APPLICATION FOR COINSURANCE BENEFITS

ICR 197703-2502-007

OMB: 2502-0134

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
173512 Migrated
ICR Details
2502-0134 197703-2502-007
Historical Active 197603-2502-002
HUD/OH
APPLICATION FOR COINSURANCE BENEFITS
No material or nonsubstantive change to a currently approved collection   No
Emergency 03/14/1977
Approved with change 03/14/1977
Retrieve Notice of Action (NOA) 03/14/1977
  Inventory as of this Action Requested Previously Approved
03/31/1979 03/31/1979 03/31/1979
200 0 200
200 0 200
0 0 0



None
None


No

1
IC Title Form No. Form Name
APPLICATION FOR COINSURANCE BENEFITS HUD 4035

  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 200 200 0 0 0 0
Annual Time Burden (Hours) 200 200 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
03/14/1977


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