Rd 3550 21 Form PDF Details

Are you an owner, employee or contractor of a business that is interested in obtaining the Rd 3550 21 form? If so, this blog post has all the information you need. The Rd 3550 21 form is an important document required by certain companies and organizations; it provides proof of employment eligibility as well as authorization to work within Canada. In this guide, we’ll cover what exactly the Rd 3550 21 Form means, who requires it and how to get one for your organization. With our help, understanding and utilizing the necessary document will be more straightforward than ever before!

QuestionAnswer
Form NameRd 3550 21 Form
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesusda form 3550 21, subsidy from certification, usda 3551 21 fillable form, subsidy renewal

Form Preview Example

Rural Housing Service, Centralized Servicing Center

P.O. Box 66835

St. Louis, MO 63166

Dear Homeowner:

 

 

It is time to review your eligibility for payment subsidy on your Rural Housing Service loan. Your current subsidy agreement will

 

expire on

. It is important that you return the information requested in this letter no later than

to

continue subsidy or your payments will increase to the full note rate. If the information is received after this date, a new subsidy agreement will not be backdated and you will be responsible for the full payment until a new agreement is processed.

The amount of subsidy you will receive depends upon your income, number of persons in your household, and in some instances, expenses. The information requested in this letter is required for us to calculate assistance for which you may qualify.

PLEASE SEND ALL OF THE FOLLOWING DOCUMENTS IN THE ENCLOSED PRE- ADDRESSED ENVELOPE TO:

USDA, Rural Development

Centralized Servicing Center

P.O. Box 66835

St. Louis, MO 63166

1. Income Certification. Please complete the attached Payment Subsidy Renewal Certification. This form summarizes information about your household income and expenses. You can use it as a checklist to determine which of the attachments below are needed. This form must be signed by all borrowers and returned, with all the documents you are mailing to us.

2. For all adult household members listed on the Certification, attach the following:

..

A signed copy of Form RD 3550-1, ''Authorization to Release Information;"

.

Copies of the last two consecutive pay stubs for each employed adult; and

.

Copies of the latest Federal Income Tax returns.

.

For Seasonal Workers, send IRS Form 1040 and W-2 Forms.

 

For Self-Employed Workers, send Schedule C or F with the Form 1040.

3.For any member of your household that receives income from non-employment sources, use Lines 8 and 9 of the Certification to report the income and attach a copy of your latest award or benefit letter or other proof of how much

the household. member received from that source. Income may be from some of the following

sources: . Benefit Statement/Award Letters on Social Security, Supplemental Social Security, Pensions, VA

. Documentation of Worker's Compensation, Unemployment Benefits

. Documentation of Alimony, Child Support, AFDC Gifts, Public Assistance

4.If you wish to claim expenses for Child Care, Medical, or care of a family member with disabilities that allows another household member to work, follow the instructions in Lines 10, 11, and 12 of the Certification.

PLEASE NOTE: Only Payment Assistance Renewal information is to be returned in the enclosed envelope. All payment must be mailed in the envelope provided with your billing statement. Mailing payments and other correspondence not related to your Payment Assistance Renewal to the address above will significantly delay processing of your subsidy agreement and slow response to your inquiries.

You must return this form ( not a copy) by mail. Do not FAX!

FOR ASSISTANCE, CALL 1-800-414-1226

THE RURAL HOUSING SERVICE RESERVES THE RIGHT TO REQUEST FURTHER DOCUMENTATION BEFORE APPROVING ANY PAYMENT SUBSIDY RENEWAL.

Form RD 3550-21

RURAL HOUSING SERVICE

(Rev. 03-06)

PAYMENT SUBSIDY RENEWAL CERTIFICATION

 

 

 

NAME:

 

 

 

DATE:

 

 

 

 

 

 

 

ADDRESS:

 

 

ACCOUNT NO:

 

 

 

 

 

 

 

 

 

FORM APPROVED OMB NO. 0575-0172

Please provide the following information in ink. IF ANY REQUESTED INFORMATION IS NOT PROVIDED,

YOUR PAYMENT SUBSIDY REQUEST CANNOT BE PROCESSED!

The information I (we) have provided is complete and true to the best of my (our) knowledge. I (we) understand that the information below is being collected to determine if I am (we are) eligible to receive payment subsidies and that failure to provide complete and accurate information can result in criminal and civil penalties.

Borrower Signature

Date

Borrower Signature

Date

 

 

 

 

Home Phone No:

 

 

Alternate Phone or Work No:

 

YOU MUST RETURN THIS FORM (NOT A COPY) BY MAIL. DO NOT FAX!

1.ALL ADULT HOUSEHOLD MEMBERS MUST SIGN AN ''AUTHORIZATION TO RELEASE INFORMATION'' FORM 3550-1

2.PLEASE FILL OUT THE FOLLOWING SECTION COMPLETELY:

HOUSEHOLD MEMBER'S

RELATIONSHIP

AGE

SOCIAL SECURITY

 

 

 

 

 

 

 

 

FULL TIME

 

DISABLED

FULL NAME - BEGIN WITH

TO THE HEAD

 

NUMBER

EMPLOYED

STUDENT

 

YOURSELF

 

 

 

 

YES or NO

YES or NO

 

 

YES or NO

 

SELF

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3. Yes

No

Did anyone living in your household file Federal Income Tax last year?

YOU MUST INCLUDE A COPY OF LAST YEAR'S IRS FORM(S) 1040, 1040EZ, 1040A, OR TELEFILE TAX RECORDS FOR ALL ADULT HOUSEHOLD MEMBERS WHO FILED. DO NOT SEND FORM 8453!!!

4. Yes

No

Is anyone living in your household self-employed?

IF YES --YOU MUST INCLUDE A COPY OF LAST YEAR'S FEDERAL INCOME TAX SCHEDULE FOR C OR F.

5. $

 

Amount of Real Estate Taxes due each year.

I am exempt from paying.

6. $

 

Amount of Property Insurance paid each year.

I do not have insurance.

 

7.ATTACH THE TWO (2) MOST RECENT AND CONSECUTIVE PAY STUBS FOR ALL JOBS IN YOUR HOUSEHOLD AND COMPLETE THE FOLLOWING FOR EACH JOB:

HOUSEHOLD MEMBER'S

FULL NAME

AMOUNT OF

YEARLY INCOME

EMPLOYER NAME AND ADDRESS

EMPLOYER PHONE NO.

*** COMPLETE 2ND PAGE OF THIS FORM ***

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 0575-0172. 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.

No Does anyone living in your household receive income from:
(IF YES --- ATTACH A COPY OF THE CURRENT BENEFIT STATEMENT OR AWARD LETTER)
SOCIAL SECURITY (SS or SSI)
RETIREMENT (PENSION)
UNEMPLOYMENT
OTHER: PLEASE SPECIFY

8. Yes

9. Yes

No

Does anyone living in your household receive child support or alimony?

IF YES -- ATTACH

A. THE CLERK OF COURT'S STATEMENT THAT STATES HOW MUCH YOU RECEIVED IN THE LAST TWELVE MONTHS (If collected by the courts), OR

B. THE COURT ORDER THAT SHOWS THE AMOUNT YOU SHOULD RECEIVE, OR C. IF NOT COURT ORDERED, A STATEMENT OF THE AMOUNT PAID SIGNED BY THE

PERSON WHO PAYS YOU.

PLEASE FILL OUT THE FOLLOWING SECTION FOR INCOME RECEIVED FROM LINES 8 AND 9.

PERSON RECEIVING INCOME or BENEFITS

RECEIVED FROM INDIVIDUAL OR AGENCY NAME

AMOUNT RECEIVED

EACH MONTH

NOTE: ATTACH SEPARATE SHEETS, IF NEEDED.

DO NOT SEND RECEIPTS, BILLS, OR OTHER STATEMENTS OF EXPENSES PAID FOR LINES 10, 11, AND 12.

10.CHILD CARE EXPENSES: Complete only if child care is not reimbursed and is needed for children under 13 years of age that allows a household member to work or go to school. Separate expenses for work and school.

NAME OF CHILD

CARE PROVIDER'S OR EDUCATIONAL INSTITUTION'S NAME, ADDRESS AND HOURS OF CARE PER WEEK

PHONE NO.

COST

PER

WEEK

HOUSEHOLD

MEMBERS NAME

ENABLED TO WORK OR GO TO SCHOOL

Hours:

Hours:

11.MEDICAL EXPENSES: Complete only if the borrower or co-borrower is 62 years of age or older, or if the borrower or co-borrower is disabled. Include expenses actually paid by you (not by insurance). If you have any bills with a payment agreement, include ONLY the amount to be paid in the next twelve months.

TYPE OF MEDICAL EXPENSES

TOTAL AMOUNT OF EXPENSE EACH YEAR

DOCTOR

HOSPITAL

MEDICAL INSURANCE

DRUGS or PHARMACEUTICALS

OTHER: Specify

12.DISABILITY ASSISTANCE EXPENSES: Complete only if you have expenses for the care of a household member with disabilities that are not reimbursed by another source and is needed to allow a family member to work.

HOUSEHOLD MEMBER'S NAME

WITH DISABILITIES

CARE PROVIDER'S NAME AND

ADDRESS

PHONE NO.

COST PER

WEEK

HOUSEHOLD

MEMBER'S NAME

ENABLED TO WORK

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1. While completing the usda 3551 21 fillable form, make certain to include all important blanks within the corresponding section. It will help to hasten the process, allowing your information to be handled fast and appropriately.

subsidy renewal completion process detailed (step 1)

2. Immediately after this section is done, go to type in the relevant information in these - NAME, ADDRESS, PAYMENT SUBSIDY RENEWAL, DATE, ACCOUNT NO, Please provide the following, YOUR PAYMENT SUBSIDY REQUEST, The information I we have provided, Borrower Signature, Home Phone No, Date, Borrower Signature, Date, Alternate Phone or Work No, and YOU MUST RETURN THIS FORM NOT A.

Filling in part 2 in subsidy renewal

3. Within this part, check out Yes, Did anyone living in your, YOU MUST INCLUDE A COPY OF LAST, Yes, Is anyone living in your household, IF YES YOU MUST INCLUDE A COPY OF, Amount of Real Estate Taxes due, Amount of Property Insurance paid, I am exempt from paying, I do not have insurance, ATTACH THE TWO MOST RECENT AND, COMPLETE THE FOLLOWING FOR EACH, AMOUNT OF, FULL NAME, and YEARLY INCOME. Each of these will need to be taken care of with highest precision.

Yes, Did anyone living in your, and Is anyone living in your household inside subsidy renewal

4. All set to fill in the next portion! In this case you'll get all of these Yes, Does anyone living in your, IF YES ATTACH A COPY OF THE, SOCIAL SECURITY SS or SSI, Yes, Does anyone living in your, IF YES ATTACH A THE CLERK OF, TWELVE MONTHS If collected by the, B THE COURT ORDER THAT SHOWS THE, PERSON WHO PAYS YOU, PLEASE FILL OUT THE FOLLOWING, PERSON RECEIVING INCOME or BENEFITS, RECEIVED FROM INDIVIDUAL OR AGENCY, AMOUNT RECEIVED, and EACH MONTH fields to fill in.

A way to fill out subsidy renewal part 4

5. To wrap up your document, this final segment features several extra blanks. Entering NAME OF CHILD, CARE PROVIDERS OR EDUCATIONAL, PHONE NO, COST PER WEEK, ENABLED TO WORK OR GO TO SCHOOL, Hours, Hours, MEDICAL EXPENSES Complete only if, TYPE OF MEDICAL EXPENSES, TOTAL AMOUNT OF EXPENSE EACH YEAR, DOCTOR, HOSPITAL, MEDICAL INSURANCE, DRUGS or PHARMACEUTICALS, and OTHER Specify will finalize everything and you're going to be done quickly!

Hours, TYPE OF MEDICAL EXPENSES, and NAME OF CHILD inside subsidy renewal

People who use this form generally make some mistakes when filling out Hours in this section. You need to read again everything you type in right here.

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