Document Name Document Type
Form fnma-1025 Home Equity Conversion Mortgage (HECM) Insurance Application for Reverse Mortgages and Related Documents Form
HUD-92902 Certificate of HECM Counseling HUD-92902.doc Form
HUD-92901 HECM Anti Churning Disclosure 92901 Anti Churning.pdf Form
FANNIE-MAE-1009 Residential Loan Application for Reverse Mortgages fnma1009.pdf Form
HUD-92900-A HUD-VA Addendum to Uniform Residential Loan Application 92900-a.pdf Form
fnma-1003 Uniform Residential Loan Application 1003.pdf Form
fnma-1004 Uniform Residential Appraisal Report 1004.pdf Form
fnma-1004c Manufactured Home Appraisal Report 1004c.pdf Form
fnma-1025 Small Residential Income Property Appraisal Report 1025.pdf Form
HUD-92051 Compliance Inspection Report 92051.pdf Form
HUD-92561 Borrows Contract with Respect to Hotel and Transient Use 92561.pdf Form
HUD-92800-5b Conditional Commitment Direct Endorsement Statement of A 92800-5b.pdf Form
HUD-1 Settlement Statement HUD-1.pdf Form
HUD-1a Settlement Statement Optional for Transactions Without S HUD-1a.pdf Form
Fannie Mae 1073 Fannie Mae 1073 1073.pdf Form and Instruction
AUTHORIZATION TO ESTABLISH A PAD ACCOUNT.doc Authorization to Establish PAD Account IC Document
CONDOMINIUM RIDER.doc Condominium Rider IC Document
HOME EQUITY CONVERSION LOAN AGREEMENT.doc Home Equity Conversion Loan Agreement IC Document
MODEL ADJUSTABLE RATE NOTE FORM.doc Model Adjustable Rate Note Form IC Document
NOTICE TO THE BORROWER.doc Notice to the Borrower IC Document
Periodic Disclosure of Interest Rate Change.doc Periodic Disclosure of Interest Rate Change IC Document
PLANNED UNIT DEVELOPMENT RIDER.doc Planned Unit Development Rider IC Document
MODEL FIXED RATE SECOND NOTE FORM.doc Model Fixed Rate Second Note Form IC Document
REPAIR RIDER.doc Repair Rider IC Document
SHARED APPRECIATION RIDER.doc Shared Appreciation Rider IC Document
HOME EQUITY CONVERSION MORTGAGE PAYMENT PLAN.doc Home Equity Conversion Mortgage Payment Play IC Document
MODEL SECOND MORTGAGE FORM.doc Model Second Mortgage Form IC Document
MODEL ADJUSTABLE RATE SECOND NOTE FORM.doc Model Adjustable Rate Second Note Form IC Document
MODEL FIXED RATE NOTE FORM.doc Model Fixed Rate Note Form IC Document
MODEL MORTGAGE FORM.doc Model Mortgage Form IC Document
MODEL FIXED RATE SECOND NOTE FORM.doc Model Fixed Rate Second Note Form IC Document
SHARED APPRECIATION ALLONGE.doc Shared Appreciation Allonge IC Document

Information Collection (IC) Details

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IC Title:	Home Equity Conversion Mortgage (HECM) Insurance Application for Reverse Mortgages and Related Documents	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 24 CFR 206 24 CFR 200.95

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	fnma-1025	Small Residential Income Property Appraisal Report	1025.pdf	Yes	No	Fillable Printable
Form	HUD-92051	Compliance Inspection Report	92051.pdf	Yes	No	Fillable Printable
Form	HUD-92561	Borrows Contract with Respect to Hotel and Transient Use of Property	92561.pdf	Yes	No	Fillable Printable
Form	HUD-92800-5b	Conditional Commitment Direct Endorsement Statement of Appraised Value	92800-5b.pdf	Yes	No	Fillable Printable
Form	HUD-1	Settlement Statement	HUD-1.pdf	Yes	No	Fillable Printable
Form	HUD-1a	Settlement Statement Optional for Transactions Without Sellers	HUD-1a.pdf	Yes	No	Fillable Printable
Form and Instruction	Fannie Mae 1073	Fannie Mae 1073	1073.pdf	No		Fillable Printable
Form	HUD-92902	Certificate of HECM Counseling	HUD-92902.doc	Yes	Yes	Fillable Fileable
Form	HUD-92901	HECM Anti Churning Disclosure	92901 Anti Churning.pdf	Yes	No	Fillable Printable
Form	FANNIE-MAE-1009	Residential Loan Application for Reverse Mortgages	fnma1009.pdf	Yes	No	Fillable Printable
Form	HUD-92900-A	HUD-VA Addendum to Uniform Residential Loan Application	92900-a.pdf	Yes	No	Fillable Printable
Form	fnma-1003	Uniform Residential Loan Application	1003.pdf	Yes	No	Fillable Printable
Form	fnma-1004	Uniform Residential Appraisal Report	1004.pdf	Yes	No	Fillable Printable
Form	fnma-1004c	Manufactured Home Appraisal Report	1004c.pdf	Yes	No	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: Community and Social Services

Subfunction: Homeownership Promotion

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,100	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	100,000	-29,000	129,000
Annual IC Time Burden (Hours)	450,235	0	450,235
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Authorization to Establish PAD Account	AUTHORIZATION TO ESTABLISH A PAD ACCOUNT.doc	09/26/2007
Condominium Rider	CONDOMINIUM RIDER.doc	09/26/2007
Home Equity Conversion Loan Agreement	HOME EQUITY CONVERSION LOAN AGREEMENT.doc	09/26/2007
Model Adjustable Rate Note Form	MODEL ADJUSTABLE RATE NOTE FORM.doc	09/26/2007
Notice to the Borrower	NOTICE TO THE BORROWER.doc	09/26/2007
Periodic Disclosure of Interest Rate Change	Periodic Disclosure of Interest Rate Change.doc	09/26/2007
Planned Unit Development Rider	PLANNED UNIT DEVELOPMENT RIDER.doc	09/26/2007
Model Fixed Rate Second Note Form	MODEL FIXED RATE SECOND NOTE FORM.doc	09/26/2007
Repair Rider	REPAIR RIDER.doc	09/26/2007
Shared Appreciation Rider	SHARED APPRECIATION RIDER.doc	09/26/2007
Home Equity Conversion Mortgage Payment Play	HOME EQUITY CONVERSION MORTGAGE PAYMENT PLAN.doc	09/26/2007
Model Second Mortgage Form	MODEL SECOND MORTGAGE FORM.doc	09/26/2007
Model Adjustable Rate Second Note Form	MODEL ADJUSTABLE RATE SECOND NOTE FORM.doc	09/26/2007
Model Fixed Rate Note Form	MODEL FIXED RATE NOTE FORM.doc	09/26/2007
Model Mortgage Form	MODEL MORTGAGE FORM.doc	09/26/2007
Model Fixed Rate Second Note Form	MODEL FIXED RATE SECOND NOTE FORM.doc	09/26/2007
Shared Appreciation Allonge	SHARED APPRECIATION ALLONGE.doc	09/26/2007

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

Home Equity Conversion Mortgage (HECM) Insurance Application for Reverse Mortgages and Related Documents

Home Equity Conversion Mortgage (HECM) Insurance Application for Reverse Mortgages and Related Documents

OMB: 2502-0524

IC ID: 27279

View Information Collection (IC)