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[" ",null,null,null,"Reports","Total Annual","Est. No. of","Est. Total","Wages","Cost to the"]
[" ",null,"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)","$/Hr.","(H) x (I)"]
["(A)","(B)","(C)","(D)","(E)","(F)","(G)","(H)","(I)","(J)"]
["REPORTING REQUIREMENTS - FORMS APPROVED WITH THIS DOCKET"]
[]
["1780.33(h)(1); 1942.5(b)(1)(ii)(C); 1951.222(c)(3); 3570.71(h)","Operating Budget","442-7"]
[null,"RHS",null,700,1,700,5,3500,51,178500]
[null,"RUS",null,1000,1,1000,5,5000,51,255000]
["1780.41(a)(3); 1942.5(b)(1)(ii)(E); 1951.230(a)(9);1955.10(f)(3)(i); & 3570.82","Balance Sheet or Financial Statement","442-3",{"$nulls":6},0]
[null,"RHS",null,450,1,450,1,450,51,22950]
[null,"RUS",null,1000,1,1000,1,1000,51,51000]
["1780.29(b)(1); 1942.17(l)(i)","Agreement for Engineering Services","1942-19",{"$nulls":6},0]
[null,"RHS",null,185,1,185,4,740,51,37740]
[null,"RUS",null,1000,1,1000,4,4000,51,204000]
["1780.39(f); Guide 16 of 1942-A; 3570.61(e)","Resolution of Members or Stockholders","1942-8",{"$nulls":6},0]
[null,"RHS",null,67,1,67,1,67,51,3417]
[null,"RUS",null,200,1,200,1,200,51,10200]
["1780.41(a)(6); 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",{"$nulls":6},0]
[null,"RHS",null,430,1,430,1,430,51,21930]
[null,"RBS (Small Socially Disadvantaged Producer Grant Program)",null,10,1,10,1,10,51,510]
[null,"RUS",null,1000,1,1000,1,1000,51,51000]
["1942.17(j)(4)(i)(A); 3570.76","Right-of-Way Easement","442-20",{"$nulls":6},0]
[null,"RHS",null,225,1,225,1,225,51,11475]
["1942.17(j)(4)(i); 3570.76","Right-of-Way Certificate","442-21"]
[null,"RHS",null,225,1,225,1,225,51,11475]
["1780.44(g)(1)(i), 1942.17(j)(4)(i); 3570.76","Opinion of Counsel Relative to Rights-of-Way","442-22"]
[null,"RHS",null,185,1,185,1,185,51,9435]
[null,"RUS",null,1000,1,1000,1,1000,51,51000]
["1942.17(n)(2)","Loan Resolution (Public Bodies)","1942-47"]
[null,"RHS",null,140,1,140,1,140,51,7140]
["1942.17(n)(2)","Loan Resolution Security Agreement","1942-9"]
[null,"RHS",null,285,1,285,1,285,51,14535]
["1780.45(b)(1)(ii); 1942.17(p)(2)(ii); 1944.235(c)","Estimate of Funds Needed for 30-Day Period Commencing ____\"","440-11"]
[null,"RHS",null,540,3,1620,1,1620,51,82620]
[null,"RUS",null,900,1,900,1,900,51,45900]
[null,"Promissory Note","440-22"]
[null,"RHS",null,475,2,950,0.25,237.5,51,12112.5]
[null,"RUS",null,1000,1,1000,0.25,250,51,12750]
["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"]
[null,"RHS",null,605,1,605,2.5,1512.5,51,77137.5]
[null,"RUS",null,1000,1,1000,2.5,2500,51,127500]
["1942.18(f)","Water Purchase Contract","442-30"]
[null,"RUS",null,200,1,200,1,200,51,10200]
["1942.8(d)","Bond Registration Book","442-28"]
[null,"RHS",null,130,1,130,1,130,51,6630]
["1942.17(j)(3)(ii)(B)","Position Fidelity Schedule Bond Declarations","440-24",720,1,720,0.5,360,51,18360]
[]
[]
["REPORTING REQUIREMENTS - NO FORMS "]
["1942.17(c)(2)(vii)","Application to Obtain Additional Funding","Written"]
[null,"RHS",null,26,1,26,4,104,51,5304]
["1942.17(b)(3); 3570.61(c)","Statement on ability to obtain credit elsewhere","Written"]
[null,"RHS",null,575,1,575,1,575,51,29325]
["1942.17(e)","Notification of declination of service","Written"]
[null,"RHS",null,8,1,8,3,24,51,1224]
["1942.17(g)(2)(iii)(A); 3570.80","Liens on real and chattel property","Written"]
[null,"RHS",null,45,1,45,1,45,51,2295]
["1942.17(g)(3)(i)(B)","Financing Statement","Written"]
[null,"RHS",null,245,1,245,1,245,51,12495]
["1942.17(j)(9); 3570.71","Public Information","Written"]
[null,"RHS",null,615,1,615,2,1230,51,62730]
["1942.5(b)(1)(ii)(D) and Guides 6-10; 3570.65","Preliminary Architectural or Engineering Report","Written"]
[null,"RHS",null,315,1,315,4,1260,51,64260]
["1942.17(l)(1); 3570.71","Agreement for professional services","Written"]
[null,"RHS",null,375,1,375,4,1500,51,76500]
["1942.17(h)(2)(iii)","Positive programs to encourage connections","Written"]
[null,"RHS",null,8,1,8,3,24,51,1224]
["1942.17(n)(3)","Interim financing","Written"]
[null,"RHS",null,1175,1,1175,4,4700,51,239700]
["1942.17(j)(3)(iii)(A)","Property insurance","Written"]
[null,"RHS",null,430,1,430,1,430,51,21930]
["1942.17(j)(3)(iii)(B)","Liability and Property Damage Insurance","Written "]
[null,"RHS",null,405,1,405,1,405,51,20655]
["1942.17(j)(3)(iii)(D)","Flood Insurance","Written"]
[null,"RHS",null,42,1,42,1,42,51,2142]
["1942.17(j)(3)(iii)(E)","Workman's compensation insurance","Written"]
[null,"RHS",null,300,1,300,0.5,150,51,7650]
["1942.17(n)(6); 3570.80","Evidence of Disbursement of other funds","Written"]
[null,"RHS",null,200,1,200,1,200,51,10200]
["1942.17(j)(4)(ii)","Acquistion of Land, Easement, Water Rights & Existing Facilities","Written"]
[null,"RHS",null,300,1,300,3,900,51,45900]
["1942.3; 3570.65","Appraisal Report","Written"]
[null,"RHS",null,375,1,375,2,750,51,38250]
["1942.5(b)(1)(ii)(I); 3570.70","Lease/Management agreement","Written"]
[null,"RHS",null,37,1,37,5,185,51,9435]
["1942.17(g)(2)","Notes, bonds, warrants or other contractural obligations","Written"]
[null,"RHS",null,305,1,305,5,1525,51,77775]
["1942.18(e) & Guides 17 thru 19; 3570.76","Construction contract forms","Written"]
[null,"RHS",null,305,1,305,1,305,51,15555]
["1942.8(g); 3570.80","Certification by borrower's attorney","Written"]
[null,"RHS",null,305,1,305,15,4575,51,233325]
["1942.18(m); 3570.76","Contracts awarded prior to application","Written"]
[null,"RHS",null,18,1,18,2,36,51,1836]
["1942.18(o)(3); 3570.76","Resident Inspector resume","Written"]
[null,"RHS",null,225,1,225,0.5,112.5,51,5737.5]
["1942.18(o)(4); 3570.76","Daily inspection report","Written"]
[null,"RHS",null,100,12,1200,0.5,600,51,30600]
["1942.5(b)(1)(ii)(G)","Evidence that facility cannot be provided by a public body","Written"]
[null,"RHS",null,165,1,165,1,165,51,8415]
["1942.5(b)(1)(ii)(H); 3570.65","Financial feasibility report","Written"]
[null,"RHS",null,410,1,410,4,1640,51,83640]
["1942.17(b)(4); 3570.65","Organizational documents","Written"]
[null,"RHS",null,520,1,520,1,520,51,26520]
["1942.5(a)(1)(ii), 1942.17(f)(1)","Borrower request to choose interest rate","Written"]
[null,"RHS",null,425,1,425,0.167,70.97500000000001,51,3619.7250000000004]
["1942.5(b)(1)(ii)(F)","Five Year Financial History","Written"]
[null,"RHS",null,200,1,200,1,200,51,10200]
["1942.17(g)(2)(iii)(A)(9)(ii)","Exceptional Community Support and Documentation","Written"]
[null,"RHS",null,145,1,145,4,580,51,29580]
["1942.17(g)(3)(i)(D)","Other Security","Written"]
[null,"RHS",null,165,1,165,1,165,51,8415]
["1942.17(j)(3)(iii)(C)","Malpractice Insurance","Written"]
[null,"RHS",null,152,1,152,0.5,76,51,3876]
["1942.17(j)(4)(iii)","Land Purchase Contract","Written"]
[null,"RHS",null,60,1,60,2,120,51,6120]
["1942.17(j)(8)","Certificate of Need","Written"]
[null,"RHS",null,40,1,40,1,40,51,2040]
["1942.17(k); 3570.70","Certification of appropriate regulatory agencies","Written"]
[null,"RHS",null,145,1,145,4,580,51,29580]
["1942.17(r)(1)(ii)(B) & Guide 22","Positive Action Plan","Written"]
[null,"RHS",null,40,1,40,2,80,51,4080]
["1942.17(q)(4); 3570.83","Audits","Written"]
[null,"RHS",null,520,1,520,3,1560,51,79560]
["1942.17(q)(4)(ii)","Financial Statements - borrowers under $100,000 gross income","Written"]
[null,"RHS",null,525,1,525,4,2100,51,107100]
["1942.18(j)(5)(iv)","Utilization of small business & minority owned business","Written"]
[null,"RHS",null,85,1,85,0.5,42.5,51,2167.5]
["1942.18(k)(5); 3570.75","Procurement when other than bid or negotiation is used","Written"]
[null,"RHS",null,58,1,58,1,58,51,2958]
["1942.18(l); 3570.76","Unconventional contracting methods","Written"]
[null,"RHS",null,58,1,58,5,290,51,14790]
["1942.2(a)(1)(iii); 3570.65(a)(1)","State clearinghouse review","Written"]
[null,"RHS",null,435,1,435,1,435,51,22185]
["1942.17(q)(1)(ii)","Approval of Audit","Written"]
[null,"RHS",null,285,1,285,0.5,142.5,51,7267.5]
["1942.17(q)(2)(ii)(A); 3570.83","Governing body members and terms of office","Written"]
[{"$nulls":5},0,null,0,null,0]
[null,"RHS",null,285,1,285,0.5,142.5,51,7267.5]
[]
["RECORDKEEPING REQUIREMENTS"]
[]
["1942.17(q)(1)(iv)","Borrower shall maintain accounting records for 3 years",null,3231,null,null,0.25,807.75,51,41195.25]
[]
[" "]
["TOTAL",{"$nulls":4},27779,null,55904.725,null,2851140.975]
[]
["REPORTING REQUIREMENTS - FORMS APPROVED UNDER OTHER OMB NUMBERS"]
[]
["1942.17(j)(4)(i)(B)","Preliminary Title Opinion","1927-9 (0575-0147)"]
[null,"Cleared under docket","(0575-0147)",null,null,0,null,0,null,0]
[null,"RHS",null,1385,2,2770,1.5,4155,51,211905]
["1942.17(j)(4)(i)(B)","Final Title Opinion","1927-10 (0575-0147)"]
[null,"Cleared under docket","(0575-0147)",null,null,0,null,0,25,0]
[null,"RHS",null,1385,2,11000,0.33,3630,51,185130]
["1942.17(p)(5) & Guide 18","Partial Payment Estimate","1924-18 (0575-0042)"]
[null,"Cleared under docket",null,null,null,0,null,0,25,0]
[null,"RHS",null,2400,2,4800,0.5,2400,51,122400]
["1942.18(o)(7)(ii) & Guide 18","Contract Change Order","1924-7 (0575-0042)"]
[null,"Cleared under docket",null,null,null,0,null,0,25,0]
[null,"RHS",null,1875,1,1875,0.25,468.75,51,23906.25]
["1942.2(b)","Request for Environmental Information","1940-20 (0575-0094)"]
[null,"Cleared under docket",null,null,null,0,null,0,25,0]
[null,"RHS",null,1385,1,1385,0.25,346.25,51,17658.75]
["1942.17(n)(2)(x)","Equal Opportunity Agreement","400-1 (0575-0018)"]
[null,"Cleared under docket",null,null,null,0,null,0,25,0]
[null,"RHS",null,1385,1,1385,0.167,231.29500000000002,51,11796.045]
["1942.17(n)(2)(x)","Assurance Agreement"," 400-4 (0575-0018)"]
[null,"Cleared under docket",null,null,null,0,null,0,25,0]
[null,"RHS",null,1385,1,1385,0.25,346.25,51,17658.75]
["1942.2(c)(2)","Application for Federal Assistance (For Construction)","SF 424.2 (4040-0004)"]
[null,"Cleared under docket",null,null,null,0,null,0,25,0]
[{"$nulls":5},0,null,0,25,0]
[null,"RHS",null,1385,1,1385,0.75,1038.75,51,52976.25]

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