RUS Form 87 Request for Mail List Data

RUS Form 87 or the "Request For Mail List Data" is a form issued by the U.S. Department of Agriculture - Rural Utilities Service.

Download a PDF version of the RUS Form 87 down below or find it on the U.S. Department of Agriculture - Rural Utilities Service Forms website.

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Expiration Date
08/31/14
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 0572-0051. The time required to complete this information collection is
estimated to average 15 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
United States Department of Agriculture
BORROWER DESIGNATION
Rural Utilities Service
TAX IDENTIFICATION NUMBER
REQUEST FOR MAIL LIST DATA
PRIMARY E-MAIL ADDRESS
LEGAL NAME
CORRESPONDENCE ADDRESS
WEBSITE URL
STREET
1
2
REGULAR BOARD MEETING HELD ON
3
CITY
STATE
ZIP
PHYSICAL ADDRESS
DATE SET FOR NEXT ANNUAL MEETING (mm-dd-yy)
STREET
1
2
PHONE NO.
FAX NO.
3
CITY
STATE
ZIP
CORPORATE OFFICIALS
MAILING ADDRESS
NAME
(include P.O. Box, Street Address or
(Salutation, First, Middle, and Last)
Rural Route, City, State, and Zip Code)
MANAGER OR CEO
STREET
1
2
3
TITLE
STATE
ZIP
CITY
PRESIDENT
1
STREET
2
3
TITLE
STATE
ZIP
CITY
VICE PRESIDENT
1
STREET
2
3
TITLE
STATE
ZIP
CITY
1
SECRETARY
STREET
2
3
TITLE
CITY
STATE
ZIP
TREASURER
STREET
1
2
3
TITLE
CITY
STATE
ZIP
1
STREET
2
TITLE
3
STATE
ZIP
CITY
1
STREET
2
3
TITLE
STATE
ZIP
CITY
1
STREET
2
TITLE
3
STATE
ZIP
CITY
1
STREET
2
3
TITLE
STATE
ZIP
CITY
STREET
1
2
3
TITLE
STATE
ZIP
CITY
RUS Form 87 (Rev. 5-2005)
Expiration Date
08/31/14
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 0572-0051. The time required to complete this information collection is
estimated to average 15 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
United States Department of Agriculture
BORROWER DESIGNATION
Rural Utilities Service
TAX IDENTIFICATION NUMBER
REQUEST FOR MAIL LIST DATA
PRIMARY E-MAIL ADDRESS
LEGAL NAME
CORRESPONDENCE ADDRESS
WEBSITE URL
STREET
1
2
REGULAR BOARD MEETING HELD ON
3
CITY
STATE
ZIP
PHYSICAL ADDRESS
DATE SET FOR NEXT ANNUAL MEETING (mm-dd-yy)
STREET
1
2
PHONE NO.
FAX NO.
3
CITY
STATE
ZIP
CORPORATE OFFICIALS
MAILING ADDRESS
NAME
(include P.O. Box, Street Address or
(Salutation, First, Middle, and Last)
Rural Route, City, State, and Zip Code)
MANAGER OR CEO
STREET
1
2
3
TITLE
STATE
ZIP
CITY
PRESIDENT
1
STREET
2
3
TITLE
STATE
ZIP
CITY
VICE PRESIDENT
1
STREET
2
3
TITLE
STATE
ZIP
CITY
1
SECRETARY
STREET
2
3
TITLE
CITY
STATE
ZIP
TREASURER
STREET
1
2
3
TITLE
CITY
STATE
ZIP
1
STREET
2
TITLE
3
STATE
ZIP
CITY
1
STREET
2
3
TITLE
STATE
ZIP
CITY
1
STREET
2
TITLE
3
STATE
ZIP
CITY
1
STREET
2
3
TITLE
STATE
ZIP
CITY
STREET
1
2
3
TITLE
STATE
ZIP
CITY
RUS Form 87 (Rev. 5-2005)
CORPORATE OFFICIALS (Continue)
MAILING ADDRESS
NAME
(include P.O. Box, Street Address or
(Salutation, First, Middle, and Last)
Rural Route, City, State, and Zip Code)
1
STREET
2
TITLE
3
STATE
ZIP
CITY
1
STREET
2
3
TITLE
STATE
ZIP
CITY
1
STREET
2
3
TITLE
STATE
ZIP
CITY
1
STREET
2
3
TITLE
STATE
ZIP
CITY
RELATED ORGANIZATIONS
MAILING ADDRESS
NAME OF ORGANIZATION
(include P.O. Box, Street Address or
Rural Route, City, State, and Zip Code)
ATTORNEY
STREET
1
2
3
CITY
STATE
ZIP
PHONE
C.P.A.
STREET
1
2
3
CITY
STATE
ZIP
PHONE
STREET
1
CONSULTING ENGINEER
2
3
CITY
STATE
ZIP
PHONE
TITLE
DATE PREPARED (mm-dd-yy)
SIGNATURE
RUS Form 87 ( Rev. 5-2005 )

Download RUS Form 87 Request for Mail List Data

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