| 
		
  | 
		
  | 
		
  | 
		Reports | 
		Total Annual | 
		Est. No. of | 
		Est. Total | 
		Wage | 
		Cost to the  | 
		
  | 
	
	
		| Section of | 
		
  | 
		Form No. | 
		Est. No. of | 
		Filed | 
		Responses | 
		 Man hours | 
		Man-hours | 
		Class (per | 
		Public | 
		
  | 
	
	
		| Regulation | 
		Title | 
		(if Any) | 
		Respondents | 
		Annually | 
		(D) x (E) | 
		Per Response | 
		(F) x (G) | 
		hour) | 
		(H) x (I) | 
		
  | 
	
	
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
	
	
		| (A) | 
		(B) | 
		(C) | 
		(D) | 
		(E) | 
		(F) | 
		(G) | 
		(H) | 
		(I) | 
		(J) | 
		
  | 
	
	
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
	
	
		
  | 
		 REPORTING REQUIREMENTS - NON FORMS  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
	
	
		| 4274.314(b)(14)(iv) - 100% of respondents are not-for-profit | 
		Operating plans for revolving line of credit | 
		written | 
		56 | 
		1 | 
		56 | 
		5 | 
		280 | 
		83 | 
		23,240 | 
		
  | 
	
	
		| 4274.326(a)(2) - 100% of respondents are not-for-profit | 
		Assignments of Security | 
		Written | 
		5 | 
		1 | 
		5 | 
		1.5 | 
		8.0 | 
		83 | 
		664 | 
		
  | 
	
	
		| 4274.332(b)(4) - 100% of respondents are not-for-profit | 
		Jusitification for amount of reserve | 
		Written | 
		15 | 
		1 | 
		15 | 
		2 | 
		30 | 
		83 | 
		2,490 | 
		
  | 
	
	
		| 4274.337(a) - 100% of respondents are not-for-profit | 
		Intergovernmental review comments | 
		written | 
		192 | 
		1 | 
		192 | 
		2 | 
		384 | 
		83 | 
		31,872 | 
		
  | 
	
	
		| 4274.338(a)(5) - 100% of respondents are not-for-profit | 
		Request for advance of funds | 
		written or              Form RD 440-11 (0575-0015) | 
		192 | 
		1 | 
		192 | 
		1 | 
		192 | 
		83 | 
		15,936 | 
		
  | 
	
	
		| 4274.338(a)(7)(v)(c) - 100% of respondents are not-for-profit | 
		Evidence of fidelity bond coverage | 
		written | 
		192 | 
		1 | 
		192 | 
		1.5 | 
		288 | 
		83 | 
		23,904 | 
		
  | 
	
	
		| 4274.343(a)(2) - 100% of respondents are not-for-profit | 
		Workplan | 
		written | 
		192 | 
		1 | 
		192 | 
		18 | 
		3456 | 
		83 | 
		286,848 | 
		
  | 
	
	
		| 4274.343(a)(9) - 100% of respondents are not-for-profit | 
		Certification of lack of financing | 
		written | 
		192 | 
		1 | 
		192 | 
		1.5 | 
		288 | 
		83 | 
		23,904 | 
		
  | 
	
	
		| 4274.344(c)(2)(ii) - 100% of respondents are not-for-profit | 
		Low-income counties | 
		written | 
		37 | 
		1 | 
		37 | 
		2 | 
		74 | 
		83 | 
		6,142 | 
		
  | 
	
	
		| 4274.344(c)(2)(iv) - 100% of respondents are business or other for-profit | 
		Ultimate recipients certification of low-income work force | 
		written | 
		185 | 
		1 | 
		185 | 
		0.5 | 
		93 | 
		83 | 
		7,719 | 
		
  | 
	
	
		| 4274.350 - 100% of respondents are not-for-profit | 
		Letter of Conditions | 
		 Form RD 1942-46 (0575-0015)              | 
		192 | 
		1 | 
		192 | 
		1 | 
		192 | 
		83 | 
		15,936 | 
		
  | 
	
	
		| 4274.356 - 100% of respondents are not-for-profit | 
		Loan Closing Certifications | 
		written | 
		192 | 
		1 | 
		192 | 
		1 | 
		192 | 
		83 | 
		15,936 | 
		
  | 
	
	
		| 4274.361(b)(1) - 100% of respondents are not-for-profit | 
		Certifications to make loans to ultimate recipients | 
		written | 
		192 | 
		1 | 
		192 | 
		1.5 | 
		288 | 
		83 | 
		23,904 | 
		
  | 
	
	
		| 4274.373 - 100% of respondents are not-for-profit | 
		Request for Appeal | 
		written | 
		5 | 
		1 | 
		5 | 
		2 | 
		10 | 
		83 | 
		830 | 
		
  | 
	
	
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
	
	
		
  | 
		FORMS APPROVED WITH THIS DOCKET | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
	
	
		| 4274.338 - 100% of respondents are not-for-profit | 
		Loan Agreement | 
		4274-4 | 
		100 | 
		1 | 
		100 | 
		1.5 | 
		150 | 
		83 | 
		12,450 | 
		
  | 
	
	
		| 4274.338 - 100% of respondents are not-for-profit | 
		Supplemental Loan Agreement | 
		4274-5 | 
		50 | 
		1 | 
		50 | 
		1 | 
		50 | 
		83 | 
		4,150 | 
		
  | 
	
	
		| 4274.338(b)(9) - 100% of respondents are not-for-profit | 
		Promissory Note | 
		4274-3 | 
		192 | 
		1 | 
		192 | 
		1.5 | 
		288 | 
		83 | 
		23,904 | 
		
  | 
	
	
		| 4274.343(a)(1) - 100% of respondents are not-for-profit | 
		Application for Loan (IRP) | 
		4274-1 | 
		202 | 
		1 | 
		202 | 
		56 | 
		11,312 | 
		83 | 
		938,896 | 
		
  | 
	
	
		
  | 
		Totals | 
		
  | 
		202 | 
		
  | 
		2,383 | 
		
  | 
		17,959 | 
		
  | 
		1,490,597 | 
		
  | 
	
	
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
	
	
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
	
	
		
  | 
		REPORTING REQUIREMENTS APPROVED UNDER OTHER NUMBERS | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
	
	
		| 4274.337(B) | 
		Request for Environmental Information | 
		1940-20 (0575-0094) | 
		192 | 
		1 | 
		192 | 
		6 | 
		1,152 | 
		83 | 
		95,616 | 
		
  | 
	
	
		| 4274.338(b)(4)(ii)(C) | 
		Report of IRP/RDLF | 
		1951-4 (0570-0015) | 
		192 | 
		1 | 
		192 | 
		4 | 
		768 | 
		83 | 
		63,744 | 
		
  | 
	
	
		| 4274.343(a)(7) | 
		Assurance Agreement | 
		400-4 (0575-0018) | 
		192 | 
		1 | 
		192 | 
		0.25 | 
		48 | 
		83 | 
		3,984 | 
		
  | 
	
	
		| 4274.326(a)(3) | 
		Deposit Agreement | 
		402-1 (0575-0158) | 
		192 | 
		1 | 
		192 | 
		0.08 | 
		15 | 
		83 | 
		1,245 | 
		
  | 
	
	
		| 4274.337(c)(4) | 
		Compliance Review | 
		400-8 (0575-0018) | 
		192 | 
		1 | 
		192 | 
		8 | 
		1536 | 
		83 | 
		127,488 | 
		
  | 
	
	
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
	
	
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
	
	
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
	
	
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		                                                                                   | 
		
  | 
		
  | 
		
  | 
		
  | 
	
	
	
	
	
	
	
	
	
	
	
	
	
		
  | 
		
  | 
		
  | 
		
  | 
		Reports | 
		Total Annual | 
		Est. No. of | 
		Est. Total | 
		Wage | 
		Cost to the  | 
		
  | 
		
  | 
		
  | 
	
	
		| Section of | 
		
  | 
		Form No. | 
		Est. No. of | 
		Filed | 
		Responses | 
		 Man hours | 
		Man-hours | 
		Class (per | 
		Public | 
		
  | 
		
  | 
		
  | 
	
	
		| Regulation | 
		Title | 
		(if Any) | 
		Respondents | 
		Annually | 
		(D) x (E) | 
		Per Response | 
		(F) x (G) | 
		hour) | 
		(H) x (I) | 
		
  | 
		
  | 
		
  | 
	
	
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
	
	
		| (A) | 
		(B) | 
		(C) | 
		(D) | 
		(E) | 
		(F) | 
		(G) | 
		(H) | 
		(I) | 
		(J) | 
		
  | 
		
  | 
		
  | 
	
	
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
	
	
		
  | 
		 REPORTING REQUIREMENTS - NON FORMS  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
	
	
		| 4274.314(b)(14)(iv) - 100% of respondents are not-for-profit | 
		Operating plans for revolving line of credit | 
		written | 
		56 | 
		1 | 
		56 | 
		5 | 
		280 | 
		83 | 
		23,240 | 
		
  | 
		
  | 
		
  | 
	
	
		| 4274.326(a)(2) - 100% of respondents are not-for-profit | 
		Assignments of Security | 
		Written | 
		5 | 
		1 | 
		5 | 
		1.5 | 
		8 | 
		83 | 
		623 | 
		
  | 
		
  | 
		
  | 
	
	
		| 4274.332(b)(4) - 100% of respondents are not-for-profit | 
		Jusitification for amount of reserve | 
		Written | 
		15 | 
		1 | 
		15 | 
		2 | 
		30 | 
		83 | 
		2,490 | 
		
  | 
		
  | 
		
  | 
	
	
		| 4274.337(a) - 100% of respondents are not-for-profit | 
		Intergovernmental review comments | 
		written | 
		192 | 
		1 | 
		192 | 
		2 | 
		384 | 
		83 | 
		31,872 | 
		
  | 
		
  | 
		
  | 
	
	
		| 4274.338(a)(5) - 100% of respondents are not-for-profit | 
		Request for advance of funds | 
		written or              Form RD 440-11 (0575-0015) | 
		192 | 
		1 | 
		192 | 
		1 | 
		192 | 
		83 | 
		15,936 | 
		
  | 
		
  | 
		
  | 
	
	
		| 4274.338(a)(7)(v)(c) - 100% of respondents are not-for-profit | 
		Evidence of fidelity bond coverage | 
		written | 
		192 | 
		1 | 
		192 | 
		1.5 | 
		288 | 
		83 | 
		23,904 | 
		
  | 
		
  | 
		
  | 
	
	
		| 4274.343(a)(2) - 100% of respondents are not-for-profit | 
		Workplan | 
		written | 
		192 | 
		1 | 
		192 | 
		18 | 
		3456 | 
		83 | 
		286,848 | 
		
  | 
		
  | 
		
  | 
	
	
		| 4274.343(a)(9) - 100% of respondents are not-for-profit | 
		Certification of lack of financing | 
		written | 
		192 | 
		1 | 
		192 | 
		1.5 | 
		288 | 
		83 | 
		23,904 | 
		
  | 
		
  | 
		
  | 
	
	
		| 4274.344(c)(2)(ii) - 100% of respondents are not-for-profit | 
		Low-income counties | 
		written | 
		37 | 
		1 | 
		37 | 
		2 | 
		74 | 
		83 | 
		6,142 | 
		
  | 
		
  | 
		
  | 
	
	
		| 4274.344(c)(2)(iv) - 100% of respondents are business or other for-profit | 
		Ultimate recipients certification of low-income work force | 
		written | 
		185 | 
		1 | 
		185 | 
		0.5 | 
		93 | 
		83 | 
		7,678 | 
		
  | 
		
  | 
		
  | 
	
	
		| 4274.350 - 100% of respondents are not-for-profit | 
		Letter of Conditions | 
		 Form RD 1942-46 (0575-0015)              | 
		192 | 
		1 | 
		192 | 
		1 | 
		192 | 
		83 | 
		15,936 | 
		
  | 
		
  | 
		
  | 
	
	
		| 4274.356 - 100% of respondents are not-for-profit | 
		Loan Closing Certifications | 
		written | 
		192 | 
		1 | 
		192 | 
		1 | 
		192 | 
		83 | 
		15,936 | 
		
  | 
		
  | 
		
  | 
	
	
		| 4274.361(b)(1) - 100% of respondents are not-for-profit | 
		Certifications to make loans to ultimate recipients | 
		written | 
		192 | 
		1 | 
		192 | 
		1.5 | 
		288 | 
		83 | 
		23,904 | 
		
  | 
		
  | 
		
  | 
	
	
		| 4274.373 - 100% of respondents are not-for-profit | 
		Request for Appeal | 
		written | 
		5 | 
		1 | 
		5 | 
		2 | 
		10 | 
		83 | 
		830 | 
		
  | 
		
  | 
		
  | 
	
	
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
	
	
		
  | 
		FORMS APPROVED WITH THIS DOCKET | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
	
	
		| 4274.338 - 100% of respondents are not-for-profit | 
		Loan Agreement | 
		4274-4 | 
		100 | 
		1 | 
		100 | 
		1.5 | 
		150 | 
		83 | 
		12,450 | 
		
  | 
		
  | 
		
  | 
	
	
		| 4274.338 - 100% of respondents are not-for-profit | 
		Supplemental Loan Agreement | 
		4274-5 | 
		50 | 
		1 | 
		50 | 
		1 | 
		50 | 
		83 | 
		4,150 | 
		
  | 
		
  | 
		
  | 
	
	
		| 4274.338(b)(9) - 100% of respondents are not-for-profit | 
		Promissory Note | 
		4274-3 | 
		192 | 
		1 | 
		192 | 
		1.5 | 
		288 | 
		83 | 
		23,904 | 
		
  | 
		
  | 
		
  | 
	
	
		| 4274.343(a)(1) - 100% of respondents are not-for-profit | 
		Application for Loan (IRP) | 
		4274-1 | 
		202 | 
		1 | 
		202 | 
		56 | 
		11,312 | 
		83 | 
		938,896 | 
		
  | 
		
  | 
		
  | 
	
	
		
  | 
		Totals | 
		
  | 
		202 | 
		
  | 
		2,383 | 
		
  | 
		17,599 | 
		
  | 
		1,460,717 | 
		
  | 
		
  | 
		
  | 
	
	
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
	
	
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
	
	
		
  | 
		REPORTING REQUIREMENTS APPROVED UNDER OTHER NUMBERS | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
	
	
		| 4274.337(B) | 
		Request for Environmental Information | 
		1940-20 (0575-0094) | 
		192 | 
		1 | 
		192 | 
		6 | 
		1,152 | 
		83 | 
		95,616 | 
		
  | 
		
  | 
		
  | 
	
	
		| 4274.338(b)(4)(ii)(C) | 
		Report of IRP/RDLF | 
		1951-4 (0570-0015) | 
		192 | 
		1 | 
		192 | 
		4 | 
		768 | 
		83 | 
		63,744 | 
		
  | 
		
  | 
		
  | 
	
	
		| 4274.343(a)(7) | 
		Assurance Agreement | 
		400-4 (0575-0018) | 
		192 | 
		1 | 
		192 | 
		0.25 | 
		48 | 
		83 | 
		3,984 | 
		
  | 
		
  | 
		
  | 
	
	
		| 4274.326(a)(3) | 
		Deposit Agreement | 
		402-1 (0575-0158) | 
		192 | 
		1 | 
		192 | 
		0.08 | 
		15 | 
		83 | 
		1,245 | 
		
  | 
		
  | 
		
  | 
	
	
		| 4274.337(c)(4) | 
		Compliance Review | 
		400-8 (0575-0018) | 
		192 | 
		1 | 
		192 | 
		8 | 
		1536 | 
		83 | 
		127,488 | 
		
  | 
		
  | 
		
  | 
	
	
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
	
	
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
	
	
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
		
  | 
	
	
		
  | 
		
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		                                                                                   | 
		
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