Office of Hospital Facilities Transactional Forms for FHA Programs 242, 241, 223(f), 223(a)(7)

Forms and Documents

Document Name	Status
Form HUD-92330A-OHF Hospital Facilities projects pursuant to FHA Programs 242, 241, 223(f), 223(a)(7) Form	Modified
2502-0602 Laws and Regs.zipx Supplementary Document	2016-05-12
2502-0602 Supporting Statement A (5-26-16)f.docx Supporting Statement A	2016-05-27

IC Document Collections

IC ID	Document Title	Status
199247	Hospital Facilities projects pursuant to FHA Programs 242, 241, 223(f), 223(a)(7) Form	Modified

ICR Details

OMB Control No: 2502-0602	ICR Reference No: 201509-2502-002
Status: Historical Active	Previous ICR Reference No: 201312-2502-006
Agency/Subagency: HUD/OH	Agency Tracking No:
Title: Office of Hospital Facilities Transactional Forms for FHA Programs 242, 241, 223(f), 223(a)(7)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/19/2016
	Date Received in OIRA: 05/31/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2019	36 Months From Approved	08/31/2016
Responses	496	0	4,054
Time Burden (Hours)	73,047	0	98,812
Cost Burden (Dollars)	0	0	0

---

Abstract: This information is collected from OHF staff, mortgagees, mortgagors, contractors and agents to manage and monitor the application, procedure, project administration and initial/final endorsement of projects undertaken by Office of Hospital Facilities.

---

Authorizing Statute(s): US Code: 12 USC 1709,1710,1715b,1715n(f), 1715 Name of Law: Mortgage Insurance for Hospitals
   US Code: 42 USC 3535(d) Name of Law: Mortgage Insurance for Hospitals
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 61225	10/09/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 34368	05/31/2016
Did the Agency receive public comments on this ICR? No

---

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

IC Title	Form No.	Form Name
Hospital Facilities projects pursuant to FHA Programs 242, 241, 223(f), 223(a)(7)	HUD-92452-OHF, HUD-92464-OHF, HUD-92441-OHF, HUD-92422, HUD-92452A-OHF, HUD-92448-OHF, HUD-91725-OHF-CERT, HUD-92013-OHF, HUD-92023-OHF, HUD-91725-INST-OHF, HUD-92330A-OHF, HUD-92554-OHF, HUD-92576-OHF, HUD-93305-OHF, HUD-94000-OHF, HUD-94001-OHF, HUD-9250-OHF, HUD-92476-OHF, HUD-91725-OHF, HUD-91070-OHF, HUD-91071-OHF, HUD-91703-OHF, HUD-92070-OHF, HUD-92403-OHF, HUD-92434-OHF, HUD-92422-OHF, HUD-92455-OHF, HUD-92456-OHF, HUD-92476A-OHF, HUD-92466-OHF, HUD-92479-OHF, HUD-94128-OHF, HUD-9111-OHF, HUD-92080-OHF, HUD-92117-OHF, HUD-92205-OHF, HUD-92223-OHF, HUD-92322-OHF, HUD-92330-OHF, HUD-92403A-OHF	Contractor's Certificate of Actual Cost - Hospitals/Section 242 ,   Borrower's Certificate of Actual Cost - Hospitals/Section 242 ,   Borrower's and Architect's Certification ,   Application for Insurance of Mortgage Proceeds ,   Lender's Certificate ,   Construction Contract ,   Request for Endorsement of Credit Instrument & Certificate of Lender, Borrower & General Contractor ,   Escrow Agreement for Incomplete Construction ,   Escrow Agreement for Limited Rehabilitation ,   Regulatory Agreement - Borrower ,   Off-Site Bond ,   Supplementary Conditions of the Contract for Construction ,   Certificate for Need for Health Facility and Assurance of Enforcement of State Standards ,   Agreement and Certification ,   Security Instrument/ Mortgage/Deed of Trust ,   Healthcare Facility Note ,   Environmental Assessment and Compliance Findings ,   Payment Bond ,   Data Request ,   Performance Bond ,   Request for Approval of Advance of Escrow Funds ,   HUD-91725-CERT-OHF Exhibit A to Opinion ,   Application for Hospital Mortgage Insurance ,   Request for Final Endorsement of Credit ,   Building Loan Agreement ,   Contractor's Requisition ,   HUD-91725-INST-OHF Instructions to Opinion ,   Escrow for Deferred Work ,   Opinion of Borrower's Counsel ,   Funds Authorizations ,   Consolidated Certification ,   Off Site Escrow ,   Survey Instructions and Surveyor's Report ,   Survey Instructions and Borrower's Certification ,   Lease Addendum ,   Mortgage Record Change ,   Borrower's Certification- Full or Partial Completion of Project ,   Borrower's Certificate of Known Costs (Section 242/223f) ,   Surplus Cash Note ,   Intercreditor Agreement

---

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	496	4,054	0	0	-3,558	0
Annual Time Burden (Hours)	73,047	98,812	0	0	-25,765	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: This is a revision of a currently approved collection. The currently approved PRA package was based on an assumed annual volume of 15 Section 242 applications. It shows 73,047 burden hours for an annual cost of $5,531,419. Recently, OHF and the Office of General 15. This is a revision of a currently approved collection. The currently approved PRA package was based on an assumed annual volume of 15 Section 242 applications. It shows 73,047 burden hours for an annual cost of $5,531,419. Recently, OHF and the Office of General Counsel conducted a comprehensive review of the paperwork burden associated with the Section 242 hospital mortgage insurance program. As a result of that review, there were substantial changes to the documents included in this package and the number of respondents, frequency of response, burden hours per response, and hourly cost per response for many data collection items affecting various aspects of the program. Several documents previously included in 2502-0602 were determined unnecessary for inclusion or streamlined into consolidated versions. HUD believes that the changes lead to a much more realistic estimate of burden hours and a significantly improved collection of documents to be used by the public.

---

Annual Cost to Federal Government: $496,800

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

---

Common Form ICR:  No

---

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: 05/31/2016

---