Estimate of Funds Needed

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USDA-RD
Form RD 440-11
(Rev. 10-00)

Submit

ESTIMATE OF FUNDS NEEDED

FORM APPROVED

FOR
30-Day Period Commencing

OMB NO. 0575-0015
OMB NO. 0570-0021

Exp. Date: MM/DD/YY

Name of Borrower

Items

Amount of Funds
$

Development
Contract or Job No.
Contract or Job No.
Contract or Job No.
Land and Rights-of-Way
Legal Services
Engineering Fees
Interest
Equipment
Contingencies
Refinancing
Initial O&M
Other

$

TOTAL

Prepared by
Name of Borrower

By
Date
Approved by
Date

A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of
information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a currently valid OMB Control Number. The OMB
Control Number for this information collection is 0575-0015 and 0570-0021. Public reporting for this collection of information is estimated to be approximately 1 hour per
response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, completing and reviewing the collection
of information. All responses to this collection of information are voluntary. However, in order to obtain or retain a benefit, the information in this form is required under
Section 7 CFR Part 1942, Subpart A “Community Facility Loans,” and 7 CFR 4274-D, Intermediary Relending Program (IRP). Rural Development has no plans to publish
information collected under the provisions of this program. Send comments regarding this burden estimate or any other aspect of this collection of information, including
suggestions for reducing this burden to: Information Collection Clearance Officer, Rural Development Innovation Center, Regulations Management Division at
[email protected]

Position 2

RD 440-11 (Rev. 10-00)

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