Form 674 Form 674 Certificate of Authority to Submit or Grant Access to Da

Operating Reports for Telecommunications and Broadband Borrowers

rus0674rdup-fillable

Operating Reports for Telecommunications and Broadband Borrowers

OMB: 0572-0031

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According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not 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
0572-0031, Exp. date 5/31/16. The time required to complete this information collection is estimated to average 15 minutes 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.

U.S. Department of Agriculture
Rural Development Utilities Programs

CERTIFICATE OF AUTHORITY TO SUBMIT OR GRANT ACCESS TO DATA
INSTRUCTIONS-Submit one copy to the Rural Development Utilities Programs headquarters and one copy to the GFR.

In accordance with the requirements of the Rural Utilities Service, an agency delivering the U.S.
Department of Agriculture Rural Development Utilities Programs, herein after referred to as the Agency,
and by resolution, attached hereto, of the board of directors or other managing body
(the "Board" of
located at

("the Borrower")
BORROWER'S NAME

,

BORROWER'S ADDRESS

,
, 20
which resolution was adopted by a quorum of the Board, held on
the Board hereby authorizes the officer or manager whose name, title, and USDA eAuthentication ID
appear below (Certifier), to certify and submit the data requested on the following Agency data
collections. Furthermore, said resolution authorizes the following employee whose name, title, and
eAuthentication ID appear below (Security Administrator), to give, as appropriate, other employees,
officers, or contractors access to the Borrower's data on the USDA Rural Development Data Collection
System, subject to the terms of the attached instructions, for the purpose of completing the required data
collection indicated below:
(Check All That Apply)
Form No. (if applicable)
7
12

---

TITLE
Financial and Statistical Report (Electric - Distribution)
Operating Report (Electric - Generation)
Operating Report for Broadband Borrowers
Operating Report for Telecommunications Borrowers

This certification of authority shall remain in force until the Agency has been notified of, and
has acknowledged to the Board, its rescinding of the attached resolution.
Certifier
TITLE

NAME (TYPE OR PRINT)

eAuthentication ID

NAME (TYPE OR PRINT)

eAuthentication ID

Security Administrator
TITLE

BORROWER'S NAME

SIGNATURE OF BOARD PRESIDENT
OR CHAIRMAN
DATE
RDUP Form 674 (03-06)

SIGNATURE OF SECRETARY


File Typeapplication/pdf
File TitleForm 674 - Certificate of Authority to Submit or Grant Access to Data
AuthorPDRA
File Modified2016-04-05
File Created2006-03-22

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