RD 3550-28, "Authorization Agreement for Preauthorization Payments", RD 1951-65, "Customer Initiated Payments (CIP)" and RD 1951-66, "Fedwire Worksheet"

OMB 0575-0184

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 latest form for RD 3550-28, "Authorization Agreement for Preauthorization Payments", RD 1951-65, "Customer Initiated Payments (CIP)" and RD 1951-66, "Fedwire Worksheet" expires 2021-03-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form RD-3550-28 Authorization Payments - Private Form
Form RD 3550-28 Authorization Payments - Tribal Form
Form RD 1951-66 Authorization Payments - Individuals Form
2020 Public Use Report 0575-0184 (updated) Supporting Statement.docx Supporting Statement A
RHS- 0575-0184 - 60-Day Federal Register Notice (2020).docx Supplementary Document
OMB-83-I - 0575-0184.pdf Supplementary Document
RHS 0575-0184 Published 60-day Federal Notice.pdf Supplementary Document
2020 - Updated Public Use Spreadsheet 0575-0184.xlsx Supplementary Document
Authorization Payments - Private Form
Authorization Payments - Tribal Form
Authorization Payments - Individuals Form

OMB Details

Authorization Payments - Private

Federal Enterprise Architecture: Economic Development - Business and Industry Development

Form RD-3550-28A	Authorization Agreement for Preauthorized Payments	Fillable Printable	Form
Form RD-1951-66	Fedwire Worksheet	Printable Only	Form
Form RD-1951-65	Customer Initiated Payments Enrollment Form	Fillable Printable	Form
Form RD-3550-28	Authorization Agreement for Preauthorization Payments	Printable Only	Form

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.

202001-0575-004 Approved with change	Revision of a currently approved collection	2021-03-15
201710-0575-004 Approved with change	Revision of a currently approved collection	2018-01-08
201408-0575-002 Approved without change	Extension without change of a currently approved collection	2014-09-23
201104-0575-001 Approved without change	Revision of a currently approved collection	2011-05-24
200803-0575-001 Approved without change	Revision of a currently approved collection	2008-05-28
200504-0575-001 Approved without change	Revision of a currently approved collection	2005-04-04
200203-0575-002 Approved without change	New collection (Request for a new OMB Control Number)	2002-03-25