Get USDA RD 3560-12 2005-2024

U.S. USDA Form usda-rd-3560-12 Form RD 3560-12 02-05 FORM APPROVED OMB NO. 0575-0189 REQUEST FOR AUTHORIZATION TO WITHDRAW RESERVE FUNDS PART I BORROWER PROJECT AMOUNT REQUESTED DATE REQUESTED // CURRENT RESERVE BALANCE AS OF // PURPOSE AND DESCRIPTION Attach invoices or scope of work and cost estimates for items in excess of Capital Replacement/Improvement Operating Maintenance Expense Recurring IS THIS REQUEST PART OF AN APPROVED CAPITAL IMPROVEMENT PLAN YES NO WILL A COMPANY WITH AN IDENTITY OF INTEREST WITH THE MANAGEMENT AGENT OR OWNER PERFORM ANY OF THE WORK YES If Yes please identify the company. CHECK WITHDRAWAL SLIP IS ENCLOSED WITH THIS REQUEST. WILL BE SENT UPON COMPLETION* If the amount of reserve funds used is more or less than the amount approved by Rural Development we will advise the Rural Development Servicing Official so the reserve account can be adjusted accordingly. Signed Name and Title --------------------------------------------------------------------------------------------------------------------------------------- PART II AMOUNT APPROVED DISAPPROVED See attachment for appeal rights and reasons for denial* INSPECTION REQUIRED Advise Rural Development when work is complete. Approval Official DATE 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 0575-0189. The time required to complete this information collection is estimated to average 30 minutes 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*. CHECK WITHDRAWAL SLIP IS ENCLOSED WITH THIS REQUEST. WILL BE SENT UPON COMPLETION* If the amount of reserve funds used is more or less than the amount approved by Rural Development we will advise the Rural Development Servicing Official so the reserve account can be adjusted accordingly. Signed Name and Title --------------------------------------------------------------------------------------------------------------------------------------- PART II AMOUNT APPROVED DISAPPROVED See attachment for appeal rights and reasons for denial* INSPECTION REQUIRED Advise Rural Development when work is complete. Signed Name and Title --------------------------------------------------------------------------------------------------------------------------------------- PART II AMOUNT APPROVED DISAPPROVED See attachment for appeal rights and reasons for denial* INSPECTION REQUIRED Advise Rural Development when work is complete. Approval Official DATE 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. Approval Official DATE 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 0575-0189. The time required to complete this information collection is estimated to average 30 minutes 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*. .