Personal Financial and Credit Statement

Forms and Documents

Document Name	Status
Form HUD-92417 Personal Financial and Credit Statement Form	Modified
2502-0001.pdf Supplementary Document	2019-07-02
2502-0001 PTA (Signed by Privacy Office) 3-28-19.pdf Supplementary Document	2019-03-28
NHA 203(b)(1) and (2).doc Supplementary Document	2015-08-25
24CFR207.251.doc Supplementary Document	2015-08-25
24CFR207.1.doc Supplementary Document	2015-08-25
2502-0001 - Supporting Statement 11-28-18.docx Supporting Statement A	2019-03-12

IC Document Collections

IC ID	Document Title	Status
26965	Personal Financial and Credit Statement Form	Modified

ICR Details

OMB Control No: 2502-0001	ICR Reference No: 201801-2502-006
Status: Active	Previous ICR Reference No: 201505-2502-002
Agency/Subagency: HUD/OH	Agency Tracking No:
Title: Personal Financial and Credit Statement
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 07/02/2019
	Date Received in OIRA: 02/28/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2022	36 Months From Approved	07/31/2019
Responses	1,230	0	1,555
Time Burden (Hours)	9,840	0	12,440
Cost Burden (Dollars)	0	0	0

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Abstract: This information collection is used to conduct a credit investigation of the sponsor, mortgagor, and general contractor to evaluate the character, capital, and ability to develop, build, complete, and maintain a multifamily project.

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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:
	83 FR 48862	09/27/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 3223	02/11/2019
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
Personal Financial and Credit Statement	HUD-92417	Personal Financial and

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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	1,230	1,555	0	-325	0	0
Annual Time Burden (Hours)	9,840	12,440	0	-2,600	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: Yes

Burden Reduction Due to: Changing Forms

Short Statement: The number of respondents has decreased from the previous information collection because HUD’s previous submission included corporations or partnerships in the number of respondents. Form HUD-92417 is only for individual mortgagors and principals. Corporate or partnership mortgagors do not use form HUD-92417; they are required to submit financial statements to demonstrate credit worthiness (OMB Control No. 2502-0029). The form HUD-2530 is a separate loan application exhibit accompanies multifamily loan applications. It is reviewed by Asset Management to verify the list of projects a principal may have. The Previous Participation Certification is the document, which contains eight statements that catches all changes that may have occurred with the Borrower(s). This certification is signed by the borrower with all the legal authority.

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Annual Cost to Federal Government: $24,507

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.     No

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.     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: 02/28/2019

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