Form 442-3

Position 3
Form RD 442-3
(Rev. 3-97)

FORM APPROVED
OMB No. 0575-0015

Name

BALANCE SHEET

Address

ASSETS
CURRENT ASSETS
1. Cash on hand in Banks ................................................................................
2. Time deposits and short-term investments ....................................................
3. Accounts receiveable ..................................................................................
4.
Less: Allowance for doubtful accounts ................................................
5. Inventories ..................................................................................................
6. Prepayments ...............................................................................................
7. _______________________________________________ .........................
8. _______________________________________________ .........................
9.
Total Current Assets (Add 1 through 8) .................................................
FIXED ASSETS
10. Land ...........................................................................................................
11. Buildings ....................................................................................................
12 Furniture and equipment ..............................................................................
13. _______________________________________________ .........................
14.
Less: Accumulated depreciation ..........................................................
15. Net Total Fixed Assets (Add 10 through 14) .................................................
OTHER ASSETS
16. _______________________________________________ .........................
17. _______________________________________________ .........................
18.
Total Assets (Add 9, 15, 16 and 17) ......................................................

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Month Day Year
Current Year

Month Day Year
Prior Year

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LIABILITIES AND EQUITIES
CURRENT LIABILITIES
19. Accounts payable ........................................................................................ ______________________________________
20. Notes payable ............................................................................................. ______________________________________
21. Current portion of USDA note ..................................................................... ______________________________________
22. Customer deposits ....................................................................................... ______________________________________
23. Taxes payable .............................................................................................. ______________________________________
24. Interest payable ........................................................................................... ______________________________________
25. _______________________________________________ ......................... ______________________________________
26. _______________________________________________ ......................... ______________________________________
27.
Total Current Liabilities (Add 19 through 26) ....................................... ______________________________________
LONG-TERM LIABILITIES
28. Notes payable USDA .................................................................................. ______________________________________
29. _______________________________________________ ......................... ______________________________________
30. _______________________________________________ ......................... ______________________________________
31.
Total Long-Term Liabilities (Add 28 through 30) ................................. ______________________________________
32.
Total Liabilities (Add 27 and 31) .......................................................... ______________________________________
EQUITY
33. Retained earnings ........................................................................................ ______________________________________
34. Memberships .............................................................................................. ______________________________________
35.
Total Equity (Add lines 33 and 34) ....................................................... ______________________________________
36.
Total Liabilities and Equity (Add lines 32 and 35) ................................ ______________________________________
Date
Appropriate Official (Signature)
CERTIFIED CORRECT
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB
control number for this information collection is 0570-0015. The time required to complete this information is estimated to average 1 hour per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

RD 442-3 (Rev. 3-97)

INSTRUCTIONS
Present Borrowers
This form may be used as a year end Balance Sheet by Rural
Development Community Program and Farm Service Agency
Group Farm Loan Program borrowers who do not have an
independent audit. Submit two copies within 60 days following
year’s end to the Agency Official. An independently audited
balance sheet will substitute for this form.

sewage system which is a part of a water-sewage system or
municipality, (b) application to finance a nursing home which is
part of a larger health care facility.
Preparation of this Form
1.

Enter data where appropriate for the current and prior year.

2.

Line 35, Total Equity, of this form will be the same as line 26,
on Form RD 442-2, “Statement of Budget, Income and
Equity”, when using the form.

3.

The term Equity is used interchangeably with Net Worth,
Fund Balance, etc.

Applicants
In preparing this form when the application for financing is for a
facility which is a unit of your overall operation, two balance
sheets are to be submitted: one for the facility being financed and
one for the entire operation. Examples: (a) application to finance a

BALANCE SHEET ITEMS
Current Assets
Current Liabilities
1.

2.

3.

4.

5.

6.

Cash on hand and in Banks
Includes undeposited cash and demand deposits.
Time Deposits and Short Term Investments
Funds in savings accounts and certificates of deposit maturing
within one year.
Accounts Receivable
Amounts billed but not paid by customers, users, etc. This is the
gross amount before any allowances in item 4.
Allowance for Doubtful Accounts
Amounts included in item 3 which are estimated to be
uncollectible.

19. Accounts Payable
Amounts due to creditors for goods delivered or services
completed.
20. Notes Payable
Amounts due to banks and other creditors for which a
promissory note has been signed.
21. Current Portion USDA Note
Amount due USDA for principal payment during the next 12
months. Includes any payments which are in arrears.
22. Customer Deposits
Funds of various kinds held for others.

Inventories
The total of all materials, supplies and finished goods on hand.
Prepayments
Payments made in advance of receipt of goods or utilization of
services. Examples: rent, insurance.

23. Taxes Payable
24. Interest Payable USDA
Interest applicable to principal amount in line 21.
25 - 26. List other payables and accruals not shown above.

7 - 8.

List other current assets not included above.
Long Term Liabilities

Fixed Assets
10 - 12. List land, buildings, furniture and equipment separately by
gross value.
13.

List other fixed assets.

14. Accumulated Depreciation
Indicate total accumulated depreciation for items 10-13.
Other Assets
16 - 17. List other assets not previously accounted for.

28. Notes Payable USDA
List total principal payments to USDA which mature after one
year and are not included in line 21.
29 - 30. List all other long term liabilities such as bonds, bank loans, etc.
which are due after one year.
Equity
33. Retained Earnings
Net income which has been accumulated from the beginning of
the operation and not distributed to members, users, etc.
34. Memberships
The total of funds collected from persons of membership type
facilities, i.e., water and sewer systems.

RD 442-3

Page 2 of 2

FORMS MANUAL INSERT

FORM RD 442-3
Used by
Rural Development
Community Program
and Farm Service
Agency Group Farm
Loan Program
applicants and
borrowers.

(see reverse)

PROCEDURE FOR PREPARATION

: RD Instructions 1942-A, 1951-E and 1955-A.

PREPARED BY

: Applicant/Borrower.

NUMBER OF COPIES

: Applicant - Original and one copy.
Borrower - Original and three copies.

SIGNATURES REQUIRED

: Appropriate Applicant/Borrower Official.

DISTRIBUTION OF COPIES

: Applicant - Original to County case docket; copy retained by
Applicant. Borrower - Original and two copies to County; copy
retained by Borrower; original to case docket, two copies to State
Office (for Community Program delinquent Borrowers, State Office
will sent copy to National Office).