Rd3560-7a

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FORM APPROVED
OMB NO. 0575-0189

UNITED STATES DEPARTMENT OF AGRICULTURE

FORM RD 3560-7A

RURAL HOUSING SERVICE

(02-05)

ON-FARM LABOR HOUSING PROJECT BUDGET

1. BORROWER NAME:

3. PROJECT NO.

2. CASE NO.

4. LABOR HOUSING PROPERTY LOCATION:
6. OCCUPANCY:

SEASONAL

5. NO. UNITS:

YEAR AROUND
YES

8. REFUNDABLE SECURITY DEPOSIT:

NO

7. AGREEMENT FOR OCCUPANCY OR LEASE

YES

9. AMOUNT OF SECURITY DEPOSIT: $
ACTUAL

PROPOSED

INCOME or TENANT CHARGES:

(

10.

Tenant Rent ($

11.

Other Tenant Shelter Cost

12.

ACTUAL CHARGES (Paid by Tenants)

NO

x

unit x 12 months)
(Specify)

)

(

$

$

$

$

$

$

ANNUAL OPERATING AND MAINTENANCE EXPENSES:
13.

Maintenance & Repairs

$

$

14.

Painting

$

$

15.

Electricity

$

$

16.

Water

$

$

17.

Sewer

$

$

18.

Fuel (Oil or Gas or Wood)

$

$

19.

Garbage & Trash Removal

$

$

20.

Real Estate Taxes

$

$

21.

Property & Liability Insurance

$

$

22.

Rural Housing Service Loan Payment

$

$

23.

Other

$

$

24.

TOTAL EXPENSES

$

$

$

$

25.

(Specify)

UNAUTHORIZED RENT REBATE or CREDIT
(TOTAL UNAUTHORIZED RENT CHARGES: $

)
27. DATE:

26. BORROWER:
(Signature)
28. AGENCY APPROVAL:

29. DATE:
(Signature of Servicing Official)

30. TITLE:
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not 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 0575-0189. The time required to complete this information collection 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.

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