RHS-Finance Office Forms

Forms and Documents

Document Name	Status
Form RD Form 1951-66 FedWire Worksheet Form and Instruction	New
Form RD 3550-28A Authorization Agreement for Preauthorized Payments-CLSS Form	New
Form RD 3550-28 Authorization Agreement for Preauthorized Payments (RBS/RUS borrowers) Form	Modified
Form RD 1951-65 Customer Initiated Payments (CIP) Form	Modified
Form RD 3550-28 Authorization Agreement for Preauthorized Payments (SFH borrowers) Form	Modified
Copy of RHS- Finance Office Forms Spreadsheet 0575-0184 FY 24 - 05292024.xlsx Supplementary Document	2024-12-06
0575-0184 Finance Office Forms 60 DFRN FY 24 Final.docx Supplementary Document	2024-11-26
2024-16033 FO 60 DFRN FY24 FR Print.pdf Supplementary Document	2024-10-16
RHS- Finance Office Forms Supporting Statement FY 24.docx Supporting Statement A	2024-10-16

IC Document Collections

IC ID	Document Title	Status
272822	FedWire Worksheet Form and Instruction	New
272819	Authorization Agreement for Preauthorized Payments-CLSS Form	New
2043	Authorization Agreement for Preauthorized Payments (RBS/RUS borrowers) Form	Modified
184183	Customer Initiated Payments (CIP) Form	Modified
184182	Authorization Agreement for Preauthorized Payments (SFH borrowers) Form	Modified

ICR Details

OMB Control No: 0575-0184	ICR Reference No: 202410-0575-001
Status: Received in OIRA	Previous ICR Reference No: 202001-0575-004
Agency/Subagency: USDA/RHS	Agency Tracking No: 0575-0184
Title: RHS-Finance Office Forms
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 01/21/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved	01/31/2025
Responses	11,062	9,598
Time Burden (Hours)	4,609	2,399
Cost Burden (Dollars)	0	0

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Abstract: Forms will be used by the Agency to obtain bank routing information from the borrower's financial institutions to establish an electronic loan payment plan. The form titles that will be used to obtain this information are: RD 3550-28, "Authorization Agreement for Preauthorization Payments", RD 1951-65, "Customer Initiated Payments (CIP)" and RD 1951-66, "Fedwire Worksheet."

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Authorizing Statute(s): US Code: 15 USC 1601
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 59041	07/22/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 7074	01/21/2025
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 5

IC Title	Form No.	Form Name
Authorization Agreement for Preauthorized Payments (RBS/RUS borrowers)	RD 3550-28	Authorization Agreement for Preauthorized Payments
Authorization Agreement for Preauthorized Payments (SFH borrowers)	RD 3550-28	Authorization Agreement for Preauthorized Payments
Authorization Agreement for Preauthorized Payments-CLSS	RD 3550-28A	Authorization Agreement for Preauthorized Payments
Customer Initiated Payments (CIP)	RD 1951-65	Customer Initiated Payments (CIP)
FedWire Worksheet	RD Form 1951-66	Fedwire Worksheet

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ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	11,062	9,598	0	0	1,464	0
Annual Time Burden (Hours)	4,609	2,399	0	1,844	366	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: This package reflects a 1464 increase in responses and 366 increase in burden hours. This is due to an increase in respondents for the SFH and Community Programs and an increase in completion of Forms 3550-28/A.

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Annual Cost to Federal Government: $135,922

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 01/21/2025

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