THIS FORM IS USED TO FILE A CLAIM FOR
SPECIALLY ADAPTED HOUSING WITH AN INDICATION AS TO THE GENERAL
LOCATION OF THE PROPOSED HOUSING UNIT. UPON RECEIPT OF THIS CLAIM
IT WILL BE DETERMINED IF THE INDIVIDUAL HAS THE NECESSARY
QUALIFYING DISABILITIES AND HAS BEEN RATED AS ELIGIBLE. THE
APPLICATION IS THEN FORWARDED TO LOAN GUARANTY FOR PROCESSING.
AUTHORITY IS 38 C.F.R. 3.809.
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.