|
|
|
|
Reports |
Total Annual |
Est. No. of |
Est. Total |
Wages |
Cost to the |
|
|
Form No. |
Est. No. of |
Filed |
Responses |
Man hours |
Man-hours |
Class |
Public |
Section of Regulation |
Title |
(if Any) |
Respond-ents |
Annually |
(D) x (E) |
Per Response |
(F) x (G) |
$/Hr. |
(H) x (I) |
(A) |
(B) |
(C) |
(D) |
(E) |
(F) |
(G) |
(H) |
(I) |
(J) |
REPORTING REQUIREMENTS - FORMS APPROVED WITH THIS DOCKET |
|
|
|
|
|
|
|
|
|
|
1780.23(h)(1); 1942.5(b)(1)(ii)(C); 1951.222(c)(3); 3570.71(h) |
Operating Budget |
442-7 |
|
|
|
|
|
|
|
|
RHS |
|
750 |
1 |
750 |
5 |
3,750 |
30 |
$112,500 |
|
RUS |
|
1,000 |
1 |
1,000 |
5 |
5,000 |
30 |
$150,000 |
1780.23(h)(2); 1942.5(b)(1)(ii)(E); 1951.230(a)(9);1955.10(f)(3)(i); & 3570.82 |
Balance Sheet or Financial Statement |
442-3 |
|
|
|
|
|
|
|
|
RHS |
|
500 |
1 |
500 |
1 |
500 |
30 |
$15,000 |
|
RUS |
|
1,000 |
0 |
0 |
1 |
0 |
30 |
$0 |
1780.29(b)(1), 1942.17(l)(i) |
Agreement for Engineering Services |
1942-19 |
|
|
|
|
|
|
|
|
RHS |
|
200 |
1 |
200 |
4 |
800 |
30 |
$24,000 |
|
RUS |
|
1,000 |
1 |
1,000 |
4 |
4,000 |
30 |
$120,000 |
1780.29(f); Guide 16 of 1942-A; 3570.61(e) |
Resolution of Members or Stockholders |
1942-8 |
|
|
|
|
|
|
|
|
RHS |
|
75 |
1 |
75 |
1 |
75 |
30 |
$2,250 |
|
RUS |
|
200 |
1 |
200 |
1 |
200 |
30 |
$6,000 |
1780.31(a)(5); 1942.5(a)(1)(ii); 1951.230(f)(2); 4274.350; 1942.315(b); 4284.638(c); 3570.71 |
Letter of Intent to Meet Conditions |
1942-46 |
|
|
|
|
|
|
|
|
RHS |
|
450 |
1 |
450 |
1 |
450 |
30 |
$13,500 |
|
RUS |
|
1,000 |
1 |
1,000 |
1 |
1,000 |
30 |
$30,000 |
1942.17(j)(4)(i)(A); 3570.76 |
Right-of-Way Easement |
442-20 |
|
|
|
|
|
|
|
|
RHS |
|
250 |
1 |
250 |
1 |
250 |
30 |
$7,500 |
|
RUS |
|
|
|
|
|
|
|
|
1942.17(j)(4)(i); 3570.76 |
Right-of-Way Certificate |
442-21 |
|
|
|
|
|
|
|
|
RHS |
|
250 |
1 |
250 |
1 |
250 |
30 |
$7,500 |
|
RUS |
|
|
|
|
|
|
|
|
1780.34(g)(1)(ii); 1942.17(j)(4)(i); 3570.76 |
Opinion of Counsel Relative to Rights-of-Way |
442-22 |
|
|
|
|
|
|
|
|
RHS |
|
200 |
1 |
200 |
1 |
200 |
30 |
$6,000 |
|
RUS |
|
1,000 |
1 |
1,000 |
1 |
1,000 |
30 |
$30,000 |
1780.35(a)(2); 1942.17(n)(2) |
Loan Resolution (Public Bodies) |
1942-47 |
|
|
|
|
|
|
|
|
RHS |
|
150 |
1 |
150 |
1 |
150 |
30 |
$4,500 |
|
RUS |
|
|
|
|
|
|
|
|
1780.35(a)(2), 1942.17(n)(2) |
Loan Resolution Security Agreement |
1942-9 |
|
|
|
|
|
|
|
|
RHS |
|
300 |
1 |
300 |
1 |
300 |
30 |
$9,000 |
|
RUS |
|
|
|
|
|
|
|
|
1780.35(b)(1)(ii); 1942.17(p)(2)(ii); 1944.235(c) |
Estimate of Funds Needed for 30-Day Period Commencing ____" |
440-11 |
|
|
|
|
|
|
|
|
RHS |
|
550 |
3 |
1,650 |
1 |
1,650 |
30 |
$49,500 |
|
RUS |
|
900 |
1 |
900 |
1 |
900 |
30 |
$27,000 |
1780.37(f); 1942.17(q)(2)(i)(A);1951.223(b)(1), 1951.230(a)(9); 3570.82 |
Statement of Budget, Income, and Equity |
442-2 |
|
|
|
|
|
|
|
|
RHS |
|
650 |
1 |
650 |
2.5 |
1,625 |
30 |
$48,750 |
|
RUS |
|
1,000 |
1 |
1,000 |
2.5 |
2,500 |
30 |
$75,000 |
1780.62; 1942.18(f) |
Water Purchase Contract |
442-30 |
|
|
|
|
|
|
|
|
RHS |
|
|
|
|
|
|
|
|
|
RUS |
|
200 |
1 |
200 |
1 |
200 |
30 |
$6,000 |
1942.8(d) |
Bond Registration Book |
442-28 |
|
|
|
|
|
|
|
|
RHS |
|
130 |
1 |
130 |
1 |
130 |
30 |
$3,900 |
|
RUS |
|
|
|
|
|
|
|
|
1942.17(j)(3)(ii)(B) |
Position Fidelity Schedule Bond Declarations |
440-24 |
736 |
1 |
736 |
0.5 |
368 |
30 |
$11,040 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
REPORTING REQUIREMENTS - NO FORMS |
1942.17(c)(2)(vii) |
Application to Obtain Additional Funding |
Written |
|
|
|
|
|
|
|
|
RHS |
|
30 |
1 |
30 |
4 |
120 |
30 |
$3,600 |
|
RUS |
|
|
|
|
|
|
|
|
1942.17(b)(3); 3570.61(c) |
Statement on ability to obtain credit elsewhere |
Written |
|
|
|
|
|
|
|
|
RHS |
|
600 |
1 |
600 |
1 |
600 |
30 |
$18,000 |
|
RUS |
|
|
|
|
|
|
|
|
1942.17(e) |
Notification of declination of service |
Written |
|
|
|
|
|
|
|
|
RHS |
|
12 |
1 |
12 |
3 |
36 |
30 |
$1,080 |
|
RUS |
|
|
|
|
|
|
|
|
1942.17(g)(2)(iii)(A); 3570.80 |
Liens on real and chattel property |
Written |
|
|
|
|
|
|
|
|
RHS |
|
55 |
1 |
55 |
1 |
55 |
30 |
$1,650 |
|
RUS |
|
|
|
|
|
|
|
|
1942.17(g)(3)(i)(B) |
Financing Statement |
Written |
|
|
|
|
|
|
|
|
RHS |
|
260 |
1 |
260 |
1 |
260 |
30 |
$7,800 |
|
RUS |
|
|
|
|
|
|
|
|
1942.17(j)(9); 3570.71 |
Public Information |
Written |
|
|
|
|
|
|
|
|
RHS |
|
650 |
1 |
650 |
2 |
1,300 |
30 |
$39,000 |
|
RUS |
|
|
|
|
|
|
|
|
1942.5(b)(1)(ii)(D) and Guides 6-10; 3570.65 |
Preliminary Architectural or Engineering Report |
Written |
|
|
|
|
|
|
|
|
RHS |
|
350 |
1 |
350 |
4 |
1,400 |
30 |
$42,000 |
|
RUS |
|
|
|
|
|
|
|
|
1942.17(l)(1); 3570.71 |
Agreement for professional services |
Written |
|
|
|
|
|
|
|
|
RHS |
|
400 |
1 |
400 |
4 |
1,600 |
30 |
$48,000 |
|
RUS |
|
|
|
|
|
|
|
|
1942.17(h)(2)(iii) |
Positive programs to encourage connections |
Written |
|
|
|
|
|
|
|
|
RHS |
|
12 |
1 |
12 |
3 |
36 |
30 |
$1,080 |
|
RUS |
|
|
|
|
|
|
|
|
1942.17(n)(3) |
Interim financing |
Written |
|
|
|
|
|
|
|
|
RHS |
|
1,250 |
1 |
1,250 |
4 |
5,000 |
30 |
$150,000 |
|
RUS |
|
|
|
|
|
|
|
|
1942.17(j)(3)(iii)(A) |
Property insurance |
Written |
|
|
|
|
|
|
|
|
RHS |
|
450 |
1 |
450 |
1 |
450 |
30 |
$13,500 |
|
RUS |
|
|
|
|
|
|
|
|
1942.17(j)(3)(iii)(B) |
Liability and Property Damage Insurance |
Written |
|
|
|
|
|
|
|
|
RHS |
|
420 |
1 |
420 |
1 |
420 |
30 |
$12,600 |
|
RUS |
|
|
|
|
|
|
|
|
1942.17(j)(3)(iii)(D) |
Flood Insurance |
Written |
|
|
|
|
|
|
|
|
RHS |
|
45 |
1 |
45 |
1 |
45 |
30 |
$1,350 |
|
RUS |
|
|
|
|
|
|
|
|
1942.17(j)(3)(iii)(E) |
Workman's compensation insurance |
Written |
|
|
|
|
|
|
|
|
RHS |
|
325 |
1 |
325 |
0.5 |
163 |
30 |
$4,075 |
|
RUS |
|
|
|
|
|
|
|
|
1942.17(n)(6); 3570.80 |
Evidence of Disbursement of other funds |
Written |
|
|
|
|
|
|
|
|
RHS |
|
215 |
1 |
215 |
1 |
215 |
30 |
$6,450 |
|
RUS |
|
|
|
|
|
|
|
|
1942.17(j)(4)(ii) |
Acquistion of Land, Easement, Water Rights & Existing Facilities |
Written |
|
|
|
|
|
|
|
|
RHS |
|
325 |
1 |
325 |
3 |
975 |
30 |
$29,250 |
|
RUS |
|
|
|
|
|
|
|
|
1942.3; 3570.65 |
Appraisal Report |
Written |
|
|
|
|
|
|
|
|
RHS |
|
400 |
1 |
400 |
2 |
800 |
30 |
$24,000 |
|
RUS |
|
|
|
|
|
|
|
|
1942.5(b)(1)(ii)(I); 3570.70 |
Lease/Management agreement |
Written |
|
|
|
|
|
|
|
|
RHS |
|
40 |
1 |
40 |
5 |
200 |
30 |
$6,000 |
|
RUS |
|
|
|
|
|
|
|
|
1942.17(g)(2) |
Notes, bonds, warrants or other contractural obligations |
Written |
|
|
|
|
|
|
|
|
RHS |
|
335 |
1 |
335 |
5 |
1,675 |
30 |
$50,250 |
|
RUS |
|
|
|
|
|
|
|
|
1942.18(e) & Guides 17 thru 19; 3570.76 |
Construction contract forms |
Written |
|
|
|
|
|
|
|
|
RHS |
|
335 |
1 |
335 |
1 |
335 |
30 |
$10,050 |
|
RUS |
|
|
|
|
|
|
|
|
1942.8(g); 3570.80 |
Certification by borrower's attorney |
Written |
|
|
|
|
|
|
|
|
RHS |
|
335 |
1 |
335 |
15 |
5,025 |
30 |
$150,750 |
|
RUS |
|
|
|
|
|
|
|
|
1942.18(m); 3570.76 |
Contracts awarded prior to application |
Written |
|
|
|
|
|
|
|
|
RHS |
|
20 |
1 |
20 |
2 |
40 |
30 |
$1,200 |
|
RUS |
|
|
|
|
|
|
|
|
1942.18(o)(3); 3570.76 |
Resident Inspector resume |
Written |
|
|
|
|
|
|
|
|
RHS |
|
235 |
1 |
235 |
0.5 |
118 |
30 |
$2,950 |
|
RUS |
|
|
|
|
|
|
|
|
1942.18(o)(4); 3570.76 |
Daily inspection report |
Written |
|
|
|
|
|
|
|
|
RHS |
|
110 |
12 |
1,320 |
0.5 |
660 |
30 |
$19,800 |
|
RUS |
|
|
|
|
|
|
|
|
1942.5(b)(1)(ii)(G) |
Evidence that facility cannot be provided by a public body |
Written |
|
|
|
|
|
|
|
|
RHS |
|
175 |
1 |
175 |
1 |
175 |
30 |
$5,250 |
|
RUS |
|
|
|
|
|
|
|
|
1942.5(b)(1)(ii)(H); 3570.65 |
Financial feasibility report |
Written |
|
|
|
|
|
|
|
|
RHS |
|
435 |
1 |
435 |
4 |
1,740 |
30 |
$52,200 |
|
RUS |
|
|
|
|
|
|
|
|
1942.17(b)(4); 3570.65 |
Organizational documents |
Written |
|
|
|
|
|
|
|
|
RHS |
|
550 |
1 |
550 |
1 |
550 |
30 |
$16,500 |
|
RUS |
|
|
|
|
|
|
|
|
1942.5(a)(1)(ii), 1942.17(f)(1) |
Borrower request to choose interest rate |
Written |
|
|
|
|
|
|
|
|
RHS |
|
455 |
1 |
455 |
0.167 |
76 |
30 |
$2,280 |
|
RUS |
|
|
|
|
|
|
|
|
1942.5(b)(1)(ii)(F) |
Five Year Financial History |
Written |
|
|
|
|
|
|
|
|
RHS |
|
220 |
1 |
220 |
1 |
220 |
30 |
$6,600 |
|
RUS |
|
|
|
|
|
|
|
|
1942.17(g)(2)(iii)(A)(9)(ii) |
Exceptional Community Support and Documentation |
Written |
|
|
|
|
|
|
|
|
RHS |
|
150 |
1 |
150 |
4 |
600 |
30 |
$18,000 |
|
RUS |
|
|
|
|
|
|
|
|
1942.17(g)(3)(i)(D) |
Other Security |
Written |
|
|
|
|
|
|
|
|
RHS |
|
175 |
1 |
175 |
1 |
175 |
30 |
$5,250 |
|
RUS |
|
|
|
|
|
|
|
|
1942.17(j)(3)(iii)(C) |
Malpractice Insurance |
Written |
|
|
|
|
|
|
|
|
RHS |
|
155 |
1 |
155 |
0.5 |
78 |
30 |
$1,950 |
|
RUS |
|
|
|
|
|
|
|
|
1942.17(j)(4)(iii) |
Land Purchase Contract |
Written |
|
|
|
|
|
|
|
|
RHS |
|
65 |
1 |
65 |
2 |
130 |
30 |
$3,900 |
|
RUS |
|
|
|
|
|
|
|
|
1942.17(j)(8) |
Certificate of Need |
Written |
|
|
|
|
|
|
|
|
RHS |
|
45 |
1 |
45 |
1 |
45 |
30 |
$1,350 |
|
RUS |
|
|
|
|
|
|
|
|
1942.17(k); 3570.70 |
Certification of appropriate regulatory agencies |
Written |
|
|
|
|
|
|
|
|
RHS |
|
150 |
1 |
150 |
4 |
600 |
30 |
$18,000 |
|
RUS |
|
|
|
|
|
|
|
|
1942.17(r)(1)(ii)(B) & Guide 22 |
Positive Action Plan |
Written |
|
|
|
|
|
|
|
|
RHS |
|
48 |
1 |
48 |
2 |
96 |
30 |
$2,880 |
|
RUS |
|
|
|
|
|
|
|
|
1942.17(q)(4); 3570.83 |
Audits |
Written |
|
|
|
|
|
|
|
|
RHS |
|
550 |
1 |
550 |
3 |
1,650 |
30 |
$49,500 |
|
RUS |
|
|
|
|
|
|
|
|
1942.17(q)(4)(ii) |
Financial Statements - borrowers under $100,000 gross income |
Written |
|
|
|
|
|
|
|
|
RHS |
|
560 |
1 |
560 |
4 |
2,240 |
30 |
$67,200 |
|
RUS |
|
|
|
|
|
|
|
|
1942.18(j)(5)(iv) |
Utilization of small business & minority owned business |
Written |
|
|
|
|
|
|
|
|
RHS |
|
100 |
1 |
100 |
0.5 |
50 |
30 |
$1,500 |
|
RUS |
|
|
|
|
|
|
|
|
1942.18(k)(5); 3570.75 |
Procurement when other than bid or negotiation is used |
Written |
|
|
|
|
|
|
|
|
RHS |
|
60 |
1 |
60 |
1 |
60 |
30 |
$1,800 |
|
RUS |
|
|
|
|
|
|
|
|
1942.18(l); 3570.76 |
Unconventional contracting methods |
Written |
|
|
|
|
|
|
|
|
RHS |
|
60 |
1 |
60 |
5 |
300 |
30 |
$9,000 |
|
RUS |
|
|
|
|
|
|
|
|
1942.2(a)(1)(iii); 3570.65(a)(1) |
State clearinghouse review |
Written |
|
|
|
|
|
|
|
|
RHS |
|
455 |
1 |
455 |
1 |
455 |
30 |
$13,650 |
|
RUS |
|
|
|
|
|
|
|
|
1942.17(q)(1)(ii) |
Approval of Audit |
Written |
|
|
|
|
|
|
|
|
RHS |
|
305 |
1 |
305 |
0.5 |
153 |
30 |
$3,825 |
|
RUS |
|
|
|
|
|
|
|
|
1942.17(q)(2)(ii)(A); 3570.83 |
Governing body members and terms of office |
Written |
|
|
|
|
|
|
|
|
RHS |
|
305 |
1 |
305 |
0.5 |
153 |
30 |
$4,575 |
|
|
|
|
|
|
|
|
|
|
RECORDKEEPING REQUIREMENTS |
|
|
|
|
|
|
|
|
|
|
1942.17(q)(1)(iv) |
Borrower shall maintain accounting records for 3 years |
|
|
|
3,231 |
0.25 |
808 |
30 |
$20,200 |
|
|
|
|
|
|
|
|
|
|
TOTAL |
|
|
|
|
29,259 |
|
57,177 |
|
$1,708,785 |
|
|
|
|
|
|
|
|
|
|
REPORTING REQUIREMENTS - FORMS APPROVED UNDER OTHER OMB NUMBERS |
|
|
|
|
|
|
|
|
|
|
1942.17(j)(4)(i)(B) |
Preliminary Title Opinion |
1927-9 (0575-0147) |
|
|
|
|
|
|
|
|
RHS |
|
1,450 |
2 |
2,900 |
1.5 |
4,350 |
30 |
$130,500 |
1942.17(j)(4)(i)(B) |
Final Title Opinion |
1927-10 (0575-0147) |
|
|
|
|
|
|
|
|
RHS |
|
1,450 |
2 |
2,900 |
0.33 |
957 |
30 |
$28,710 |
1942.17(p)(5) & Guide 18 |
Partial Payment Estimate |
1924-18 (0575-0042) |
|
|
|
|
|
|
|
|
RHS |
|
2,475 |
2 |
4,950 |
0.5 |
2,475 |
30 |
$74,250 |
1942.18(o)(7)(ii) & Guide 18 |
Contract Change Order |
1924-7 (0575-0042) |
|
|
|
|
|
|
|
|
RHS |
|
1,897 |
1 |
1,897 |
0.25 |
474 |
30 |
$19,525 |
1942.2(b) |
Request for Environmental Information |
1940-20 (0575-0094) |
|
|
|
|
|
|
|
|
RHS |
|
1,450 |
1 |
1,450 |
0.25 |
363 |
30 |
$10,875 |
1942.17(n)(2)(x) |
Equal Opportunity Agreement |
400-1 (0575-0018) |
|
|
|
|
|
|
|
|
RHS |
|
1,450 |
1 |
1,450 |
0.167 |
242 |
30 |
$4,125 |
1942.17(n)(2)(x) |
Assurance Agreement |
400-4 (0575-0018) |
|
|
|
|
|
|
|
|
RHS |
|
1,450 |
1 |
1,450 |
0.25 |
363 |
30 |
$19,525 |
1942.2(c)(2) |
Application for Federal Assistance (For Construction) |
SF 424.2 (0348-0043) |
|
|
|
|
|
|
|
|
RHS |
|
1,450 |
1 |
1,450 |
0.75 |
1,088 |
30 |
$3,275 |