Information Collection

Single Family Application for Insurance Benefits

IC 42065 under ICR 202005-2502-005 · OMB 2502-0429.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2502-0429 can be found here:

2024-01-18 - Revision of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form HUD 91022 Single Family Application for Insurance Benefits	Form and Instruction
HUD 91022 Mortgagee Notice of Foreclosure 91022.pdf	Form and Instruction
HUD 50012 Mortgagee's Request fo Extension of Time Requirments 50012.pdf	Form and Instruction
HUD 50002 Request to Exceed Cost Limits for Preservaiton and Prote 50002.pdf	Form and Instruction
HUD 09539 Request for Occupied Conveyance 9539.pdf	Form and Instruction
HUD-9519a Property Inspection Report 9519a.pdf	Form and Instruction
HUD-27011 Single Family Application for Insurance Benefits HUD-27011 (8-14-2020).pdf	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Single Family Application for Insurance Benefits

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 203.377 - 379 24 CFR 203.381, 382 24 CFR 203.670 - 681 24 CFR 203.402, 414 24 CFR 203.362 - 365 24 CFR 203.350, 355, 357, 359, 360 24 CFR 203.368 - 371 24 CFR 203.389 24 CFR 206.123, 125, 127, 129

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	HUD 91022	Mortgagee Notice of Foreclosure	91022.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	HUD 50012	Mortgagee's Request fo Extension of Time Requirments	50012.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	HUD 09539	Request for Occupied Conveyance	9539.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	HUD 50002	Request to Exceed Cost Limits for Preservaiton and Protection	50002.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	HUD-9519a	Property Inspection Report	9519a.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	HUD-27011	Single Family Application for Insurance Benefits	HUD-27011 (8-14-2020).pdf	Yes	Yes	Fillable Fileable

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: 440

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 94 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,125,455	-72,716	1,198,171
Annual IC Time Burden (Hours)	933,416	-153,167	1,086,583
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.