	75
	7 CFR 1777-Colonias		2	1	2	1.00	2
	7 CFR 1778-ECWAG		3	1	3	1.00	3
1780.44(g)(4)	Lease agreement	Written	42	1	42	5.00	210
	7 CFR 1777-Colonias		3	1	3	5.00	15
	7 CFR 1778-ECWAG		5	1	5	5.00	25
1780.45(a)	Notes, bonds, warrants or other contractural obligations	Written	707	1	707	5.00	3,535
	7 CFR 1777-Colonias		0	1	0	5.00	0
	7 CFR 1778-ECWAG		0	1	0	5.00	0
	SUBTOTAL				1,940		4,911
1780.45(a)(2)	Loan Resolution (Public Bodies)	RUS Bulletin 1780-27	591	1	591	1.00	591
	7 CFR 1777-Colonias		0	1	0	1.00	0
	7 CFR 1778-ECWAG		0	1	0	1.00	0
1780.45(a)(2)	Loan Resolution, Security Agreement	RUS Bulletin 1780-28	116	1	116	1.00	116
	7 CFR 1777-Colonias		0	1	0	1.00	0
	7 CFR 1778-ECWAG		0	1	0	1.00	0
1780.45(c)	Grant Agreement	RUS Bulletin 1780-12	353	1	353	1.00	353
	7 CFR 1777-Colonias		19	1	19	1.00	19
	7 CFR 1778-ECWAG		4	1	4	1.00	4
	Rural Alaska Village Grants	Written	10		10		10
1780.47(d)	Audits	Written	3,288	1	3,288	8.00	26,304
	7 CFR 1777-Colonias		19	1	19	8.00	152
	7 CFR 1778-ECWAG		4	1	4	8.00	32
1780.47(f)	Management report	Written	707	4	2,828	8.00	22,624
	7 CFR 1777-Colonias		19	4	76	8.00	608
	7 CFR 1778-ECWAG		4	4	16	8.00	128
1780.61	Construction contract forms	Written	707	1	707	3.00	2,121
	7 CFR 1777-Colonias		19	1	19	3.00	57
	7 CFR 1778-ECWAG		4	1	4	3.00	12
	SUBTOTAL				8,054		53,131
1780.61(b)	Borrower attorney's certification of construction contract	Written	707	1	707	15.00	10,605
	7 CFR 1777-Colonias		19	1	19	15.00	285
	7 CFR 1778-ECWAG		4	1	4	15.00	60
1780.63	Sewage treatment and bulk water sales contracts	Written	89	1	89	3.00	267
	7 CFR 1777-Colonias		6	1	6	3.00	18
	7 CFR 1778-ECWAG		0	1	0	3.00	0
1780.74	Contracts awarded prior to application	Written	20	1	20	2.00	40
	7 CFR 1777-Colonias		1	1	1	2.00	2
	7 CFR 1778-ECWAG		0	1	0	2.00	0
1780.76(b)	Monitoring construction	Written	707	1	707	5.00	3,535
	7 CFR 1777-Colonias		19	1	19	5.00	95
	7 CFR 1778-ECWAG		4	1	4	5.00	20
1780.76(c)	Resident Inspector resume	Written	707	1	707	2.00	1,414
	7 CFR 1777-Colonias		19	1	19	2.00	38
	7 CFR 1778-ECWAG		4	1	4	2.00	8
1780.76(d)	Daily inspection report	Written	707	18	12,726	0.50	6,363
	7 CFR 1777-Colonias		19	18	342	0.50	171
	7 CFR 1778-ECWAG		4	18	72	0.50	36
1780.37(b)	Borrower shall maintain accounting records for 3 years							7,000	0.08	560
	Contractor required records							7,000	0.08	560
	SUBTOTAL				15,446		22,957	14,000		1,120
	FORMS APPROVED UNDER OTHER OMB NUMBERS
1780.44(g)(2)	Preliminary Title Opinion	RD 1927-9	707	1	707	1.50	1,061
	7 CFR 1777-Colonias	(0575-0147)	19	1	19	1.50	29
	7 CFR 1778-ECWAG		4	1	4	1.50	6
1780.44(g)(2)	Final Title Opinion	RD 1927-10	707	1	707	0.34	240
	7 CFR 1777-Colonias	(0575-0147)	19	1	19	0.34	6
	7 CFR 1778-ECWAG		4	1	4	0.34	1
1780.76(e)	Partial Payment Estimate	RD 1924-18	707	1	707	0.50	354
	7 CFR 1777-Colonias	(0575-0042)	19	1	19	0.50	10
	7 CFR 1778-ECWAG		4	1	4	0.50	2
1780.76(h)(2)	Contract Change Order	RD 1924-7	707	1	707	0.25	177
	7 CFR 1777-Colonias	(0575-0042)	19	1	19	0.25	5
	7 CFR 1778-ECWAG		4	1	4	0.25	1
1780.33(h)(3)	Equal Opportunity Agreement	RD 400-1	707	1	707	0.08	57
	7 CFR 1777-Colonias	(0575-0018)	19	1	19	0.08	2
	7 CFR 1778-ECWAG		4	1	4	0.08	0
1780.33(h)(4)	Assurance Agreement	RD 400-4	707	1	707	0.25	177
	7 CFR 1777-Colonias	(0575-0018)	19	1	19	0.25	5
	7 CFR 1778-ECWAG		4	1	4	0.25	1
1780.33(a)	Application for Federal Assistance	SF 424	829	1	829	1.00	829
	7 CFR 1777-Colonias	(4040-0004)	22	1	22	1.00	22
	7 CFR 1778-ECWAG		5	1	5	1.00	5
1780.33(h)(1)	Operating Budget	RD 442-7	707	1	707	5.00	3,535
	7 CFR 1777-Colonias	(0575-0015)	19	1	19	5.00	95
	7 CFR 1778-ECWAG		4	1	4	5.00	20
1780.41(a)(3)	Balance Sheet or Financial Statement	RD 442-3	707	1	707	1.00	707
	7 CFR 1777-Colonias	(0575-0015)	19	1	19	1.00	19
	7 CFR 1778-ECWAG		4	1	4	1.00	4
1780.29(b)(1)	Agreement for Engineering Services	1942-19	707	1	707	4.00	2,828
	7 CFR 1777-Colonias	(0575-0015)	19	1	19	4.00	76
	7 CFR 1778-ECWAG		4	1	4	4.00	16
1780.39(f)	Resolution of Members or Stockholders	RD 1942-8	155	1	167	1.00	167
	7 CFR 1777-Colonias	(0575-0015)	8	1	13	1.00	13
	7 CFR 1778-ECWAG		1	1	20	1.00	20
1780.41(a)(6)	Letter of Intent to Meet Conditions	RD 1942-46	707	1	707	1.00	707
	7 CFR 1777-Colonias	(0575-0015)	19	1	19	1.00	19
	7 CFR 1778-ECWAG		4	1	4	1.00	4
1780.44(g)(1)(i)	Opinion of Counsel Relative to Right-of-Way and Easements	RD 442-22	707	1	707	1.00	707
	7 CFR 1777-Colonias	(0575-0015)	19	1	19	1.00	19
	7 CFR 1778-ECWAG		4	1	4	1.00	4
1780.45(b)(1)(ii)	Estimate of Funds Needed for 30-Day Period Commencing ____"	RD 440-11	707	1	707	1.00	707
	7 CFR 1777-Colonias	(0575-0015)	19	1	19	1.00	19
	7 CFR 1778-ECWAG		4	1	4	1.00	4
1780.37(f)	Statement of Budget, Income, and Equity	RD 442-2	707	1	707	2.50	1,768
	7 CFR 1777-Colonias	(0575-0015)	19	1	19	2.50	48
	7 CFR 1778-ECWAG		4	1	4	2.50	10
1780.62	Water Purchase Contract	RD 442-30	167	1	167	1.00	167
	7 CFR 1777-Colonias	(0575-0015)	13	1	13	1.00	13
	7 CFR 1778-ECWAG		1	1	1	1.00	1
1780.75	Certification of Contractor's Lease	RD 1924-9	707	1	707	0.25	177
	7 CFR 1777 - Colonias	(0575-0042)	19	1	19	0.25	5
	7 CFR 1778 -ECWAG		4	1	4	0.25	1
1780.75	Release by Claimants	RD 1924-10	707	1	707	0.50	354
	7 CFR 1777 - Colonias	(0575-0042)	19	1	19	0.50	10
	7 CFR 1778 -ECWAG		4	1	4	0.50	2
1780.76(f)	Insepction Report	RD 1924-12	707	3	2,121	0.25	530
	7 CFR 1777 - Colonias	(0575-0042)	19	3	57	0.25	14
	7 CFR 1778 -ECWAG		4	3	12	0.25	3
1780.45(a)	Promissory Note	RD 440-22	707	1	707	0.25	177
	7 CFR 1777 - Colonias	(0575-0015)	19	1	19	0.25	5
	7 CFR 1778 -ECWAG		4	1	4	0.25	1
RUS Form 36 (07-91)