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FORM APPROVED
OMB NO. 0575-0189
UNITED STATES DEPARTMENT OF AGRICULTURE
FORM RD 3560-7A
RURAL HOUSING SERVICE
(02-05)
ON-FARM LABOR HOUSING PROJECT BUDGET
1. BORROWER NAME:
3. PROJECT NO.
2. CASE NO.
4. LABOR HOUSING PROPERTY LOCATION:
6. OCCUPANCY:
SEASONAL
5. NO. UNITS:
YEAR AROUND
YES
8. REFUNDABLE SECURITY DEPOSIT:
NO
7. AGREEMENT FOR OCCUPANCY OR LEASE
YES
9. AMOUNT OF SECURITY DEPOSIT: $
ACTUAL
PROPOSED
INCOME or TENANT CHARGES:
(
10.
Tenant Rent ($
11.
Other Tenant Shelter Cost
12.
ACTUAL CHARGES (Paid by Tenants)
NO
x
unit x 12 months)
(Specify)
)
(
$
$
$
$
$
$
ANNUAL OPERATING AND MAINTENANCE EXPENSES:
13.
Maintenance & Repairs
$
$
14.
Painting
$
$
15.
Electricity
$
$
16.
Water
$
$
17.
Sewer
$
$
18.
Fuel (Oil or Gas or Wood)
$
$
19.
Garbage & Trash Removal
$
$
20.
Real Estate Taxes
$
$
21.
Property & Liability Insurance
$
$
22.
Rural Housing Service Loan Payment
$
$
23.
Other
$
$
24.
TOTAL EXPENSES
$
$
$
$
25.
(Specify)
UNAUTHORIZED RENT REBATE or CREDIT
(TOTAL UNAUTHORIZED RENT CHARGES: $
)
27. DATE:
26. BORROWER:
(Signature)
28. AGENCY APPROVAL:
29. DATE:
(Signature of Servicing Official)
30. TITLE:
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 0575-0189. The time required to complete this information collection is estimated to average 1 hour 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.
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File Type | application/pdf |
File Modified | 0000-00-00 |
File Created | 0000-00-00 |