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10-00. 0575-0015 Name of Borrower Items Amount of Funds Development. Contract or Job No* Land and Rights-of-Way. Legal Services. Engineering Fees. Interest. Equipment. Contingencies. Refinancing. Initial O M. Other. TOTAL. Prepared by By Date Approved by According to the Paperwork Reduction Act of 1995 an agency may not conduct or sponsor and a person in not required to respond to a collection of information unless it displays a valid OMB control number. 0575-0015 Name of Borrower Items Amount ...

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