|
|
|
|
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 |
|
620 |
1 |
620 |
5 |
3,100 |
69.5 |
$215,450 |
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 |
|
380 |
1 |
380 |
1 |
380 |
56 |
$21,280 |
1780.29(b)(1); 1942.17(l)(i) |
Agreement for Engineering Services |
1942-19 |
|
|
|
|
|
|
|
|
RHS |
|
160 |
1 |
160 |
4 |
640 |
56 |
$35,840 |
1780.39(f); Guide 16 of 1942-A; 3570.61(e) |
Resolution of Members or Stockholders |
1942-8 |
|
|
|
|
|
|
|
|
RHS |
|
57 |
1 |
57 |
1 |
57 |
56 |
$3,192 |
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 |
|
375 |
1 |
375 |
1 |
375 |
69.5 |
$26,063 |
|
RBS (Small Socially Disadvantaged Producer Grant Program) |
|
15 |
1 |
15 |
1 |
15 |
69.5 |
$1,043 |
1942.17(j)(4)(i)(A); 3570.76 |
Right-of-Way Easement |
442-20 |
|
|
|
|
|
|
|
|
RHS |
|
190 |
1 |
190 |
1 |
190 |
56 |
$10,640 |
1942.17(j)(4)(i); 3570.76 |
Right-of-Way Certificate |
442-21 |
|
|
|
|
|
|
|
|
RHS |
|
190 |
1 |
190 |
1 |
190 |
56 |
$10,640 |
1780.44(g)(1)(i), 1942.17(j)(4)(i); 3570.76 |
Opinion of Counsel Relative to Rights-of-Way |
442-22 |
|
|
|
|
|
|
|
|
RHS |
|
160 |
1 |
160 |
1 |
160 |
56 |
$8,960 |
1942.17(n)(2) |
Loan Resolution (Public Bodies) |
1942-47 |
|
|
|
|
|
|
|
|
RHS |
|
120 |
1 |
120 |
1 |
120 |
56 |
$6,720 |
1942.17(n)(2) |
Loan Resolution Security Agreement |
1942-9 |
|
|
|
|
|
|
|
|
RHS |
|
240 |
1 |
240 |
1 |
240 |
56 |
$13,440 |
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 |
|
510 |
3 |
1,530 |
1 |
1,530 |
83 |
$126,990 |
|
Promissory Note |
440-22 |
|
|
|
|
|
|
|
|
RHS |
|
405 |
2 |
810 |
0.25 |
203 |
56 |
$11,340 |
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 |
|
|
0 |
|
|
|
|
|
RHS |
|
514 |
1 |
514 |
2.5 |
1,285 |
56 |
$71,960 |
1942.8(d) |
Bond Registration Book |
442-28 |
|
|
0 |
|
|
|
|
|
RHS |
|
110 |
1 |
110 |
1 |
110 |
56 |
$6,160 |
1942.17(j)(3)(ii)(B) |
Position Fidelity Schedule Bond Declarations |
440-24 |
|
|
|
|
|
|
|
|
RHS |
|
660 |
1 |
660 |
0.5 |
330 |
69.5 |
$22,935 |
1942.30(e )(1) |
Re-lender's Agreement |
1942-55 |
|
|
|
|
|
|
|
|
RHS |
|
10 |
1 |
10 |
1.5 |
15 |
83 |
$1,245 |
1942.30(e )(2) |
Promissory Note |
1942-56 |
|
|
|
|
|
|
|
|
RHS |
|
10 |
1 |
10 |
1 |
10 |
83 |
$830 |
1942.30(e )(4) |
Adequate collateral (Loan Resolution Security Agreement |
1942-57 |
|
|
|
|
|
|
|
|
RHS |
|
10 |
1 |
10 |
0.5 |
5 |
83 |
$415 |
1942.17(n)(2)(x) |
Equal Opportunity Agreement |
400-1 |
|
|
|
|
|
|
|
|
RHS |
|
1,205 |
1 |
1,205 |
0.17 |
205 |
69.5 |
$14,237 |
1942.17(n)(2)(x) |
Assurance Agreement |
400-4 |
|
|
|
|
|
|
|
|
RHS |
|
1,205 |
1 |
1,205 |
0.25 |
301 |
69.5 |
$20,937 |
|
Certification Regarding Debarment, Suspension & Other Responsibility Matters-Primary Covered Transactions |
AD 1047 |
|
|
|
|
|
|
|
|
RHS |
|
20 |
1 |
20 |
0.25 |
5 |
83 |
$415 |
1942.17(j)(4)(i)(B) |
Preliminary Title Opinion |
1927-9 |
|
|
|
|
|
|
|
|
RHS |
|
1,185 |
2 |
2,370 |
1.5 |
3,555 |
56 |
$199,080 |
1942.17(j)(4)(i)(B) |
Final Title Opinion |
1927-10 |
|
|
|
|
|
|
|
|
RHS |
|
1,185 |
2 |
2,370 |
0.33 |
782 |
56 |
$43,798 |
1942.17(p)(5) & Guide 18 |
Partial Payment Estimate |
1924-18 |
|
|
|
|
|
|
|
|
RHS |
|
2,060 |
2 |
4,120 |
0.5 |
2,060 |
56 |
$115,360 |
1942.18(o)(7)(ii) & Guide 18 |
Contract Change Order |
1924-7 |
|
|
|
|
|
|
|
|
RHS |
|
1,605 |
1 |
1,605 |
0.25 |
401 |
56 |
$22,470 |
|
Deposit Agreement |
402-1 |
|
|
|
|
|
|
|
|
RHS |
|
10 |
1 |
10 |
0.25 |
3 |
69.5 |
$174 |
|
Representations Regarding Felony Convictions and Tax Deliquency Status for Corporate Applicants |
AD 3030 |
|
|
|
|
|
|
|
|
RHS |
|
20 |
1 |
20 |
0.25 |
5 |
83 |
$415 |
|
Assurances Regarding Felony Convictions and Tax Delinquency Status for Corporate Appliants |
AD 3031 |
|
|
|
|
|
|
|
|
RHS |
|
20 |
1 |
20 |
0.05 |
1 |
83 |
$83 |
Subtotal |
|
|
|
|
19,106 |
|
16,272 |
|
1,012,110 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
REPORTING REQUIREMENTS - NO FORMS |
1942.17(c)(2)(vii) |
Application to Obtain Additional Funding |
Written |
|
|
|
|
|
|
|
|
RHS |
|
24 |
1 |
24 |
4 |
96 |
56 |
$5,376 |
1942.17(b)(3); 3570.61(c) |
Statement on ability to obtain credit elsewhere |
Written |
|
|
|
|
|
|
|
|
RHS |
|
600 |
1 |
600 |
1 |
600 |
56 |
$33,600 |
1942.17(e) |
Notification of declination of service |
Written |
|
|
|
|
|
|
|
|
RHS |
|
0 |
1 |
0 |
3 |
0 |
56 |
$0 |
1942.17(g)(2)(iii)(A); 3570.80 |
Liens on real and chattel property |
Written |
|
|
|
|
|
|
|
|
RHS |
|
15 |
1 |
15 |
1 |
15 |
56 |
$840 |
1942.17(g)(3)(i)(B) |
Financing Statement |
Written |
|
|
|
|
|
|
|
|
RHS |
|
210 |
1 |
210 |
1 |
210 |
56 |
$11,760 |
1942.17(j)(9); 3570.71 |
Public Information |
Written |
|
|
|
|
|
|
|
|
RHS |
|
600 |
1 |
600 |
2 |
1,200 |
56 |
$67,200 |
1942.5(b)(1)(ii)(D) and Guides 6-10; 3570.65 |
Preliminary Architectural or Engineering Report |
Written |
|
|
|
|
|
|
|
|
RHS |
|
270 |
1 |
270 |
4 |
1,080 |
56 |
$60,480 |
1942.17(l)(1); 3570.71 |
Agreement for professional services |
Written |
|
|
|
|
|
|
|
|
RHS |
|
320 |
1 |
320 |
4 |
1,280 |
56 |
$71,680 |
1942.17(h)(2)(iii) |
Positive programs to encourage connections |
Written |
|
|
|
|
|
|
|
|
RHS |
|
0 |
1 |
0 |
3 |
0 |
56 |
$0 |
1942.17(n)(3) |
Interim financing |
Written |
|
|
|
|
|
|
|
|
RHS |
|
425 |
1 |
425 |
4 |
1,700 |
56 |
$95,200 |
1942.17(j)(3)(iii)(A) |
Property insurance |
Written |
|
|
|
|
|
|
|
|
RHS |
|
370 |
1 |
370 |
1 |
370 |
56 |
$20,720 |
1942.17(j)(3)(iii)(B) |
Liability and Property Damage Insurance |
Written |
|
|
|
|
|
|
|
|
RHS |
|
350 |
1 |
350 |
1 |
350 |
56 |
$19,600 |
1942.17(j)(3)(iii)(D) |
Flood Insurance |
Written |
|
|
|
|
|
|
|
|
RHS |
|
36 |
1 |
36 |
1 |
36 |
56 |
$2,016 |
1942.17(j)(3)(iii)(E) |
Workman's compensation insurance |
Written |
|
|
|
|
|
|
|
|
RHS |
|
270 |
1 |
270 |
0.5 |
135 |
69.5 |
$9,383 |
1942.17(n)(6); 3570.80 |
Evidence of Disbursement of other funds |
Written |
|
|
|
|
|
|
|
|
RHS |
|
170 |
1 |
170 |
1 |
170 |
56 |
$9,520 |
1942.17(j)(4)(ii) |
Acquistion of Land, Easement, Water Rights & Existing Facilities |
Written |
|
|
|
|
|
|
|
|
RHS |
|
260 |
1 |
260 |
3 |
780 |
56 |
$43,680 |
1942.3; 3570.65 |
Appraisal Report |
Written |
|
|
|
|
|
|
|
|
RHS |
|
415 |
1 |
415 |
2 |
830 |
56 |
$46,480 |
1942.5(b)(1)(ii)(I); 3570.70 |
Lease/Management agreement |
Written |
|
|
|
|
|
|
|
|
RHS |
|
60 |
1 |
60 |
5 |
300 |
56 |
$16,800 |
1942.17(g)(2) |
Notes, bonds, warrants or other contractural obligations |
Written |
|
|
|
|
|
|
|
|
RHS |
|
260 |
1 |
260 |
5 |
1,300 |
56 |
$72,800 |
1942.18(e) & Guides 17 thru 19; 3570.76 |
Construction contract forms |
Written |
|
|
|
|
|
|
|
|
RHS |
|
260 |
1 |
260 |
1 |
260 |
56 |
$14,560 |
1942.8(g); 3570.80 |
Certification by borrower's attorney |
Written |
|
|
|
|
|
|
|
|
RHS |
|
260 |
1 |
260 |
15 |
3,900 |
56 |
$218,400 |
1942.18(m); 3570.76 |
Contracts awarded prior to application |
Written |
|
|
|
|
|
|
|
|
RHS |
|
15 |
1 |
15 |
2 |
30 |
56 |
$1,680 |
1942.18(o)(3); 3570.76 |
Resident Inspector resume |
Written |
|
|
|
|
|
|
|
|
RHS |
|
190 |
1 |
190 |
0.5 |
95 |
56 |
$5,320 |
1942.18(o)(4); 3570.76 |
Daily inspection report |
Written |
|
|
|
|
|
|
|
|
RHS |
|
1,020 |
12 |
12,240 |
0.5 |
6,120 |
56 |
$342,720 |
1942.5(b)(1)(ii)(G) |
Evidence that facility cannot be provided by a public body |
Written |
|
|
|
|
|
|
|
|
RHS |
|
140 |
1 |
140 |
1 |
140 |
56 |
$7,840 |
1942.5(b)(1)(ii)(H); 3570.65 |
Financial feasibility report |
Written |
|
|
|
|
|
|
|
|
RHS |
|
400 |
1 |
400 |
4 |
1,600 |
56 |
$89,600 |
1942.17(b)(4); 3570.65 |
Organizational documents |
Written |
|
|
|
|
|
|
|
|
RHS |
|
600 |
1 |
600 |
1 |
600 |
56 |
$33,600 |
1942.5(a)(1)(ii), 1942.17(f)(1) |
Borrower request to choose interest rate |
Written |
|
|
|
|
|
|
|
|
RHS |
|
600 |
1 |
600 |
0.167 |
100 |
56 |
$5,611 |
1942.5(b)(1)(ii)(F) |
Five Year Financial History |
Written |
|
|
|
|
|
|
|
|
RHS |
|
425 |
1 |
425 |
1 |
425 |
56 |
$23,800 |
1942.17(g)(2)(iii)(A)(9)(ii) |
Exceptional Community Support and Documentation |
Written |
|
|
|
|
|
|
|
|
RHS |
|
375 |
1 |
375 |
4 |
1,500 |
56 |
$84,000 |
1942.17(g)(3)(i)(D) |
Other Security |
Written |
|
|
|
|
|
|
|
|
RHS |
|
140 |
1 |
140 |
1 |
140 |
56 |
$7,840 |
1942.17(j)(3)(iii)(C) |
Malpractice Insurance |
Written |
|
|
|
|
|
|
|
|
RHS |
|
130 |
1 |
130 |
0.5 |
65 |
56 |
$3,640 |
1942.17(j)(4)(iii) |
Land Purchase Contract |
Written |
|
|
|
|
|
|
|
|
RHS |
|
50 |
1 |
50 |
2 |
100 |
56 |
$5,600 |
1942.17(j)(8) |
Certificate of Need |
Written |
|
|
|
|
|
|
|
|
RHS |
|
35 |
1 |
35 |
1 |
35 |
56 |
$1,960 |
1942.17(k); 3570.70 |
Certification of appropriate regulatory agencies |
Written |
|
|
|
|
|
|
|
|
RHS |
|
125 |
1 |
125 |
4 |
500 |
56 |
$28,000 |
1942.17(r)(1)(ii)(B) & Guide 22 |
Positive Action Plan |
Written |
|
|
|
|
|
|
|
|
RHS |
|
35 |
1 |
35 |
2 |
70 |
56 |
$3,920 |
1942.17(q)(4); 3570.83 |
Audits |
Written |
|
|
|
|
|
|
|
|
RHS |
|
450 |
1 |
450 |
3 |
1,350 |
56 |
$75,600 |
1942.17(q)(4)(ii) |
Financial Statements - borrowers under $100,000 gross income |
Written |
|
|
|
|
|
|
|
|
RHS |
|
450 |
1 |
450 |
4 |
1,800 |
56 |
$100,800 |
1942.18(j)(5)(iv) |
Utilization of small business & minority owned business |
Written |
|
|
|
|
|
|
|
|
RHS |
|
70 |
1 |
70 |
0.5 |
35 |
56 |
$1,960 |
1942.18(k)(5); 3570.75 |
Procurement when other than bid or negotiation is used |
Written |
|
|
|
|
|
|
|
|
RHS |
|
50 |
1 |
50 |
1 |
50 |
56 |
$2,800 |
1942.18(l); 3570.76 |
Unconventional contracting methods |
Written |
|
|
|
|
|
|
|
|
RHS |
|
50 |
1 |
50 |
5 |
250 |
56 |
$14,000 |
1942.2(a)(1)(iii); 3570.65(a)(1) |
State clearinghouse review |
Written |
|
|
|
|
|
|
|
|
RHS |
|
370 |
1 |
370 |
1 |
370 |
56 |
$20,720 |
1942.17(q)(1)(ii) |
Approval of Audit |
Written |
|
|
|
|
|
|
|
|
RHS |
|
245 |
1 |
245 |
0.5 |
123 |
56 |
$6,860 |
1942.17(q)(2)(ii)(A); 3570.83 |
Governing body members and terms of office |
Written |
|
|
|
|
|
|
|
|
RHS |
|
245 |
1 |
245 |
0.5 |
123 |
56 |
$6,860 |
1942.30(a) |
Documentation of Legal Powers |
Written |
|
|
|
|
|
|
|
|
RHS |
|
20 |
1 |
20 |
0.5 |
10 |
83 |
830 |
1942.30(a) |
Certification of Compliance with Federal, State, and Local Requirements |
Written |
|
|
|
|
|
|
|
|
RHS |
|
20 |
1 |
20 |
1 |
20 |
83 |
1,660 |
1942.30(a) |
Documentation of Serving Persistent Poverty County(ies) or High Poverty Areas |
Written |
|
|
|
|
|
|
|
|
RHS |
|
20 |
1 |
20 |
1 |
20 |
83 |
1,660 |
1942.30(a) |
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 |
|
|
|
|
|
|
|
|
RHS |
|
20 |
1 |
20 |
5 |
100 |
83 |
8,300 |
1942.30(a) |
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 |
|
|
|
|
|
|
|
|
RHS |
|
9 |
1 |
9 |
2 |
18 |
83 |
1,494 |
1942.30(a) |
Documentation of strong Financial Strength and Performance rating |
Written |
|
|
|
|
|
|
|
|
RHS |
|
4 |
1 |
4 |
5 |
20 |
83 |
1,660 |
1942.30(a) |
Documentation of being a financially sound institution for Agency assessment |
Written |
|
|
|
|
|
|
|
|
RHS |
|
7 |
1 |
7 |
64 |
448 |
83 |
37,184 |
1942.30(a) |
Documentation of Legal, Non-governmental Status (except for Tribal governments) |
Written |
|
|
|
|
|
|
|
|
RHS |
|
20 |
1 |
20 |
0.5 |
10 |
83 |
830 |
1942.30(a) |
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 |
|
|
|
|
|
|
|
|
RHS |
|
20 |
1 |
20 |
2 |
40 |
83 |
3,320 |
1942.30(a) |
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 |
|
|
|
|
|
|
|
|
RHS |
|
20 |
1 |
20 |
0.17 |
3 |
83 |
282 |
1942.30(a) |
Multi-tier Action Environmental Compliance Agreement |
Writtn |
|
|
|
|
|
|
|
|
RHS |
|
20 |
1 |
20 |
0.08 |
2 |
83 |
133 |
1942.30(a) |
Documentation of Assitance Provided to RD Employees |
Written |
|
|
|
|
|
|
|
|
RHS |
|
20 |
1 |
20 |
0.17 |
3 |
83 |
282 |
1942.30(a) |
Documentation of each evaluation factor |
Written |
|
|
|
|
|
|
|
|
RHS |
|
20 |
1 |
20 |
2 |
40 |
83 |
3,320 |
1942.30(e )(3) |
Irrevocable Letter of Credit |
Written |
|
|
|
|
|
|
|
|
RHS |
|
50 |
1 |
50 |
1 |
50 |
83 |
4,150 |
1942.30(b) |
Loan Origination and Servicing - applicant eligibility |
Written |
|
|
|
|
|
|
|
|
RHS |
|
50 |
1 |
50 |
1.5 |
75 |
83 |
6,225 |
Subtotal |
|
|
|
|
22,945 |
|
31,102 |
|
$1,766,986 |
|
|
|
|
|
|
|
|
|
|
RECORDKEEPING REQUIREMENTS |
|
|
|
|
|
|
|
|
|
|
1942.17(q)(1)(iv) |
Borrower shall maintain accounting records for 3 years |
Written |
2,769 |
1 |
2,769 |
0.25 |
692 |
83 |
$57,457 |
|
Quarterly Financial Statements |
Written |
10 |
4 |
40 |
2 |
80 |
83 |
$6,640 |
|
Quarterly Report of Re-rent Loans |
Written |
10 |
4 |
40 |
1 |
40 |
83 |
$3,320 |
|
Annual Audits |
Written |
10 |
1 |
10 |
5 |
50 |
83 |
$4,150 |
|
Financial Strength and Performance Rating |
Written |
10 |
1 |
10 |
5 |
50 |
83 |
$4,150 |
|
Certification of 7CFR 3575.42 & 3575.43 |
Written |
50 |
1 |
50 |
0.25 |
13 |
83 |
$1,038 |
|
Civil Rights Data |
Written |
10 |
1 |
10 |
1 |
10 |
83 |
$830 |
|
Documentation of providing funds to Persistent Poverty County(ies) and High Poverty Area(s) |
Written |
10 |
1 |
10 |
1 |
10 |
83 |
$830 |
Subtotal |
|
|
|
|
2,939 |
|
945 |
|
78,414 |
Grand Total |
|
|
|
|
44,990 |
|
48,319 |
|
$2,857,510.45 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
REPORTING REQUIREMENTS - FORMS APPROVED UNDER OTHER OMB NUMBERS |
1942.2(c)(2) |
Application for Federal Assistance (For Construction) |
SF-424 (4040-0004) |
|
|
|
|
|
|
|
|
RHS |
|
1,205 |
|
|
|
|
|
|
|
Budget Information - Non Construction Programs |
SF-424A (4040-0006) |
|
|
|
|
|
|
|
|
RHS |
|
20 |
|
|
|
|
|
|
|
Assurances - Non Construction Programs |
SF-424B (4040-0007) |
|
|
|
|
|
|
|
|
RHS |
|
20 |
|
|
|
|
|
|
|
Certification of Non-Lobbying Activities or Disclosure of Lobbying Activities |
SF-LLL (4040-0013) |
|
|
|
|
|
|
|
|
RHS |
|
20 |
|
|
|
|
|
|
|
ACH Vendor/Miscellaneous Payment Enrollment Form |
SF-3881 (1510-0056) |
|
|
|
|
|
|
|
|
RHS |
|
20 |
|
|
|
|
|
|
|
Environmental Policies and Procedures |
Written (0575-0197) |
|
|
|
|
|
|
|
|
RHS |
|
1185 |
|
|
|
|
|
|