DEPARTMENT OF AGRICULTURE
RURAL UTILITIES SERVICE
CONSTRUCTION CHANGE ORDER
REFER TO ITEM NO.
REASON FOR CHANGE
CHANGE AUTHORIZED BY:
ITEMIZED COST OF ABOVE ORDER
RUS Form 216 (Rev. 7-67)
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not 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 0572-0059.. The time required to complete this
information is estimated to average 1 hour 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.