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 94000-ORCF-ADD Transactional Documents for Mortgagees and Contractors	Form	Modified	Repair queued
2502-0605 Supporting Statement 1-22-21.docx	Supporting Statement A	Uploaded 2021-01-22	Missing upstream
Emergency Justification Memo_PRA_90011t.jpg	Supplementary Document	Uploaded 2021-01-21	Repair queued
2502-0605 - PTA (Signed by Privacy Office).pdf	Supplementary Document	Uploaded 2018-12-21	Missing upstream
Re-Published 15-Day FRN for Collection 2502-0605, 6-29-18.pdf	Supplementary Document	Uploaded 2018-12-21	Repair queued
Published 30 Day FRN for Collection 2502-0605, 4-10-2018.pdf	Supplementary Document	Uploaded 2018-12-21	Repair queued
Published 60 FRN for Collection 2502-0605, 5-19-2017.pdf	Supplementary Document	Uploaded 2018-12-21	Repair queued
12 US CODE 1713.pdf	Supplementary Document	Uploaded 2018-12-21	Repair queued
12 US CODE 1715n.pdf	Supplementary Document	Uploaded 2018-12-21	Repair queued
12 US CODE 1715.pdf	Supplementary Document	Uploaded 2018-12-21	Missing upstream
12 USC 1701.pdf	Supplementary Document	Uploaded 2018-12-21	Repair queued
48 Stat. 1246.pdf	Supplementary Document	Uploaded 2018-12-21	Repair queued
Public Law 73-479, National Housing Act.pdf	Supplementary Document	Uploaded 2018-12-21	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
204773	Transactional Documents for Mortgagees and Contractors	Form	Modified

ICR Details

OMB Control No: 2502-0605	ICR Reference No: 202101-2502-003
Status: Received in OIRA	Previous ICR Reference No: 202008-2502-004
Agency/Subagency: HUD/OH	Agency Tracking No:
Title: Comprehensive Listing of Transactional Documents for Mortgagors, Mortgagees and Contractors
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  Yes
Type of Review Request: Emergency	Approval Requested By: 02/09/2021
Date Submitted to OIRA: 02/03/2021

table that charts list comparision

	Requested	Previously Approved
Expiration Date	05/31/2021	06/30/2022
Responses	26,225	26,125
Time Burden (Hours)	50,727	49,226
Cost Burden (Dollars)	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).

Emergency Justfication: To implement emergency legislation contained in the recently enacted Consolidated Appropriations Act of 2021, the Department issued Mortgagee Letter 21-01 on Friday, January 15. That ML referenced as forthcoming the Lender Narrative essential for lenders’ applications under the emergency legislation. This emergency processing is essential to implement emergency legislation providing healthcare facilities FHA-insured loans needed due to losses resulting from the COVID-19 pandemic. Immediate implementation is needed to help assure viability of some currently insured facilities and thus diminish the risk of insurance claims. HUD is seeking emergency review of the Paperwork Reduction Act requirements contained the document entitled “Lender Narrative – Operating Loss Loan-COVID--Section 232/223(d).” This is a new temporary form, requested under the current OMB Approval No. 2502-0605 (exp. 6/30/222) and having document number HUD-90011t-ORCF. This new form has been adapted from a PRA-approved document that continues to be in use and is not itself being revised, that being HUD-90011-ORCF, “Lender Narrative—Operating Loss Loan Section 232/223(d).” The supplemental temporary form, containing “COVID” in its title, is for the operating loss loans that are specifically COVID-related and are being submitted pursuant to the temporary emergency legislative authority.

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

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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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	94000-ORCF-ADD, 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, 92334A-ORCF, 92467-ORCF, 94001A-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, 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, 94001-ORCF-RI, 92467A-ORCF, 1044-D-ORCF, 92340A-ORCF, 92441B-ORCF, 93335-ORCF, 2747-ORCF, 9807-ORCF, 90032-ORCF, 92266B-ORCF, 92323A-ORCF, 92434A-ORCF, 94000A-ORCF, 91117-ORCF, 92264a-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, 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, 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, 92485-ORCF, 935.2D-ORCF, 92000-ORCF, 90023-ORCF, 94000-ORCF-ADD, 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, 90030-ORCF, 90031-ORCF, 90033-ORCF, 92266A-ORCF, 92324A-ORCF, 94000-ORCF-ADD, 94000-ORCF-ADD, 91071-ORCF, 92476C-ORCF, 92327-ORCF, HUD-90011t-ORCF	Security Instrument/Mortgage/Deed of Trust Addenda (various states - NH) ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - NE) ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - NM) ,   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 - VT) ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - WV) ,   Healthcare Facility Note - Rider (various states - AK) ,   Healthcare Facility Note - Rider (various states - LA) ,   Healthcare Facility Note - Rider (various states - OR) ,   Healthcare Facility Note - Rider (various states - WA) ,   Mortgage Record Change - 232 ,   Supplemental Master Lease Addendum ,   Supplemental Master Lease SNDA ,   Amendment to HUD Master Lease (Partial Termination and Release) ,   Management Agreement Addendum ,   Operator Assignment of Leases and Rents ,   Mortgagor's Certificate of Actual Cost ,   Contractor's Certificate of Actual Cost ,   Rider to Security Instrument - LIHTC ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - AK) ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - CO) ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - CNM) ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - DE) ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - KS) ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - MD) ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - NC) ,   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 - SC) ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - TN) ,   Supplemental Master Tenant Assignment of Leases and Rents ,   Supplemental Healthcare Regulatory Agreement – Borrower ,   Supplemental Healthcare Facility Note ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - AZ) ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - IN) ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - MA) ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - ME) ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - MO) ,   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 - GA) ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - FL) ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - GU) ,   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 - MN) ,   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 - NV) ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - NY) ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states -TX) ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - WI) ,   Termination and Release of Cross-Default Guaranty of Subtenants ,   Healthcare Facility Note - Rider (various states - ME) ,   Mortgagee's Application for Partial Settlement ,   232 Healthcare Portal Access ,   Application for Change of Ownership ,   Servicer's Notification to HUD of Risks to Healthcare Project ,   Supplemental Addendum to Operating Lease ,   Supplemental Healthcare Regulatory Agreement – Master Tenant ,   Healthcare Facility Note - Rider (various states - VT) ,   Supplemental Healthcare Regulatory Agreement – Operator ,   Multifamily Insurance Branch Claim ,   Supplemental Master Tenant Security Agreement ,   Supplemental Building Loan Agreement for 241(a) ,   Operator's Notification to HUD of Threats to Permits and Approvals ,   Application for Insurance Benefits ,   Insurance Termination Request ,   Lender Narrative, Loan Modification ,   Lender Narrative, Change of Management Agent ,   Supplemental Operator Security Agreement ,   Supplemental Lender's Certificate for 241(a) ,   Supplemental Security Instrument/Mortgage/Deed of Trust ,   Operator Estoppel Certificate ,   Maximum Insurable Loan Calculation ,   Operator Security Agreement ,   Subordination Agreement Financing ,   Healthcare Regulatory Agreement – Borrower ,   Funds Authorization ,   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 Physical Condition Compliance ,   Monthly Report for Establishing Net Income ,   Schedule B - Schedule of Disbursements ,   Forecasted Staffing Schedule ,   Financial Statement Certification-General Contractor ,   Lender Certification for New Construction, Cost Certifications ,   HUD Amendment to AIA Document B108 ,   Escrow Agreement for Working Capital ,   Building Loan Agreement ,   Building Loan Agreement Supplemental ,   Construction Contract ,   Performance Bond - Dual Obligee ,   Payment Bond ,   Accounts Receivable Financing Certification ,   Intercreditor Agreement ,   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 ,   Subordination, Non-Disturbance and Attornment Agreement of Operating Lease (SNDA) ,   Refund Request for Overpayment of Firm Application Exam Fee ,   Financial Statement Certification-Borrower ,   Residual Receipts Note (Nonprofit Borrowers) ,   Lease Addendum ,   Surplus Cash Note ,   Healthcare Regulatory Agreement – Operator ,   Security Instrument/ Mortgage/Deed of Trust ,   Healthcare - Facility Note ,   Certification of Exigent Health & Safety (EH&S) Issues ,   Schedule C - Schedule of Accounts Payable ,   Computation of Surplus Cash, Distributions and Residual Receipts ,   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 ,   Lender Narrative – Section 232/241(a) ,   Lender Narrative-Section 232/223(f) Refinance ,   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 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 – 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 ,   Off-Site Bond – Dual Obligee ,   Escrow Agreement for Incomplete Construction ,   Supplementary Conditions of the Contract for Construction ,   Agreement and Certification ,   Completion of Assurance ,   Memo Requesting Post-Commitment Early Start of Construction ,   Design Professional’s Certification of Liability Insurance ,   Design Architect’s Certification ,   Request for Final Endorsement of Credit Instrument ,   Request for Permission to Commence Construction ,   Consolidated Certifications – Principal of Borrower ,   Request for Endorsement of Credit Instrument & Certificate of Lender, Borrower & General Contractor ,   Guide for Opinion of Borrower’s Counsel ,   Lender’s FHA Number Request ,   Borrower’s Certificate of Actual Cost ,   Management Certification—Residential Care Facility ,   Contact Sheet ,   Survey Instructions and Borrower'’s Certification ,   Addendum to Operating Lease ,   Previous Participation Certification – Controlling Participant ,   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 ,   Early Commencement/Early Start – Borrower Certification ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - AR) ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - CA) ,   Limited Guaranty and Security Agreement ,   Master Tenant Assignment of Leases and Rents ,   Subordinate Cross-Default Guaranty of Subtenants ,   Lender's Certification - Insurance Coverage ,   Healthcare Regulatory Agreement – Fire Safety ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - AL) ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - HI) ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - LA) ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - MI) ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - NJ) ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - RI) ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - SD) ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - WY) ,   Lender Narrative, Requests to Release or Modify Original Loan Collateral ,   Lender Narrative, Accounts Receivable ,   Loan Modification Lender Certification ,   Lender Narrative, Change of Operator/Lessee ,   Supplemental Operator Assignment of Leases and Rents ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - UT) ,   Security Instrument/Mortgage/Deed of Trust Addenda (various states - WA) ,   Escrow Agreement for Off-site Facilities ,   Escrow Agreement for Debt Service Reserves ,   Consolidated Operator Opinion [Single State] ,   Lender Narrative – Operating Loss Loan Section 232/223(d) – COVID

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ICR Summary of Burden

table that charts list of burden

	Total Request	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	26,225	26,125	0	100	0	0
Annual Time Burden (Hours)	50,727	49,226	0	1,501	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Changing Regulations

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

Burden Reduction Due to:

Short Statement: HUD-90011t is being added as a supplemental temporary form, containing “COVID” in its title, is for the operating loss loans that are specifically COVID-related and are being submitted pursuant to the temporary emergency legislative authority. This emergency processing is essential to implement emergency legislation providing healthcare facilities FHA-insured loans needed due to losses resulting from the COVID-19 pandemic. Immediate implementation is needed to help assure viability of some currently insured facilities and thus diminish the risk of mortgage insurance claims.

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Annual Cost to Federal Government: $5,682,629

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

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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: 02/03/2021

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