Information Collection

Application For Coinsurance Benefits Its Instructions And Supporting Schedules

IC 143962 under ICR 198205-2502-005 · OMB 2502-0158.

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Information Collection (IC) Details

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IC Title:	APPLICATION FOR COINSURANCE BENEFITS ITS INSTRUCTIONS AND SUPPORTING SCHEDULES	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	HUD-426,	No	No
Form	426A, 426.1	No	No
Form	& 427	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 56	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	67	17	50
Annual IC Time Burden (Hours)	134	34	100
Annual IC Cost Burden (Dollars)	0	0	0

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.