Comprehensive Listing of Transactional Documents for Mortgagors, Mortgagees and Contractors

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 92450-ORCF Completion of Assurance	Form	Unchanged	Available
Form 92434-ORCF Lender’s Certificate	Form	Unchanged	Available
Form 91130-ORCF Building Code Certification	Form	Unchanged	Available
Form 91118-ORCF Borrower's Certification - Completion of Critical Repairs	Form	Unchanged	Available
Form 90022-ORCF Certification for Submission of Electronic Firm Application	Form and Instruction	Unchanged	Available
Form 90019-ORCF Auditor Certification	Form and Instruction	Unchanged	Available
Form 90018-ORCF Consolidated Certifications – Contractor	Form and Instruction	Unchanged	Available
Form 90017-ORCF Consolidated Certifications – Management Agent	Form and Instruction	Unchanged	Available
Form 90016-ORCF Consolidated Certifications - Parent of the Operator	Form and Instruction	Unchanged	Available
Form 90015-ORCF Consolidated Certifications – Operator	Form and Instruction	Unchanged	Available
Form 90014-ORCF Consolidated Certifications – Principal of Borrower	Form and Instruction	Unchanged	Available
Form 90013-ORCF Consolidated Certifications – Borrower	Form and Instruction	Unchanged	Available
Form 90012-ORCF Consolidated Certifications – Lender	Form	Unchanged	Available
Form 9445-ORCF Certification of Outstanding Obligations - Section 232/223(f)	Form	Unchanged	Available
Form 92340-ORCF Master Tenant Security Agreement	Form	Unchanged	Available
Form 92339-ORCF Master Tenant Estoppel Certificate	Form	Unchanged	Available
Form 92337-ORCF Healthcare Regulatory Agreement – Master Tenant	Form	Unchanged	Available
Form 92335-ORCF Guide for Opinion of Master Tenant’s Counsel	Form	Unchanged	Available
Form 92333-ORCF Master Lease Subordination, Non-Disturbance and Attornment Agreement	Form	Unchanged	Available
Form 92331-ORCF Cross-Default Guaranty of Subtenants	Form	Unchanged	Available
Form 92211-ORCF Master Lease Addendum	Form	Unchanged	Available
Form 90025a-ORCF Lender Narrative – Blended Rate 2 Stage, Final Firm Submission	Form and Instruction	Unchanged	Available
Form 90025-ORCF Lender Narrative – Existing Buildings with New Construction Blended Rate 2 Stage, Initial Firm Submission	Form and Instruction	Unchanged	Available
Form 90011-ORCF Lender Narrative – Operating Loss Loan	Form and Instruction	Unchanged	Available
Form 90010-ORCF Lender Narrative - Fire Safety Equipment Installation, with Existing HUD-Insured Mortgage	Form and Instruction	Unchanged	Available
Form 9444-ORCF Lender Narrative Supplement – Cost Certification	Form and Instruction	Unchanged	Available
Form 9009-ORCF Lender Narrative - Fire Safety Equipment Installation, without Existing HUD-Insured Mortgage	Form and Instruction	Unchanged	Available
Form 9008-ORCF Lender Narrative – Existing Buildings with New Construction Blended Rate Single Stage	Form and Instruction	Unchanged	Available
Form 9007a-OCRF Lender Narrative Substantial Rehabilitation 2 Stage, Final Firm Submission	Form and Instruction	Unchanged	Available
Form 9007-ORCF Lender Narrative – Substantial Rehabilitation 2 Stage Initial Firm Submission	Form and Instruction	Unchanged	Available
Form 9006-ORCF Lender Narrative – Substantial Rehabilitation Single Stage	Form and Instruction	Unchanged	Available
Form 9005a-ORCF Lender Narrative – New Construction 2 Stage, Final Firm Submission	Form and Instruction	Unchanged	Available
Form 9005-ORCF Lender Narrative – New Construction 2 Stage, Initial Firm Submission	Form and Instruction	Unchanged	Available
Form 9004-ORCF Lender Narrative – New Construction Single Stage	Form and Instruction	Unchanged	Available
Form 9003-ORCF Lender Narrative – Section 232/241(a)	Form and Instruction	Unchanged	Available
Form 9002-ORCF Lender Narrative-Section 232/223(f) Refinance	Form and Instruction	Unchanged	Available
Form 9001i-ORCF Addendum to Underwriting Narrative – Accounts Receivable (AR) Financing	Form and Instruction	Unchanged	Available
Form 9001h-ORCF Addendum to Underwriting Narrative – Transfer of Physical Assets	Form and Instruction	Unchanged	Available
Form 9001g-ORCF Addendum to Underwriting Narrative – Management Agent	Form and Instruction	Unchanged	Available
Form 9001f-ORCF Addendum to Underwriting Narrative – Operator	Form and Instruction	Unchanged	Available
Form 9001e-ORCF Addendum to Underwriting Narrative – Principal of the Borrower	Form and Instruction	Unchanged	Available
Form 9001d-ORCF Addendum to Underwriting Narrative – Other Eligible Existing Indebtedness	Form and Instruction	Unchanged	Available
Form 9001c-ORCF Addendum to Underwriting Narrative – Environmental	Form and Instruction	Unchanged	Available
Form 9001b-ORCF Addendum to Underwriting Narrative – ALTA/ACSM Land Title Survey	Form and Instruction	Unchanged	Available
Form 9001a-ORCF Addendum to Underwriting Narrative – Project Capital Needs Assessment (PCNA)	Form and Instruction	Unchanged	Available
Form 9001-ORCF Lender Narrative – Section 232/223(a)7 Refinance	Form and Instruction	Unchanged	Available
Form 92476B-ORCF Escrow Agreement For Operating Deficits	Form	Unchanged	Available
Form 92476-ORCF Escrow Agreement for Non-critical, Deferred Repairs	Form	Unchanged	Available
Form 92464-ORCF Request for Approval of Advance/Release of Escrow Funds	Form	Unchanged	Available
Form 92414-ORCF Escrow Agreement For Latent Defects	Form	Unchanged	Available
Form 91128-ORCF Initial Operating Deficit Escrow Calculation	Form	Unchanged	Available
Form 9443-ORCF Minor Movable Equipment Escrow Agreement	Form	Unchanged	Available
Form 95379-ORCF HUD Representative’s Trip Report	Form and Instruction	Unchanged	Repair queued
Form 93305-ORCF Agreement and Certification	Form	Unchanged	Available
Form 92554-ORCF Supplementary Conditions of the Contract for Construction	Form	Unchanged	Available
Form 92479-ORCF Off-Site Bond – Dual Obligee	Form	Unchanged	Available
Form 92456-ORCF Escrow Agreement for Incomplete Construction	Form	Unchanged	Available
Form 92455-ORCF Request for Endorsement of Credit Instrument & Certificate of Lender, Borrower & General Contractor	Form	Unchanged	Available
Form 92452A-ORCF Payment Bond	Form	Unchanged	Available
Form 92452-ORCF Performance Bond - Dual Obligee	Form	Unchanged	Available
Form 92442-ORCF Construction Contract	Form	Unchanged	Available
Form 92441a-ORCF Building Loan Agreement Supplemental	Form	Unchanged	Available
Form 92441-ORCF Building Loan Agreement	Form	Unchanged	Available
Form 92415-ORCF Request for Permission to Commence Construction	Form	Unchanged	Available
Form 92412-ORCF Escrow Agreement for Working Capital	Form	Unchanged	Available
Form 92408-ORCF HUD Amendment to AIA Document B108	Form	Unchanged	Available
Form 92023-ORCF Request for Final Endorsement of Credit Instrument	Form	Unchanged	Available
Form 91129-ORCF Lender Certification for New Construction, Cost Certifications	Form	Unchanged	Available
Form 91127-OCRF Financial Statement Certification-General Contractor	Form	Unchanged	Available
Form 91125-ORCF Forecasted Staffing Schedule	Form	Unchanged	Available
Form 91124-ORCF Design Architect’s Certification	Form	Unchanged	Available
Form 91123-ORCF Design Professional’s Certification of Liability Insurance	Form	Unchanged	Available
Form 9442-ORCF Memo Requesting Post-Commitment Early Start of Construction	Form	Unchanged	Available
Form 93486-ORCF Computation of Surplus Cash, Distributions and Residual Receipts	Form and Instruction	Unchanged	Available
Form 93481-ORCF Schedule C - Schedule of Accounts Payable	Form and Instruction	Unchanged	Available
Form 93480-ORCF Schedule B - Schedule of Disbursements	Form and Instruction	Unchanged	Available
Form 93479-ORCF Monthly Report for Establishing Net Income	Form and Instruction	Unchanged	Available
Form 93333-ORCF Certification of Physical Condition Compliance	Form	Unchanged	Available
Form 93332-ORCF Certification of Exigent Health & Safety (EH&S) Issues	Form	Unchanged	Repair queued
Form 92417-ORCF Personal Financial and Credit Statement	Form	Unchanged	Available
Form 92266-ORCF Application for Transfer of Physical Assets	Form and Instruction	Unchanged	Available
Form 92228-ORCF Model Form - Bill of Sale	Form	Unchanged	Available
Form 92117-ORCF Borrower’s Certification- Full or Partial Completion of Non-Critical Repairs	Form and Instruction	Unchanged	Available
Form 9250A-ORCF Borrower Certification and Request Detail	Form	Unchanged	Available
Form 9250-ORCF Funds Authorization	Form	Unchanged	Available
Form 94001-ORCF Healthcare - Facility Note	Form	Unchanged	Repair queued
Form 94000-ORCF Security Instrument/ Mortgage/Deed of Trust	Form and Instruction	Unchanged	Available
Form 92576A-ORCF Certificate of Need, (CON), for Health Facility and Assurance of Enforcement of State Standards	Form	Unchanged	Repair queued
Form 92466A-ORCF Healthcare Regulatory Agreement – Operator	Form	Unchanged	Available
Form 92466-ORCF Healthcare Regulatory Agreement – Borrower	Form	Unchanged	Available
Form 92420-ORCF Subordination Agreement Financing	Form	Unchanged	Available
Form 92323-ORCF Operator Security Agreement	Form	Unchanged	Available
Form 92264a-ORCF Maximum Insurable Loan	Form and Instruction	Unchanged	Available
Form 92223-ORCF Surplus Cash Note	Form	Unchanged	Available
Form 92070 - ORCF Lease Addendum	Form	Unchanged	Available
Form 91708-ORCF Agreement for Payment of Real Property Taxes	Form	Unchanged	Available
Form 91126-ORCF Financial Statement Certification-Borrower	Form	Unchanged	Available
Form 91119-ORCF Schedule of Facilities Owned, Operated or Managed	Form	Unchanged	Available
Form 91116-ORCF Addendum to Operating Lease	Form	Unchanged	Available
Form 91112-ORCF Refund Request for Overpayment of Firm Application Exam Fee	Form and Instruction	Unchanged	Available
Form 91111-ORCF Survey Instructions and Borrower’s Certification	Form and Instruction	Unchanged	Available
Form 91110-ORCF Subordination, Non-Disturbance and Attornment Agreement	Form	Unchanged	Available
Form 90024-ORCF Contact Sheet	Form	Unchanged	Available
Form 9839-ORCF Management Certification -Residential Care Facility	Form	Unchanged	Available
Form 2205a-ORCF Borrower’s Certificate of Actual Cost	Form	Unchanged	Available
Form 941-ORCF Lender’s FHA Number Request	Form	Unchanged	Available
Form 2-ORCF Request for Waiver of Housing Directive	Form	Unchanged	Available
Form 92325-ORCF Guide for Opinion of Operator’s Counsel, and Certification	Form	Unchanged	Available
Form 91725INST-ORCF Instructions to Guide for Opinion of Borrower’s and Operator’s Counsel	Form and Instruction	Unchanged	Available
Form 91725CERT-ORCF Exhibit A to Opinion of Borrower’s Counsel - Certification	Form	Unchanged	Available
Form 91725-ORCF Guide for Opinion of Borrower’s Counsel	Form	Unchanged	Available
Form 91117-ORCF Estoppel Certificate	Form	Unchanged	Available
Form 92322-ORCF Intercreditor Agreement	Form	Unchanged	Available
Form 90020-ORCF Accounts Receivable Financing Certification	Form	Unchanged	Repair queued
Form 91710-ORCF Residual Receipts Note (Nonprofit Borrowers)	Form	Unchanged	Available
83C (2502-0605-ORCF).doc	Justification for No Material/Nonsubstantive Change	Uploaded 2017-08-14	Repair queued
Supporting Statement A2.doc	Supporting Statement A	Uploaded 2014-05-06	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Completion of Assurance
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Lender’s Certificate
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Building Code Certification
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Borrower's Certification - Completion of Critical Repairs
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Certification for Submission of Electronic Firm Application
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Auditor Certification
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Consolidated Certifications – Contractor
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Consolidated Certifications – Management Agent
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Consolidated Certifications - Parent of the Operator
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Consolidated Certifications – Operator
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Consolidated Certifications – Principal of Borrower
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Consolidated Certifications – Borrower
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Consolidated Certifications – Lender
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Certification of Outstanding Obligations - Section 232/223(f)
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Master Tenant Security Agreement
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Master Tenant Estoppel Certificate
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Healthcare Regulatory Agreement – Master Tenant
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Guide for Opinion of Master Tenant’s Counsel
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Master Lease Subordination, Non-Disturbance and Attornment Agreement
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Cross-Default Guaranty of Subtenants
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Master Lease Addendum
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Lender Narrative – Blended Rate 2 Stage, Final Firm Submission
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Lender Narrative – Existing Buildings with New Construction Blended Rate 2 Stage, Initial Firm Submission
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Lender Narrative – Operating Loss Loan
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Lender Narrative - Fire Safety Equipment Installation, with Existing HUD-Insured Mortgage
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Lender Narrative Supplement – Cost Certification
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Lender Narrative - Fire Safety Equipment Installation, without Existing HUD-Insured Mortgage
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Lender Narrative – Existing Buildings with New Construction Blended Rate Single Stage
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Lender Narrative Substantial Rehabilitation 2 Stage, Final Firm Submission
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Lender Narrative – Substantial Rehabilitation 2 Stage Initial Firm Submission
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Lender Narrative – Substantial Rehabilitation Single Stage
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Lender Narrative – New Construction 2 Stage, Final Firm Submission
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Lender Narrative – New Construction 2 Stage, Initial Firm Submission
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Lender Narrative – New Construction Single Stage
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Lender Narrative – Section 232/241(a)
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Lender Narrative-Section 232/223(f) Refinance
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Addendum to Underwriting Narrative – Accounts Receivable (AR) Financing
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Addendum to Underwriting Narrative – Transfer of Physical Assets
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Addendum to Underwriting Narrative – Management Agent
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Addendum to Underwriting Narrative – Operator
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Addendum to Underwriting Narrative – Principal of the Borrower
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Addendum to Underwriting Narrative – Other Eligible Existing Indebtedness
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Addendum to Underwriting Narrative – Environmental
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Addendum to Underwriting Narrative – ALTA/ACSM Land Title Survey
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Addendum to Underwriting Narrative – Project Capital Needs Assessment (PCNA)
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Lender Narrative – Section 232/223(a)7 Refinance
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Escrow Agreement For Operating Deficits
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Escrow Agreement for Non-critical, Deferred Repairs
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Request for Approval of Advance/Release of Escrow Funds
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Escrow Agreement For Latent Defects
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Initial Operating Deficit Escrow Calculation
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Minor Movable Equipment Escrow Agreement
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	HUD Representative’s Trip Report
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Agreement and Certification
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Supplementary Conditions of the Contract for Construction
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Off-Site Bond – Dual Obligee
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Escrow Agreement for Incomplete Construction
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Request for Endorsement of Credit Instrument & Certificate of Lender, Borrower & General Contractor
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Payment Bond
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Performance Bond - Dual Obligee
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Construction Contract
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Building Loan Agreement Supplemental
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Building Loan Agreement
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Request for Permission to Commence Construction
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Escrow Agreement for Working Capital
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	HUD Amendment to AIA Document B108
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Request for Final Endorsement of Credit Instrument
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Lender Certification for New Construction, Cost Certifications
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Financial Statement Certification-General Contractor
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Forecasted Staffing Schedule
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Design Architect’s Certification
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Design Professional’s Certification of Liability Insurance
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Memo Requesting Post-Commitment Early Start of Construction
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Computation of Surplus Cash, Distributions and Residual Receipts
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Schedule C - Schedule of Accounts Payable
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Schedule B - Schedule of Disbursements
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Monthly Report for Establishing Net Income
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Certification of Physical Condition Compliance
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Certification of Exigent Health & Safety (EH&S) Issues
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Personal Financial and Credit Statement
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Application for Transfer of Physical Assets
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Model Form - Bill of Sale
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Borrower’s Certification- Full or Partial Completion of Non-Critical Repairs
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Borrower Certification and Request Detail
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Funds Authorization
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Healthcare - Facility Note
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Security Instrument/ Mortgage/Deed of Trust
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Certificate of Need, (CON), for Health Facility and Assurance of Enforcement of State Standards
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Healthcare Regulatory Agreement – Operator
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Healthcare Regulatory Agreement – Borrower
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Subordination Agreement Financing
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Operator Security Agreement
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Maximum Insurable Loan
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Surplus Cash Note
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Lease Addendum
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Agreement for Payment of Real Property Taxes
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Financial Statement Certification-Borrower
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Schedule of Facilities Owned, Operated or Managed
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Addendum to Operating Lease
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Refund Request for Overpayment of Firm Application Exam Fee
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Survey Instructions and Borrower’s Certification
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Subordination, Non-Disturbance and Attornment Agreement
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Contact Sheet
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Management Certification -Residential Care Facility
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Borrower’s Certificate of Actual Cost
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Lender’s FHA Number Request
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Request for Waiver of Housing Directive
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Guide for Opinion of Operator’s Counsel, and Certification
204773	Transactional Documents for Mortgagees and Contractors	Form and Instruction	Unchanged	Instructions to Guide for Opinion of Borrower’s and Operator’s Counsel
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Exhibit A to Opinion of Borrower’s Counsel - Certification
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Guide for Opinion of Borrower’s Counsel
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Estoppel Certificate
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Intercreditor Agreement
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Accounts Receivable Financing Certification
204773	Transactional Documents for Mortgagees and Contractors	Form	Unchanged	Residual Receipts Note (Nonprofit Borrowers)

ICR Details

OMB Control No: 2502-0605	ICR Reference No: 201708-2502-001
Status: Historical Active	Previous ICR Reference No: 201308-2502-009
Agency/Subagency: HUD/OH	Agency Tracking No:
Title: Comprehensive Listing of Transactional Documents for Mortgagors, Mortgagees and Contractors
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  Yes
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/30/2017
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/14/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2017	12/31/2017	12/31/2017
Responses	20,322	0	20,322
Time Burden (Hours)	44,221	0	44,221
Cost Burden (Dollars)	0	0	0

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Abstract: Information provided includes documents comprising the application for FHA mortgage insurance of residential care facilities, and for servicing of the mortgages. The information is submitted from HUD-approved mortgagees, sponsors, mortgagors and contractors. The included documents are necessary for the application, review, commitment, initial/final endorsement, administration, servicing, technical oversight and audit of the Office of Residential Care Facilities projects pursuant to FHA programs 232, 241, 223(f) and 223(a)(7).

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Authorizing Statute(s): US Code: 12 USC 1715n Name of Law: Misc Housing Insurance
   US Code: 12 USC 1713 Name of Law: Rental Housing Insurance
   US Code: 12 USC 1701 Name of Law: Rental Supplement Payments
   US Code: 12 USC 1715 Name of Law: Housing for Moderate and Displaced Families
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
2502-AJ05	Final or interim final rulemaking	77 FR 55120	09/07/2012

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 55282	09/10/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 11114	02/27/2014
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Transactional Documents for Mortgagees and Contractors	91725INST-ORCF, 92325-ORCF, 2-ORCF, 91110-ORCF, 91112-ORCF, 9443-ORCF, 91128-ORCF, 92414-ORCF, 92464-ORCF, 92476-ORCF, 92476B-ORCF, 91126-ORCF, 91708-ORCF, 91710-ORCF, 92070 - ORCF, 92223-ORCF, 92466A-ORCF, 92576A-ORCF, 94000-ORCF, 94001-ORCF, 93332-ORCF, 93481-ORCF, 93486-ORCF, 95379-ORCF, 9001-ORCF, 9001a-ORCF, 9001b-ORCF, 9001c-ORCF, 9001d-ORCF, 9003-ORCF, 9002-ORCF, 9004-ORCF, 9005-ORCF, 9005a-ORCF, 9006-ORCF, 9007-ORCF, 9007a-OCRF, 9008-ORCF, 9009-ORCF, 9444-ORCF, 90010-ORCF, 90011-ORCF, 90025-ORCF, 90025a-ORCF, 92211-ORCF, 92331-ORCF, 92333-ORCF, 92335-ORCF, 92337-ORCF, 92339-ORCF, 92340-ORCF, 9445-ORCF, 90012-ORCF, 90013-ORCF, 90015-ORCF, 90016-ORCF, 90017-ORCF, 90018-ORCF, 90019-ORCF, 90022-ORCF, 91118-ORCF, 91130-ORCF, 92434-ORCF, 92479-ORCF, 92456-ORCF, 92554-ORCF, 93305-ORCF, 92450-ORCF, 9442-ORCF, 91123-ORCF, 91124-ORCF, 92023-ORCF, 92415-ORCF, 90014-ORCF, 92455-ORCF, 91725-ORCF, 941-ORCF, 2205a-ORCF, 9839-ORCF, 90024-ORCF, 91111-ORCF, 91116-ORCF, 91117-ORCF, 91119-ORCF, 92264a-ORCF, 92323-ORCF, 92420-ORCF, 92466-ORCF, 9250-ORCF, 9250A-ORCF, 92117-ORCF, 92228-ORCF, 92266-ORCF, 92417-ORCF, 93333-ORCF, 93479-ORCF, 93480-ORCF, 9001e-ORCF, 9001f-ORCF, 9001g-ORCF, 91725CERT-ORCF, 9001h-ORCF, 9001i-ORCF, 91125-ORCF, 91127-OCRF, 91129-ORCF, 92408-ORCF, 92412-ORCF, 92441-ORCF, 92441a-ORCF, 92442-ORCF, 92452-ORCF, 92452A-ORCF, 90020-ORCF, 92322-ORCF	Accounts Receivable Financing Certification ,   Intercreditor Agreement ,   Estoppel Certificate ,   Guide for Opinion of Borrower’s Counsel ,   Exhibit A to Opinion of Borrower’s Counsel - Certification ,   Instructions to Guide for Opinion of Borrower’s and Operator’s Counsel ,   Guide for Opinion of Operator’s Counsel, and Certification ,   Request for Waiver of Housing Directive ,   Lender’s FHA Number Request ,   Borrower’s Certificate of Actual Cost ,   Management Certification -Residential Care Facility ,   Contact Sheet ,   Subordination, Non-Disturbance and Attornment Agreement ,   Survey Instructions and Borrower’s Certification ,   Refund Request for Overpayment of Firm Application Exam Fee ,   Addendum to Operating Lease ,   Schedule of Facilities Owned, Operated or Managed ,   Financial Statement Certification-Borrower ,   Agreement for Payment of Real Property Taxes ,   Residual Receipts Note (Nonprofit Borrowers) ,   Lease Addendum ,   Surplus Cash Note ,   Maximum Insurable Loan ,   Operator Security Agreement ,   Subordination Agreement Financing ,   Healthcare Regulatory Agreement – Borrower ,   Healthcare Regulatory Agreement – Operator ,   Certificate of Need, (CON), for Health Facility and Assurance of Enforcement of State Standards ,   Security Instrument/ Mortgage/Deed of Trust ,   Healthcare - Facility Note ,   Funds Authorization ,   Borrower Certification and Request Detail ,   Borrower’s Certification- Full or Partial Completion of Non-Critical Repairs ,   Model Form - Bill of Sale ,   Application for Transfer of Physical Assets ,   Personal Financial and Credit Statement ,   Certification of Exigent Health & Safety (EH&S) Issues ,   Certification of Physical Condition Compliance ,   Monthly Report for Establishing Net Income ,   Schedule B - Schedule of Disbursements ,   Schedule C - Schedule of Accounts Payable ,   Computation of Surplus Cash, Distributions and Residual Receipts ,   Memo Requesting Post-Commitment Early Start of Construction ,   Design Professional’s Certification of Liability Insurance ,   Design Architect’s Certification ,   Forecasted Staffing Schedule ,   Financial Statement Certification-General Contractor ,   Lender Certification for New Construction, Cost Certifications ,   Request for Final Endorsement of Credit Instrument ,   HUD Amendment to AIA Document B108 ,   Escrow Agreement for Working Capital ,   Request for Permission to Commence Construction ,   Building Loan Agreement ,   Building Loan Agreement Supplemental ,   Construction Contract ,   Performance Bond - Dual Obligee ,   Payment Bond ,   Request for Endorsement of Credit Instrument & Certificate of Lender, Borrower & General Contractor ,   Escrow Agreement for Incomplete Construction ,   Off-Site Bond – Dual Obligee ,   Supplementary Conditions of the Contract for Construction ,   Agreement and Certification ,   HUD Representative’s Trip Report ,   Minor Movable Equipment Escrow Agreement ,   Initial Operating Deficit Escrow Calculation ,   Escrow Agreement For Latent Defects ,   Request for Approval of Advance/Release of Escrow Funds ,   Escrow Agreement for Non-critical, Deferred Repairs ,   Escrow Agreement For Operating Deficits ,   Lender Narrative – Section 232/223(a)7 Refinance ,   Addendum to Underwriting Narrative – Project Capital Needs Assessment (PCNA) ,   Addendum to Underwriting Narrative – ALTA/ACSM Land Title Survey ,   Addendum to Underwriting Narrative – Environmental ,   Addendum to Underwriting Narrative – Other Eligible Existing Indebtedness ,   Addendum to Underwriting Narrative – Principal of the Borrower ,   Addendum to Underwriting Narrative – Operator ,   Addendum to Underwriting Narrative – Management Agent ,   Addendum to Underwriting Narrative – Transfer of Physical Assets ,   Addendum to Underwriting Narrative – Accounts Receivable (AR) Financing ,   Lender Narrative-Section 232/223(f) Refinance ,   Lender Narrative – Section 232/241(a) ,   Lender Narrative – New Construction Single Stage ,   Lender Narrative – New Construction 2 Stage, Initial Firm Submission ,   Lender Narrative – New Construction 2 Stage, Final Firm Submission ,   Lender Narrative – Substantial Rehabilitation Single Stage ,   Lender Narrative – Substantial Rehabilitation 2 Stage Initial Firm Submission ,   Lender Narrative Substantial Rehabilitation 2 Stage, Final Firm Submission ,   Lender Narrative – Existing Buildings with New Construction Blended Rate Single Stage ,   Lender Narrative - Fire Safety Equipment Installation, without Existing HUD-Insured Mortgage ,   Lender Narrative Supplement – Cost Certification ,   Lender Narrative - Fire Safety Equipment Installation, with Existing HUD-Insured Mortgage ,   Lender Narrative – Operating Loss Loan ,   Lender Narrative – Existing Buildings with New Construction Blended Rate 2 Stage, Initial Firm Submission ,   Lender Narrative – Blended Rate 2 Stage, Final Firm Submission ,   Master Lease Addendum ,   Cross-Default Guaranty of Subtenants ,   Master Lease Subordination, Non-Disturbance and Attornment Agreement ,   Guide for Opinion of Master Tenant’s Counsel ,   Healthcare Regulatory Agreement – Master Tenant ,   Master Tenant Estoppel Certificate ,   Master Tenant Security Agreement ,   Certification of Outstanding Obligations - Section 232/223(f) ,   Consolidated Certifications – Lender ,   Consolidated Certifications – Borrower ,   Consolidated Certifications – Principal of Borrower ,   Consolidated Certifications – Operator ,   Consolidated Certifications - Parent of the Operator ,   Consolidated Certifications – Management Agent ,   Consolidated Certifications – Contractor ,   Auditor Certification ,   Certification for Submission of Electronic Firm Application ,   Borrower's Certification - Completion of Critical Repairs ,   Building Code Certification ,   Lender’s Certificate ,   Completion of Assurance

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ICR Summary of Burden

table that charts list of burden

	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	20,322	20,322	0	0	0	0
Annual Time Burden (Hours)	44,221	44,221	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The actual form changes have not affected the burden reporting. Corrections were made to burden hour calculation, due to errors found in prior publications. The errors have been corrected.

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Annual Cost to Federal Government: $1,581,864

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  Yes

Description/Changes for Common Form Usage: 

Approved RCFs using this ICR

table that charts list of RCF

Agency/Sub Agency	RCF ID	RCF Title	RCF Status	IC Title

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 08/14/2017

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