Single Family Application for Insurance Benefits

Forms and Documents

Document Name	Status
Form HUD 91022 Single Family Application for Insurance Benefits Form and Instruction	Modified
2502-0249 30 Day FR.pdf Supplementary Document	2020-09-29
2502-0429 Supporting Statement-A Final.docx Supporting Statement A	2020-09-08
3Redline HUD-27011.pdf Supplementary Document	2020-08-14
24cfr203.350.pdf Supplementary Document	2020-05-28
24cfr203.355.pdf Supplementary Document	2020-05-28

IC Document Collections

IC ID	Document Title	Status
42065	Single Family Application for Insurance Benefits Form and Instruction	Modified

ICR Details

OMB Control No: 2502-0429	ICR Reference No: 202005-2502-005
Status: Received in OIRA	Previous ICR Reference No: 201704-2502-006
Agency/Subagency: HUD/OH	Agency Tracking No:
Title: Single Family Application for Insurance Benefits
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 09/29/2020

	Requested	Previously Approved
Expiration Date	36 Months From Approved	01/31/2021
Responses	1,125,455	1,198,171
Time Burden (Hours)	933,416	1,086,583
Cost Burden (Dollars)	0	0

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Abstract: This information collection is used to provide HUD the information needed to process and pay claims on defaulted FHA-insured home mortgage loans.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 13671	03/09/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 54588	09/02/2020
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Single Family Application for Insurance Benefits	HUD 91022, HUD 50012, HUD 09539, HUD 50002, HUD-9519a, HUD-27011	Mortgagee Notice of Foreclosure ,   Mortgagee's Request fo Extension of Time Requirments ,   Request for Occupied Conveyance ,   Request to Exceed Cost Limits for Preservaiton and Protection ,   Property Inspection Report ,   Single Family Application for Insurance Benefits

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ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	1,125,455	1,198,171	0	0	-72,716	0
Annual Time Burden (Hours)	933,416	1,086,583	0	0	-153,167	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The collection of information has been updated with new figures to represent the Department’s current claims activity. As a result of this activity, increase in the number of respondents occurred, decrease in the number of responses and annual burden hours occurred, particularly since most claims are filed electronically. The Privacy statement had to be updated on the Single Family Application form.

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Annual Cost to Federal Government: $271,669

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 09/29/2020

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