Form RD 4274-1, Application for Loan (Intermediary Relending Program), is the application an intermediary submits to USDA Rural Development (RD) so the agency can analyze the request and make a loan determination. The form is printed under the Rural Business-Cooperative Service (RBS), and the intermediary is the applicant. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the form itself and its guidance, RD Instruction 4274-D, come from USDA Rural Development.
Last updated
What is RD 4274-1?
Form RD 4274-1, Application for Loan (Intermediary Relending Program), is the USDA Rural Development form in which an intermediary supplies the information needed for the analysis and loan determination process for a loan under the Intermediary Relending Program.
The form states its own purpose: the "Application for Loan" provides the information needed for the analysis and loan determination process, and complete guidance is in RD Instruction 4274-D. It is issued under the Rural Business-Cooperative Service (RBS) of the United States Department of Agriculture and carries OMB No. 0570-0021, with the revision printed as Rev. 7-99 and an expiration date of 11/30/2022.
The applicant on this form is the intermediary, not an individual borrower, so it differs from a general loan application. It has 15 numbered items:
- Identity: name, address, amount of loan required, tax identification number, date established and citizenship (items 1 to 4).
- Background: history of the intermediary, litigation, professionals engaged and their compensation, subsidiaries and affiliates (items 5 to 8).
- Disclosures: dealings with businesses in which an officer, director or member has an interest, receivership or bankruptcy, and RBS employees with an interest in the intermediary (items 9 to 11).
- Operations: management and compensation, regulatory agencies, delinquency on federal debt and the service area of the proposed revolving loan program (items 12 to 15).
A signature block for the intermediary, with a corporate seal and attestation line, and a contact person follow item 15. The form carries a warning under Section 1001 of Title 18, United States Code, about false statements.
Who needs to file RD 4274-1?
The intermediary that is applying for a loan under the Intermediary Relending Program completes Form RD 4274-1. The form's instructions are addressed to the "Intermediary (applicant)" and tell it to complete items 1 through 15.
Several items depend on the type and makeup of the applicant:
- If the intermediary is not a public body, item 4 asks what percent of its members or ownership are U.S. citizens or reside in the United States after being legally admitted for permanent residence.
- Item 12, on management and compensation, excludes elected officials on applications for loans from public bodies.
- Item 11 covers RBS employees who have a financial interest in or association with the intermediary or any of its officers, directors or members. When a member, officer or director, or their spouse, is an employee of the U.S. Government, including members of the armed forces, detailed information must be submitted with the application.
- Items 6, 10 and 14 reach beyond the entity itself, covering its members, directors and officers, and, for items 10 and 14, affiliates and others involved in operation and management.
The form does not describe who may sign for the intermediary beyond the "By" and "Title" lines, the corporate seal and the attestation line.
When to file RD 4274-1
Form RD 4274-1 is the application itself, so you submit it when the intermediary asks USDA Rural Development for a loan under the Intermediary Relending Program. No due date, filing window or renewal cycle is printed on it.
Plan the preparation time. The form estimates that completing the information collection takes an average of 56 hours per response, including time to review instructions, search existing data sources, gather and maintain the data and review the collection of information. Much of the content, such as the history of the intermediary, the list of professionals and fees, management compensation and regulatory matters, has to be gathered before the form can be finished.
For timing questions that the form does not answer, the form points to RD Instruction 4274-D for complete guidance and to the RBS National Office for additional information.
Documents you need
- All supporting documents for the application, submitted together with the original of Form RD 4274-1; RD Instruction 4274-D gives the complete guidance on what the application needs.
- An attachment with additional space, when an answer on the form needs more room than the form provides.
- A written explanation attached to the form when the answer to item 14 (delinquency on any federal debt) is "Yes."
- Detailed information submitted with the application when a member, officer or director of the intermediary, or their spouse, is an employee of the U.S. Government, including members of the armed forces (item 11).
How to fill out RD 4274-1
Enter the intermediary's name and address
Item 1: write the official name without abbreviations unless the abbreviation is part of the official name. Add the street, city, county, state, ZIP Code, telephone number and the amount of loan required.
Enter tax ID and date established
Item 2: the applicant's tax identification number. Item 3: the date the intermediary was established.
Answer the citizenship question
Item 4: if the intermediary is not a public body, enter the percent of its members or ownership who are U.S. citizens or reside in the United States after being legally admitted for permanent residence.
Describe the history of the intermediary
Item 5: give a brief description and history of the applicant, including recent experience in making and servicing commercial loans.
List litigation
Item 6: list details of any pending or final disciplinary or legal (civil or criminal) action against the intermediary, its members and its directors.
List professionals and their compensation
Item 7: list every attorney, accountant, appraiser, packager, agent and other party engaged in connection with the application, with name and address (include ZIP Code), description and justification of the service, total compensation agreed to be paid and compensation already paid. Use specific dollar amounts or hourly rates.
Identify subsidiaries and affiliates
Item 8: list the name and address of every subsidiary, parent organization or affiliate, and comment briefly on its relationship to the intermediary.
Answer items 9 and 10
Item 9: check Yes or No on dealings with a business in which an officer, director or member has a substantial interest, and explain if Yes. Item 10: check Yes or No on receivership or bankruptcy, and give names, dates and details if Yes.
Disclose RBS employee interests
Item 11: list the name and address of any RBS employee with a present or past financial interest in or association with the intermediary or its officers, directors or members, with the details of the relationship or interest.
Enter management and compensation
Item 12: for each board member, key officer, key hired manager and director, enter the name in column (a), position or title in column (b) and annual compensation in column (c). Elected officials on applications for loans from public bodies are excluded.
List regulatory agencies
Item 13: list every national, state or local agency that supervises or regulates the applicant, explain any pending matters, and indicate which permits, licenses or clearances are necessary and their status.
Answer items 14 and 15
Item 14: check Yes or No on delinquency on any federal debt, and attach an explanation if Yes. Item 15: state the service area for the proposed Intermediary Relending Program revolving loan program.
Complete the signature block
Enter the Intermediary Name, the signer's name after By, the Title, the corporate seal and attestation where applicable, and the Date Signed. Add the intermediary contact person's name, title, address and telephone.
Review and download the completed PDF
Check every item against your records, confirm that attachments for additional space and for items 11 and 14 are ready, then download or print the completed PDF from FillingPDF. Submit the original with all supporting documents as described under How to submit.
How to submit RD 4274-1
Form RD 4274-1 is submitted as an original, together with all supporting documents, to USDA Rural Development.
- To USDA Rural Development: the instructions on the form say to submit the original of the application and all supporting documents to the USDA, Rural Development. The form prints no mailing address, portal or appointment rule.
- For more information: the form says additional information may be obtained from the RBS National Office, and that complete guidance is in RD Instruction 4274-D.
Before sending, check the package. Items 1 through 15 should be complete. If more space is needed for any answer, provide it by an attachment. An explanation must be attached when item 14 is answered "Yes." Detailed information must be included when a member, officer or director, or their spouse, is a U.S. Government employee (item 11). The signature block, with the intermediary name, title, date signed and contact person, should be filled in.
FillingPDF lets you fill out and download the PDF; submission follows the USDA Rural Development channels described above.
Common mistakes to avoid
- Leaving items blank: the instructions tell the intermediary to complete items 1 through 15.
- Abbreviating the name in item 1 when the abbreviation is not part of the official name; the form asks for the official name without abbreviations.
- Writing "Unknown," "Undetermined" or similar terms in the compensation columns of item 7; the form requires specific dollar amounts or hourly rates.
- Answering "Yes" to item 9 or item 10 without giving the names, dates, details or the nature of the transactions the item asks for.
- Answering "Yes" to item 14 on federal debt delinquency without attaching an explanation.
- Omitting detailed information when a member, officer or director, or their spouse, is a U.S. Government employee, including armed forces members (item 11).
- Submitting a copy instead of the original of the application and the supporting documents.
- Entering false, concealed or misleading facts; the Section 1001 warning on the form provides for a fine or imprisonment of up to five years, or both, and misrepresentation may also be a basis for denial of credit by the RBS.
Frequently asked questions
What is Form RD 4274-1?
Form RD 4274-1, Application for Loan (Intermediary Relending Program), is the USDA Rural Development form that supplies the information needed for the analysis and loan determination process. The intermediary applying for the loan completes it, answering items 1 through 15.
Who completes the Application for Loan (Intermediary Relending Program)?
The intermediary, which the form calls the applicant. The instructions on the form are addressed to the intermediary and tell it to complete items 1 through 15. It is not a form for an individual borrower and is separate from any general loan application.
Where do I send Form RD 4274-1?
The form says to submit the original application and all supporting documents to the USDA, Rural Development. It prints no street address or portal, so use RD Instruction 4274-D or contact the RBS National Office, which the form names for additional information.
Can I fill out Form RD 4274-1 online?
You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is an independent service and does not file the application: you submit the completed original to USDA Rural Development through its channels.
What do I write for compensation in item 7?
Enter specific dollar amounts or hourly rates for the compensation agreed to be paid and the compensation already paid. The form states that "Unknown," "Undetermined" or other imprecise terms are not sufficient. Include a complete justification for each service.
Do I need to attach anything to Form RD 4274-1?
Yes, the form says to submit all supporting documents with the original. Also attach extra pages if you need more space, an explanation if you answer "Yes" to item 14, and detailed information if a member, officer or director, or their spouse, is a U.S. Government employee.
How long does it take to complete Form RD 4274-1?
The form estimates an average of 56 hours per response. That figure covers reviewing instructions, searching existing data sources, gathering and maintaining the data and completing and reviewing the information collection.
What happens if I give false information on the application?
The warning printed on the form cites Section 1001 of Title 18, United States Code: knowingly falsifying or concealing a material fact can bring a fine or imprisonment of up to five years, or both. Misrepresentation may also be a basis for denial of credit by the RBS.
Ready to fill out RD 4274-1?
Fill out RD 4274-1 now