Leasehold Mortgage Lender Checklist

Trust Land Mortgage Lender Checklists

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1076-0195 can be found here:

Documents and Forms

Document Name Document Type
Leasehold Mortgage Lender Checklist Form and Instruction
Leasehold Mortgage Lender Checklist Leasehold Mortgage Lender Checklist (3).docx www.bia.gov/policy-forms/online-forms Form and Instruction

Information Collection (IC) Details

IC Title:	Leasehold Mortgage Lender Checklist	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 25 CFR 152.34

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A	Leasehold Mortgage Lender Checklist	Leasehold Mortgage Lender Checklist (3).docx	https://www.bia.gov/policy-forms/online-forms	Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Homeownership Promotion

Privacy Act System of Records
Title: BIA-12: Indian Trust Land Mortgages	FR Citation: 48 FR 41105

Number of Respondents: 31	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
Annual Number of Responses for this IC	61	61
Annual IC Time Burden (Hours)	2,440	2,440
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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