RUS Form 216 "Construction Change Order"

What Is RUS Form 216?

This is a legal form that was released by the U.S. Department of Agriculture - Rural Utilities Service on July 1, 1967 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 1967;
  • The latest available edition released by the U.S. Department of Agriculture - Rural Utilities Service;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of RUS Form 216 by clicking the link below or browse more documents and templates provided by the U.S. Department of Agriculture - Rural Utilities Service.

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Download RUS Form 216 "Construction Change Order"

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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.
DATE
DEPARTMENT OF AGRICULTURE
RURAL UTILITIES SERVICE
CONSTRUCTION CHANGE ORDER
PROJECT
LINE
SHEET NO.
ORDER NO.
POLES NO.
REFER TO ITEM NO.
CHANGE
REASON FOR CHANGE
CHANGE AUTHORIZED BY:
SYSTEM MANAGER
BORROWER'S ENGINEER
ITEMIZED COST OF ABOVE ORDER
CONTRACTOR
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.
DATE
DEPARTMENT OF AGRICULTURE
RURAL UTILITIES SERVICE
CONSTRUCTION CHANGE ORDER
PROJECT
LINE
SHEET NO.
ORDER NO.
POLES NO.
REFER TO ITEM NO.
CHANGE
REASON FOR CHANGE
CHANGE AUTHORIZED BY:
SYSTEM MANAGER
BORROWER'S ENGINEER
ITEMIZED COST OF ABOVE ORDER
CONTRACTOR
RUS Form 216 (Rev. 7-67)