| 2016 Community Facility Loans - 7 CFR 1942, subpart A |
| OMB No 0575-NEW |
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Reports |
Total Annual |
Est. No. of |
Est. Total |
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Total |
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Form No. |
Est. No. of |
Filed |
Responses |
Man hours |
Man-hours |
Wage |
Cost |
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| Reference |
Title |
(if Any) |
Respondents |
Annually |
(D) x (E) |
Per Response |
(F) x (G) |
Class |
(H) x (I) |
Comments |
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| (A) |
(B) |
(C) |
(D) |
(E) |
(F) |
(G) |
(H) |
(I) |
(J) |
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Reporting Requirements Non-Forms |
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| 1942.30(a) |
Documentation of re-lender eligibility |
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Documentation of Legal Powers |
Written |
20 |
1 |
20 |
0.50 |
10 |
$83 |
$830 |
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Certification of Compliance with Federal, State, and Local Requirements |
Written |
20 |
1 |
20 |
1.00 |
20 |
$83 |
$1,660 |
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Documentation of Serving Persistent Poverty County(ies) or High Poverty Areas |
Written |
20 |
1 |
20 |
1.00 |
20 |
$83 |
$1,660 |
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Documentation ("Letter of Intent") from a Financial Institution that an Irrevocable Letter of Credit or similar Performance Guarantee will be issued if re-lender is approved for funding |
Written |
20 |
1 |
20 |
5.00 |
100 |
$83 |
$8,300 |
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Documentation Regulated and Supervised by a Federal or State Banking Regulatory Agency, Subject to Credit Examination, Not on a Watch List, and No Regulatory Actions Outstanding |
Written |
9 |
1 |
9 |
2.00 |
18 |
$83 |
$1,494 |
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Documentation of strong Financial Strength and Performance rating |
Written |
4 |
1 |
4 |
5.00 |
20 |
$83 |
$1,660 |
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Documentation of being a financially sound institution for Agency assessment |
Written |
7 |
1 |
7 |
64.00 |
448 |
$83 |
$37,184 |
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Documentation of Legal, Non-governmental Status (except for Tribal governments) |
Written |
20 |
1 |
20 |
0.50 |
10 |
$83 |
$830 |
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Documentation of Membership in a National Organization that provides training, technical assistance and credit evaluation or certified by a Government agency as having a primary mission of promoting development in low-income target markets and performs training and technical assistance as part of that mission. |
Written |
20 |
1 |
20 |
2.00 |
40 |
$83 |
$3,320 |
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Certification to loan a majority of funds to applicants whose projects are located in or serve Persistent Poverty County(ies) or High Poverty Area(s) |
Written |
20 |
1 |
20 |
0.17 |
3 |
$83 |
$277.22 |
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Multi-tier Action Environmental Compliance Agreement |
Written/RD Ins. 1970-A, Exhibit H |
20 |
1 |
20 |
0.08 |
2 |
$83 |
$132.80 |
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Documentation of Assitance Provided to RD Employees |
Written |
20 |
1 |
20 |
0.17 |
3 |
$83 |
$277.22 |
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Documentation of each evaluation factor |
Written |
20 |
1 |
20 |
2.00 |
40 |
$83 |
$3,320 |
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Workers Compensation Insurance |
Written |
10 |
1 |
10 |
0.17 |
2 |
$83 |
$138.61 |
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| 1942.30(e)(3) |
Irrevocable Letter of Credit |
Written |
50 |
1 |
50 |
1.00 |
50 |
$83 |
$4,150 |
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| 1942.30(b) |
Loan Origination and Servicing - applicant eligibility |
Written |
50 |
1 |
50 |
1.50 |
75 |
$83 |
$6,225 |
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| 1942.30(f) |
Loan Origination and Servicing - reporting |
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Reporting Requirements Forms |
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Letter of Intent to Meet Conditions |
1942-46 |
10 |
1 |
10 |
1.00 |
10 |
$83 |
$830 |
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| 1942.30(e)(1) |
Re-lender's Agreement |
1942-55 |
50 |
1 |
50 |
1.50 |
75 |
$83 |
$6,225 |
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| 1942.30(e)(2) |
Promissory Note |
1942-56 |
50 |
1 |
50 |
1.00 |
50 |
$83 |
$4,150 |
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| 1942.30(e)(4) |
Adequate Collateral (Loan Resolution Security Agreement) |
1942-57 |
50 |
1 |
50 |
0.50 |
25 |
$83 |
$2,075 |
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Estimate of Funds needed for 30-day Period Commencing |
440-11 |
50 |
1 |
50 |
1.00 |
50 |
$83 |
$4,150 |
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Position Fidelity Schedule Bond Declarations of Other Evidence of Coverage |
440-24 |
50 |
1 |
50 |
0.50 |
25 |
$83 |
$2,075 |
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Operating Budget |
442-7 |
20 |
1 |
20 |
5.00 |
100 |
$83 |
$8,300 |
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Equal Opportunity Agreement |
400-1 |
20 |
1 |
20 |
0.17 |
3 |
$83 |
$277.22 |
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Assurance Agreement |
400-4 |
20 |
1 |
20 |
0.25 |
5 |
$83 |
$415.00 |
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Certification Regarding Debarment, Suspension & Other Responsibility Matters-Primary Covered Transactions |
AD 1047 |
20 |
1 |
20 |
0.25 |
5 |
$83 |
$415 |
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SUBTOTAL |
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620 |
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1209 |
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$100,371 |
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Form Burden Approved Under Other OMB No. |
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Application for Federal Assistance |
SF-424 (4040-0004) |
20 |
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Budget Information- Non Construction Programs |
SF-424A (4040-0006) |
20 |
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Assurances - Non Construction Programs |
SF-424B (4040-0007) |
20 |
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Representations Regarding Felony Convictions and Tax Deliquincy Status for Corporate Applicants |
AD 3030 (0505-0025) |
20 |
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Assurances Regarding Felony Convictions and Tax Deliquincy Status for Corporate Applicants |
AD3031 (0505-0025) |
20 |
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Certfication of Non-Lobbying Activities or Disclosure of Lobbying Activities |
SF-LLL (4040-0013) |
20 |
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ACH Vendor/Miscellaneous Payment Enrollment Form |
SF-3881 (1510-0056) |
10 |
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Recordkeeping Requirements |
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Quarterly Financial Statements |
Written |
10 |
4 |
40 |
2.00 |
80 |
$83 |
$6,640 |
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Quarterly Report of Re-rent Loans |
Written |
10 |
4 |
40 |
1.00 |
40 |
$83 |
$3,320 |
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Annual Audits |
Written |
10 |
1 |
10 |
5.00 |
50 |
$83 |
$4,150 |
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Financial Strength and Performance Rating |
Written |
10 |
1 |
10 |
5.00 |
50 |
$83 |
$4,150 |
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Certification of 7CFR 3575.42 & 3575.43 |
Written |
50 |
1 |
50 |
0.25 |
13 |
$83 |
$1,038 |
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Civil Rights Data |
Written |
10 |
1 |
10 |
1.00 |
10 |
$83 |
$830 |
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Documentation of providing funds to Persistent Poverty County(ies) and High Poverty Area(s) |
Written |
10 |
1 |
10 |
1.00 |
10 |
83 |
$830 |
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SUBTOTAL |
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170 |
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253 |
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$20,958 |
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GRAND TOTAL |
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790 |
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1462 |
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$121,329 |
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