Information Collection

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

IC 27279 under ICR 202011-2502-005 · OMB 2502-0524.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2502-0524 can be found here:

2024-03-28 - Revision of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form HUD-92902 Home Equity Conversion Mortgage (HECM) Insurance Application for Reverse Mortgages and Related Documents	Form
HUD-92902 Certificate of HECM Counseling HECM certification 92902 final version.doc	Form
HUD-92902 Certificate of HECM Counseling HECM certification 92902 final version.doc	Form
HUD-92901 HECM Anti Churning Disclosure 92901 Anti Churning.pdf	Form
HUD-92901 HECM Anti Churning Disclosure 92901 Anti Churning.pdf	Form
FANNIE-MAE-1009 Residential Loan Application for Reverse Mortgages fnma1009.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
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-1003 Uniform Residential Loan Application 1003.pdf	Form
fnma-1004 Uniform Residential Appraisal Report 1004.pdf	Form
fnma-1004 Uniform Residential Appraisal Report 1004.pdf	Form
fnma-1004c Manufactured Home Appraisal Report 1004c.pdf	Form
fnma-1004c Manufactured Home Appraisal Report 1004c.pdf	Form
fnma-1025 Small Residential Income Property Appraisal Report 1025.pdf	Form
fnma-1025 Small Residential Income Property Appraisal Report 1025.pdf	Form
HUD-92051 Compliance Inspection Report 92051.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-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-92800-5b Conditional Commitment Direct Endorsement Statement of A 92800-5b.pdf	Form
HUD-1 Settlement Statement HUD-1.pdf	Form
HUD-1 Settlement Statement HUD-1.pdf	Form
HUD-1a Settlement Statement Optional for Transactions Without S HUD-1a.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
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
AUTHORIZATION TO ESTABLISH A PAD ACCOUNT.doc Authorization to Establish PAD Account	IC Document
CONDOMINIUM RIDER.doc Condominium Rider	IC Document
CONDOMINIUM RIDER.doc Condominium Rider	IC Document
HOME EQUITY CONVERSION LOAN AGREEMENT.doc Home Equity Conversion Loan Agreement	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
MODEL ADJUSTABLE RATE NOTE FORM.doc Model Adjustable Rate Note Form	IC Document
NOTICE TO THE BORROWER.doc Notice to the Borrower	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
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
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
MODEL FIXED RATE SECOND NOTE FORM.doc Model Fixed Rate Second Note Form	IC Document
REPAIR RIDER.doc Repair Rider	IC Document
REPAIR RIDER.doc Repair Rider	IC Document
SHARED APPRECIATION RIDER.doc Shared Appreciation 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
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 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 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 FIXED RATE NOTE FORM.doc Model Fixed Rate Note Form	IC Document
MODEL MORTGAGE FORM.doc Model Mortgage 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
MODEL FIXED RATE SECOND NOTE FORM.doc Model Fixed Rate Second Note Form	IC Document
SHARED APPRECIATION ALLONGE.doc Shared Appreciation Allonge	IC Document
SHARED APPRECIATION ALLONGE.doc Shared Appreciation Allonge	IC Document

Information Collection (IC) Details

View Information Collection (IC)

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HUD-92902	Certificate of HECM Counseling	HECM certification 92902 final version.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
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

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: 2,375

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	59,375	-20,625	80,000
Annual IC Time Burden (Hours)	116,399	-136,401	252,800
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.