OMB Control No: 2502-0605
ICR Reference No:
202008-2502-004
Status: Active
Previous ICR Reference No: 202001-2502-008
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: 11/02/2020
Retrieve
Notice of Action (NOA)
Date Received in OIRA:
09/01/2020
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
06/30/2022
06/30/2022
06/30/2022
Responses
26,125
0
26,125
Time Burden (Hours)
49,226
0
49,226
Cost Burden (Dollars)
0
0
0
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).
Authorizing Statute(s): 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
US Code: 12
USC 1715n Name of Law: Misc Housing Insurance
US Code: 12
USC 1713 Name of Law: Rental Housing Insurance
Citations for New Statutory
Requirements: None
Associated Rulemaking
Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices &
Comments
60-day Notice:
Federal Register Citation:
Citation Date:
82 FR
23058
05/19/2017
30-day Notice:
Federal Register Citation:
Citation Date:
83 FR
15396
04/10/2018
Did the Agency receive public comments on
this ICR?
Yes
Number of Information Collection (IC) in this
ICR: 1
IC Title
Form No.
Form Name
Transactional
Documents for Mortgagees and Contractors
92485-ORCF, 935.2D-ORCF, 92000-ORCF, 90023-ORCF,
94000-ORCF-ADD, 92343-ORCF, 92334-ORCF, 92336-ORCF, 92435-ORCF,
92468-ORCF, 94000-ORCF-ADD, 94000-ORCF-ADD, 94000-ORCF-ADD,
94000-ORCF-ADD, 94000-ORCF-ADD, 94000-ORCF-ADD, 94000-ORCF-ADD,
94000-ORCF-ADD, 94000-ORCF-ADD, 90030-ORCF, 90031-ORCF, 90033-ORCF,
94000-ORCF-ADD, 94000-ORCF-ADD, 94000-ORCF-ADD, 94000-ORCF-ADD,
94000-ORCF-ADD, 94000-ORCF-ADD, 94001-ORCF-RI, 94001-ORCF-RI,
94001-ORCF-RI, 94001-ORCF-RI, 92080-ORCF, 92211A-ORCF, 92333A-ORCF,
92342-ORCF, 92071-ORCF, 92324-ORCF, 92330-ORCF, 92330A-ORCF,
94000B-ORCF, 94000-ORCF-ADD, 94000-ORCF-ADD, 94000-ORCF-ADD,
94000-ORCF-ADD, 94000-ORCF-ADD, 94000-ORCF-ADD, 94000-ORCF-ADD,
94000-ORCF-ADD, 94000-ORCF-ADD, 94000-ORCF-ADD, 94000-ORCF-ADD,
94000-ORCF-ADD, 94000-ORCF-ADD, 94000-ORCF-ADD, 94000-ORCF-ADD,
94000-ORCF-ADD, 94000-ORCF-ADD, 92341-ORCF, 94001-ORCF-RI,
2537-ORCF, 90029-ORCF, 92266-ORCF, 93334-ORCF, 91116A-ORCF,
92338A-ORCF, 92324A-ORCF, 94000-ORCF-ADD, 94000-ORCF-ADD,
91071-ORCF, 92476C-ORCF, 92327-ORCF, 92266A-ORCF, 94000-ORCF-ADD,
94000-ORCF-ADD, 94000-ORCF-ADD, 94000-ORCF-ADD, 94000-ORCF-ADD,
94000-ORCF-ADD, 94000-ORCF-ADD, 94000-ORCF-ADD, 94000-ORCF-ADD,
92334A-ORCF, 92467-ORCF, 94001A-ORCF, 94000-ORCF-ADD,
94000-ORCF-ADD, 94000-ORCF-ADD, 94000-ORCF-ADD, 94000-ORCF-ADD,
94001-ORCF-RI, 92467A-ORCF, 1044-D-ORCF, 92340A-ORCF, 92441B-ORCF,
93335-ORCF, 2747-ORCF, 9807-ORCF, 90032-ORCF, 92266B-ORCF,
94000-ORCF-ADD, 92323A-ORCF, 92434A-ORCF, 94000A-ORCF, 91117-ORCF,
92264a-ORCF, 91127-OCRF, 91129-ORCF, 92408-ORCF, 92412-ORCF,
92441-ORCF, 92441a-ORCF, 92442-ORCF, 92452-ORCF, 92452A-ORCF,
90020-ORCF, 92322-ORCF, 91725CERT-ORCF, 91725INST-ORCF, 92325-ORCF,
2-ORCF, 91110-ORCF, 91112-ORCF, 92323-ORCF, 92420-ORCF, 92466-ORCF,
9250-ORCF, 92117-ORCF, 92228-ORCF, 92266-ORCF, 92417-ORCF,
93333-ORCF, 93479-ORCF, 93480-ORCF, 91125-ORCF, 91126-ORCF,
91710-ORCF, 92070 - ORCF, 92223-ORCF, 92466A-ORCF, 94000-ORCF,
94001-ORCF, 93332-ORCF, 93481-ORCF, 93486-ORCF, 95379-ORCF,
9443-ORCF, 91128-ORCF, 92414-ORCF, 92464-ORCF, 92476-ORCF,
92476B-ORCF, 9001-ORCF, 9003-ORCF, 9002-ORCF, 9004-ORCF, 9005-ORCF,
9005a-ORCF, 9006-ORCF, 9007-ORCF, 9007a-OCRF, 9009-ORCF, 9444-ORCF,
90010-ORCF, 90011-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,
90021-ORCF, 92328-ORCF, 92403-ORCF, 92437-ORCF, 92448-ORCF
Security
Instrument/ Mortgage/Deed of Trust , Healthcare - Facility Note
, Funds
Authorization , Borrowers 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 , Consolidated Certifications
Contractor , Auditor Certification ,
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 Professionals
Certification of Liability Insurance , Design Architects
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 Representatives 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 , 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 - 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 , Master Lease Addendum ,
Cross-Default
Guaranty of Subtenants , Master Lease Subordination,
Non-Disturbance and Attornment Agreement , Guide for Opinion of Master
Tenants 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 , Certification for Submission
of Electronic Firm Application , Borrower's Certification -
Completion of Critical Repairs , Building Code
Certification , Lenders Certificate ,
Completion of
Assurance , Previous Participation
Certification – Controlling Participant , Early Commencement/Early Start
– Borrower Certification , Contractor's and/or
Mortgagor's Cost Breakdown , Application for Insurance of
Advance of Mortgage Proceeds , Request for Construction
Changes on Project Mortgages , Contractor's Requisition ,
Permission to
Occupy , Affirmative Fair Housing
Marketing Plan – 232 , Appraisal Sockets ,
Master Tenant
Assignment of Leases and Rents , Subordinate Cross-Default
Guaranty of Subtenants , Termination and Release of
Cross-Default Guaranty of Subtenants , Amendment to HUD Master Lease
(Partial Termination and Release) , Limited Guaranty and Security
Agreement , Management Agreement
Addendum , Operator Assignment of Leases
and Rents , Mortgagor's Certificate of
Actual Cost , Contractor's Certificate of
Actual Cost , Lender's Certification -
Insurance Coverage , Healthcare Regulatory
Agreement – Fire Safety , Rider to Security Instrument -
LIHTC , Security
Instrument/Mortgage/Deed of Trust Addenda (various states - AK)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - AL)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - AR)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - AZ)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - CA)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states -
CNM) , Security
Instrument/Mortgage/Deed of Trust Addenda (various states - CO)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - DE)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - FL)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - GA)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - GU)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - HI)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - IA)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - ID)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - IL)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - IN)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - KS)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - LA)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - MA)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - MD)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - ME)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - MI)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - MN)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - MO)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - MS)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - MT)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - NC)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - NE)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - NH)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - NJ)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - NM)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - NV)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - NY)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - OH)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - OK)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - OR)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - PA)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - RI)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - SC)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - SD)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - TN)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states -TX)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - UT)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - VA)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - VI)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - VT)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - WA)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - WI)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - WV)
, Security
Instrument/Mortgage/Deed of Trust Addenda (various states - WY)
, Healthcare
Facility Note - Rider (various states - AK) , Healthcare Facility Note -
Rider (various states - LA) , Healthcare Facility Note -
Rider (various states - ME) , Healthcare Facility Note -
Rider (various states - OR) , Healthcare Facility Note -
Rider (various states - VT) , Healthcare Facility Note -
Rider (various states - WA) , Escrow Agreement for Off-site
Facilities , Escrow Agreement for Debt
Service Reserves , Consolidated Operator Opinion
[Single State] , Multifamily Insurance Branch
Claim , Application for Insurance
Benefits , Mortgagee's Application for
Partial Settlement , Insurance Termination
Request , 232 Healthcare Portal
Access , Lender Narrative, Requests to
Release or Modify Original Loan Collateral , Lender Narrative, Accounts
Receivable , Lender Narrative, Loan
Modification , Loan Modification Lender
Certification , Mortgage Record Change -
232 , Application for Change of
Ownership , Lender Narrative, Change of
Operator/Lessee , Lender Narrative, Change of
Management Agent , Servicer's Notification to HUD
of Risks to Healthcare Project , Operator's Notification to HUD
of Threats to Permits and Approvals , Supplemental Addendum to
Operating Lease , Supplemental Master Lease
Addendum , Supplemental Operator Security
Agreement , Supplemental Operator
Assignment of Leases and Rents , Supplemental Master Lease
SNDA , Supplemental Master Tenant
Assignment of Leases and Rents , Supplemental Healthcare
Regulatory Agreement – Master Tenant , Supplemental Master Tenant
Security Agreement , Supplemental Lender's
Certificate for 241(a) , Supplemental Building Loan
Agreement for 241(a) , Supplemental Healthcare
Regulatory Agreement – Borrower , Supplemental Healthcare
Regulatory Agreement – Operator , Supplemental Security
Instrument/Mortgage/Deed of Trust , Supplemental Healthcare
Facility Note , Accounts Receivable Financing
Certification , Intercreditor Agreement ,
Operator
Estoppel Certificate , Guide for Opinion of
Borrowers Counsel , Exhibit A to Opinion of
Borrowers Counsel - Certification , Instructions to Guide for
Opinion of Borrowers and Operators Counsel , Guide for Opinion of
Operators Counsel, and Certification , Request for Waiver of Housing
Directive , Lenders FHA Number
Request , Borrowers Certificate of
Actual Cost , Management
Certification—Residential Care Facility , Contact Sheet ,
Subordination,
Non-Disturbance and Attornment Agreement of Operating Lease
(SNDA) , Survey Instructions and
Borrower's Certification , Refund Request for Overpayment
of Firm Application Exam Fee , Addendum to Operating
Lease , Financial Statement
Certification-Borrower , Residual Receipts Note
(Nonprofit Borrowers) , Lease Addendum ,
Surplus Cash Note
, Maximum
Insurable Loan Calculation , Operator Security
Agreement , Subordination Agreement
Financing , Healthcare Regulatory
Agreement Borrower , Healthcare Regulatory
Agreement Operator
ICR Summary 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
26,125
26,125
0
0
0
0
Annual Time Burden (Hours)
49,226
49,226
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:
Annual Cost to Federal Government:
$5,667,253
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?
No
Agency Contact: Emmanuel Yeow 865
474-8208
Common Form ICR: Yes
Description/Changes for Common Form
Usage:
Approved RCFs using this ICR
Agency/Sub Agency
RCF ID
RCF Title
RCF Status
IC Title