Information Collection

Intermediairy Relending Program

IC 1690 under ICR 202201-0570-001 · OMB 0570-0021.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form RD 4274-1 Intermediairy Relending Program	Form
This is a place holder for the following non-form reporting requirements.docx	Other-Non-forms
RD 4274-1 Application for Loan RD Form 4274-1 exp 11-2022.pdf	Form
RD 4274-3 Intermediary Relending Program Promissory Note RD Form 4274-3 exp 8-31-24.pdf	Form
RD 4274-5 Intermediary Relending Program Supplemental Loan Agreeme RD Form 4274-5 exp 11-30-22.pdf	Form
RD Form 4274-4 Intermediary Relending Program Rural Microentrepreneur A RD Form 4274-4 exp 11-30-22.pdf	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 7 CFR 4274

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	RD 4274-1	Application for Loan	RD Form 4274-1 exp 11-2022.pdf	Yes	No	Fillable Printable
Form	RD 4274-3	Intermediary Relending Program Promissory Note	RD Form 4274-3 exp 8-31-24.pdf	Yes	No	Fillable Printable
Form	RD 4274-5	Intermediary Relending Program Supplemental Loan Agreement	RD Form 4274-5 exp 11-30-22.pdf	Yes	No	Fillable Printable
Form	RD Form 4274-4	Intermediary Relending Program Rural Microentrepreneur Assistance Program Loan Agreement	RD Form 4274-4 exp 11-30-22.pdf	Yes	No	Fillable Printable
Other-Non-forms			This is a place holder for the following non-form reporting requirements.docx	Yes	No	Fillable Printable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title: USDA/RD-1 Current or Prospective Procedures or Landowners, Applicants, Borrowers, Grantees, Tenants, and other participants in RD Programs.

FR Citation: 84 FR 21315

Number of Respondents: 140

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,224	-2,342	3,566
Annual IC Time Burden (Hours)	11,790	-13,030	24,820
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.