RD 3560-7A On-Farm Labor Housing Project Budget

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FORM APPROVED
OMB NO. 0575-0189
Exp. Date: MM/DD/YY

UNITED STATES DEPARTMENT OF AGRICULTURE

FORM RD 3560-7A

RURAL HOUSING SERVICE

(02-05)

ON-FARM LABOR HOUSING PROJECT BUDGET
1. BORROWER NAME:

2. CASE NO.

3. PROJECT 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: $
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)

ACTUAL

)

(
$
$

$
$

$

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.

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

$

$

(Specify)

26. BORROWER:
28. AGENCY APPROVAL:

(Signature)
(Signature of Servicing Official)

)

27. DATE:
29. DATE:

30. TITLE:
A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the
requirements of the Paperwork Reduction Act unless that collection of information displays a currently valid OMB Control Number. The OMB Control Number for this information collection is 0575-0189.
Public reporting for this collection of information is estimated to be approximately 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering, and maintaining
the data needed, completing, and reviewing the collection of information. All responses to this collection of information are voluntary. However, in order to obtain or retain a benefit, the information in this form
is required under Section515 Rural Rental Housing, which includes Congregate Housing, Group Homes, and Rural Cooperative Housing. Rural Development has no plans to publish information collected under
the provisions of this program. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection
Clearance Officer, Rural Development Innovation Center, Regulations Management Division at ICRMTRequests@usda.gov

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