Spreadsheet

				Reports	Total Annual	Est. No. of	Est. Total	Wages	Cost to the
		Form No.	Est. No. of	Filed	Responses	Man hours	Man-hours	Class	Public
Section of Regulation	Title	(if Any)	Respond-ents	Annually	(D) x (E)	Per Response	(F) x (G)	$/Hr.	(H) x (I)
(A)	(B)	(C)	(D)	(E)	(F)	(G)	(H)	(I)	(J)
REPORTING REQUIREMENTS - FORMS APPROVED WITH THIS DOCKET
1780.33(h)(1); 1942.5(b)(1)(ii)(C); 1951.222(c)(3); 3570.71(h)	Operating Budget	442-7
	RHS		700	1	700	5	3,500	52	$182,000
	RUS		1,000	1	1,000	5	5,000	52	$260,000
1780.41(a)(3); 1942.5(b)(1)(ii)(E); 1951.230(a)(9);1955.10(f)(3)(i); & 3570.82	Balance Sheet or Financial Statement	442-3
	RHS		450	1	450	1	450	52	$23,400
	RUS		1,000	1	1,000	1	1,000	52	$52,000
1780.29(b)(1); 1942.17(l)(i)	Agreement for Engineering Services	1942-19
	RHS		185	1	185	4	740	52	$38,480
	RUS		1,000	1	1,000	4	4,000	52	$208,000
1780.39(f); Guide 16 of 1942-A; 3570.61(e)	Resolution of Members or Stockholders	1942-8
	RHS		67	1	67	1	67	52	$3,484
	RUS		200	1	200	1	200	52	$10,400
1780.41(a)(6); 1942.5(a)(1)(ii); 1952.230(f)(2); 4274.350; 1942.315(b); 4284.638(c); 3570.71	Letter of Intent to Meet Conditions	1942-46
	RHS		430	1	430	1	430	52	$22,360
	RBS (Small Socially Disadvantaged Producer Grant Program)		10	1	10	1	10	52	$520
	RUS		1,000	1	1,000	1	1,000	52	$52,000
1942.17(j)(4)(i)(A); 3570.76	Right-of-Way Easement	442-20
	RHS		225	1	225	1	225	52	$11,700
1942.17(j)(4)(i); 3570.76	Right-of-Way Certificate	442-21
	RHS		225	1	225	1	225	52	$11,700
1780.44(g)(1)(i), 1942.17(j)(4)(i); 3570.76	Opinion of Counsel Relative to Rights-of-Way	442-22
	RHS		185	1	185	1	185	52	$9,620
	RUS		1,000	1	1,000	1	1,000	52	$52,000
1942.17(n)(2)	Loan Resolution (Public Bodies)	1942-47
	RHS		140	1	140	1	140	52	$7,280
1942.17(n)(2)	Loan Resolution Security Agreement	1942-9
	RHS		285	1	285	1	285	52	$14,820
1780.45(b)(1)(ii); 1942.17(p)(2)(ii); 1944.235(c)	Estimate of Funds Needed for 30-Day Period Commencing ____"	440-11
	RHS		540	3	1,620	1	1,620	52	$84,240
	RUS		900	1	900	1	900	52	$46,800
	Promissory Note	440-22
	RHS		475	2	950	0.25	238	52	$12,350
	RUS		1,000	1	1,000	0.25	250	52	$13,000
1780.37(f); 1942.17(q)(2)(i)(A);1951.223(b)(1), 1951.230(a)(9); 3570.82	Statement of Budget, Income, and Equity	442-2
	RHS		605	1	605	2.5	1,513	52	$78,650
	RUS		1,000	1	1,000	2.5	2,500	52	$130,000
1942.18(f)	Water Purchase Contract	442-30
	RUS		200	1	200	1	200	52	$10,400
1942.8(d)	Bond Registration Book	442-28
	RHS		130	1	130	1	130	52	$6,760
1942.17(j)(3)(ii)(B)	Position Fidelity Schedule Bond Declarations	440-24	720	1	720	0.5	360	52	$18,720
Subtotal					15,227		26,167		1,360,684
REPORTING REQUIREMENTS - NO FORMS
1942.17(c)(2)(vii)	Application to Obtain Additional Funding	Written
	RHS		26	1	26	4	104	52	$5,408
1942.17(b)(3); 3570.61(c)	Statement on ability to obtain credit elsewhere	Written
	RHS		575	1	575	1	575	52	$29,900
1942.17(e)	Notification of declination of service	Written
	RHS		8	1	8	3	24	52	$1,248
1942.17(g)(2)(iii)(A); 3570.80	Liens on real and chattel property	Written
	RHS		45	1	45	1	45	52	$2,340
1942.17(g)(3)(i)(B)	Financing Statement	Written
	RHS		245	1	245	1	245	52	$12,740
1942.17(j)(9); 3570.71	Public Information	Written
	RHS		615	1	615	2	1,230	52	$63,960
1942.5(b)(1)(ii)(D) and Guides 6-10; 3570.65	Preliminary Architectural or Engineering Report	Written
	RHS		315	1	315	4	1,260	52	$65,520
1942.17(l)(1); 3570.71	Agreement for professional services	Written
	RHS		375	1	375	4	1,500	52	$78,000
1942.17(h)(2)(iii)	Positive programs to encourage connections	Written
	RHS		8	1	8	3	24	52	$1,248
1942.17(n)(3)	Interim financing	Written
	RHS		1,175	1	1,175	4	4,700	52	$244,400
1942.17(j)(3)(iii)(A)	Property insurance	Written
	RHS		430	1	430	1	430	52	$22,360
1942.17(j)(3)(iii)(B)	Liability and Property Damage Insurance	Written
	RHS		405	1	405	1	405	52	$21,060
1942.17(j)(3)(iii)(D)	Flood Insurance	Written
	RHS		42	1	42	1	42	52	$2,184
1942.17(j)(3)(iii)(E)	Workman's compensation insurance	Written
	RHS		300	1	300	0.5	150	52	$7,800
1942.17(n)(6); 3570.80	Evidence of Disbursement of other funds	Written
	RHS		200	1	200	1	200	52	$10,400
1942.17(j)(4)(ii)	Acquistion of Land, Easement, Water Rights & Existing Facilities	Written
	RHS		300	1	300	3	900	52	$46,800
1942.3; 3570.65	Appraisal Report	Written
	RHS		375	1	375	2	750	52	$39,000
1942.5(b)(1)(ii)(I); 3570.70	Lease/Management agreement	Written
	RHS		37	1	37	5	185	52	$9,620
1942.17(g)(2)	Notes, bonds, warrants or other contractural obligations	Written
	RHS		305	1	305	5	1,525	52	$79,300
1942.18(e) & Guides 17 thru 19; 3570.76	Construction contract forms	Written
	RHS		305	1	305	1	305	52	$15,860
1942.8(g); 3570.80	Certification by borrower's attorney	Written
	RHS		305	1	305	15	4,575	52	$237,900
1942.18(m); 3570.76	Contracts awarded prior to application	Written
	RHS		18	1	18	2	36	52	$1,872
1942.18(o)(3); 3570.76	Resident Inspector resume	Written
	RHS		225	1	225	0.5	113	52	$5,850
1942.18(o)(4); 3570.76	Daily inspection report	Written
	RHS		100	12	1,200	0.5	600	52	$31,200
1942.5(b)(1)(ii)(G)	Evidence that facility cannot be provided by a public body	Written
	RHS		165	1	165	1	165	52	$8,580
1942.5(b)(1)(ii)(H); 3570.65	Financial feasibility report	Written
	RHS		410	1	410	4	1,640	52	$85,280
1942.17(b)(4); 3570.65	Organizational documents	Written
	RHS		520	1	520	1	520	52	$27,040
1942.5(a)(1)(ii), 1942.17(f)(1)	Borrower request to choose interest rate	Written
	RHS		425	1	425	0.167	71	52	$3,691
1942.5(b)(1)(ii)(F)	Five Year Financial History	Written
	RHS		200	1	200	1	200	52	$10,400
1942.17(g)(2)(iii)(A)(9)(ii)	Exceptional Community Support and Documentation	Written
	RHS		145	1	145	4	580	52	$30,160
1942.17(g)(3)(i)(D)	Other Security	Written
	RHS		165	1	165	1	165	52	$8,580
1942.17(j)(3)(iii)(C)	Malpractice Insurance	Written
	RHS		152	1	152	0.5	76	52	$3,952
1942.17(j)(4)(iii)	Land Purchase Contract	Written
	RHS		60	1	60	2	120	52	$6,240
1942.17(j)(8)	Certificate of Need	Written
	RHS		40	1	40	1	40	52	$2,080
1942.17(k); 3570.70	Certification of appropriate regulatory agencies	Written
	RHS		145	1	145	4	580	52	$30,160
1942.17(r)(1)(ii)(B) & Guide 22	Positive Action Plan	Written
	RHS		40	1	40	2	80	52	$4,160
1942.17(q)(4); 3570.83	Audits	Written
	RHS		520	1	520	3	1,560	52	$81,120
1942.17(q)(4)(ii)	Financial Statements - borrowers under $100,000 gross income	Written
	RHS		525	1	525	4	2,100	52	$109,200
1942.18(j)(5)(iv)	Utilization of small business & minority owned business	Written
	RHS		85	1	85	0.5	43	52	$2,210
1942.18(k)(5); 3570.75	Procurement when other than bid or negotiation is used	Written
	RHS		58	1	58	1	58	52	$3,016
1942.18(l); 3570.76	Unconventional contracting methods	Written
	RHS		58	1	58	5	290	52	$15,080
1942.2(a)(1)(iii); 3570.65(a)(1)	State clearinghouse review	Written
	RHS		435	1	435	1	435	52	$22,620
1942.17(q)(1)(ii)	Approval of Audit	Written
	RHS		285	1	285	0.5	143	52	$7,410
1942.17(q)(2)(ii)(A); 3570.83	Governing body members and terms of office	Written
	RHS		285	1	285	0.5	143	52	$7,410
Subtotal					12,552		28,930		1,504,359
RECORDKEEPING REQUIREMENTS
1942.17(q)(1)(iv)	Borrower shall maintain accounting records for 3 years		3,231		0	0.25	808	52	$42,003
Total					27,779		55,905		2,907,046
REPORTING REQUIREMENTS - FORMS APPROVED UNDER OTHER OMB NUMBERS
1942.2(c)(2)	Application for Federal Assistance (For Construction)	SF-424
	RHS		1,385	1	1,385	0.75	1,039
1942.17(j)(4)(i)(B)	Preliminary Title Opinion	1927-9 (0575-0147)
	RHS		1,385	2	2,770	1.5	4,155
1942.17(j)(4)(i)(B)	Final Title Opinion	1927-10 (0575-0147)
	RHS		1,385	2	11,000	0.33	3,630
1942.17(p)(5) & Guide 18	Partial Payment Estimate	1924-18 (0575-0042)
	RHS		2,400	2	4,800	0.5	2,400
1942.18(o)(7)(ii) & Guide 18	Contract Change Order	1924-7 (0575-0042)
	RHS		1,875	1	1,875	0.25	469
1942.2(b)	Request for Environmental Information	1940-20 (0575-0094)
	RHS		1,385	1	1,385	0.25	346
1942.17(n)(2)(x)	Equal Opportunity Agreement	400-1 (0575-0018)
	RHS		1,385	1	1,385	0.167	231
1942.17(n)(2)(x)	Assurance Agreement	400-4 (0575-0018)
	RHS		1,385	1	1,385	0.25	346