New Equipment Contract (RUS Contract Form 395) for Telecommunications and Broadband Borrowers

New Equipment Contract (Form 395) for Telecommunications and Broadband Borrowers

Documents and Forms

Document Name Document Type
Form 395 New Equipment Contract (RUS Contract Form 395) for Telecommunications and Broadband Borrowers Form
This is a place holder for the following non-form reporting requirements.docx Other-Non Form
395 RUS Contract Form 395 RUS 395.pdf www.rurdev.usda.gov/UP_ETPW_Forms.html#Telecom Form
395a RUS Form 395a - CERTIFICATE OF COMPLETION Form 395a FINAL.docx tp://www.rurdev.usda.gov/UP_ETPW_Forms.html#Telecom Form
395b RUS Form 395b - Certificate of Completion RUS 395b.pdf www/rurdev.usda.gov/UP_ETPW_Forms.html#telecom Form
395c RUS Form 395c - Certificate of Seller RUS 395c.pdf www/rurdev.usda.gov/UP_ETPW_Forms.html#Telecom Form
395d RUS Form 395d - Results Of Equiptment Tests RUS 395d.pdf www/rurdev.usda.gov/UP_ETPW_Forms.html#Telecom Form
AD 1048 Debarment Certificate - Lower Tier Covered AD-1048 DebarmentCert-LowerTierCovered.pdf Form

Information Collection (IC) Details

IC Title:	New Equipment Contract (RUS Contract Form 395) for Telecommunications and Broadband Borrowers	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 1755 7 CFR 1753

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	395	RUS Contract Form 395	RUS 395.pdf	http://www.rurdev.usda.gov/UP_ETPW_Forms.html#Telecom	Yes	No	Printable Only
Form	395a	RUS Form 395a - CERTIFICATE OF COMPLETION	Form 395a FINAL.docx	tp://www.rurdev.usda.gov/UP_ETPW_Forms.html#Telecom	Yes	No	Printable Only
Form	395b	RUS Form 395b - Certificate of Completion	RUS 395b.pdf	http://www/rurdev.usda.gov/UP_ETPW_Forms.html#telecom	Yes	No	Printable Only
Form	395c	RUS Form 395c - Certificate of Seller	RUS 395c.pdf	http://www/rurdev.usda.gov/UP_ETPW_Forms.html#Telecom	Yes	No	Printable Only
Form	395d	RUS Form 395d - Results Of Equiptment Tests	RUS 395d.pdf	http://www/rurdev.usda.gov/UP_ETPW_Forms.html#Telecom	Yes	No	Printable Only
Form	AD 1048	Debarment Certificate - Lower Tier Covered	AD-1048 DebarmentCert-LowerTierCovered.pdf		Yes	Yes	Fillable Fileable
Other-Non Form			This is a place holder for the following non-form reporting requirements.docx		Yes	Yes	Fillable Printable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records
Title: USDA/RD–1 Current or Prospective Producers or Landowners, Applicants, Borrowers, Grantees, Tenants, and other participants in RD programs.	FR Citation: 87 FR 21315

Number of Respondents: 28	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	161	-74	235
Annual IC Time Burden (Hours)	114	-46	160
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.