Single Family Application for Insurance Benefits

Forms and Documents

Document Name	Status
Form HUD 50012 Single Family Application for Insurance Benefits Form and Instruction	Modified
30 Day FR 2502-0429.pdf Supplementary Document	2014-02-24
24 CFR 203.pdf Supplementary Document	2014-02-21
Supporting Statement A -1.docx Supporting Statement A	2014-02-21

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: 201310-2502-012
Status: Historical Active	Previous ICR Reference No: 201104-2502-009
Agency/Subagency: HUD/OH	Agency Tracking No:
Title: Single Family Application for Insurance Benefits
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/26/2014
	Date Received in OIRA: 02/24/2014
Terms of Clearance: HUD shall update its estimates to account for changes to the FHA program, affecting the number of respondents.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2017	36 Months From Approved	06/30/2014
Responses	1,087,913	0	1,087,913
Time Burden (Hours)	1,347,549	0	1,347,549
Cost Burden (Dollars)	0	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:
	78 FR 67384	11/12/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 10178	02/24/2014
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 27011, HUD-9519a	Mortgagee's Request fo Extension of Time Requirments ,   Claim for Insurance Benefits ,   Request to Exceed Cost Limits for Preservaiton and Protection ,   Request for Occupied Conveyance ,   Mortgagee Notice of Foreclosure ,   Property Inspection Report

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ICR Summary of Burden

	Total Approved	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	1,087,913	1,087,913	0	0	0	0
Annual Time Burden (Hours)	1,347,549	1,347,549	0	0	0	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:

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Annual Cost to Federal Government: $363,750

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

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

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? Uncollected

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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: 02/24/2014

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