APPLICATION FOR INSURANCE BENEFITS AND GENERAL ASSIGNMENT

ICR 197904-2502-008

OMB: 2502-0050

Federal Form Document

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Document
Name
Status
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ICR Details
2502-0050 197904-2502-008
Historical Active 197901-2502-019
HUD/OH
APPLICATION FOR INSURANCE BENEFITS AND GENERAL ASSIGNMENT
Extension without change of a currently approved collection   No
Regular
Approved without change 05/10/1979
Retrieve Notice of Action (NOA) 04/16/1979
  Inventory as of this Action Requested Previously Approved
07/31/1980 07/31/1980 06/30/1979
5,000 0 5,000
2,500 0 2,500
0 0 0



None
None


No

1
IC Title Form No. Form Name
APPLICATION FOR INSURANCE BENEFITS AND GENERAL ASSIGNMENT 2777B, HUD 2777,, 2777A, &

  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 5,000 5,000 0 0 0 0
Annual Time Burden (Hours) 2,500 2,500 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.
04/16/1979


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