Information Collection

HECM Counseling Client Survey

IC 188036 under ICR 202202-2502-002 · OMB 2502-0585.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Sample Client Survey Letter.docx	Other-Sample Letter
HUD-92911 Home Equity Conversion Mortgage Counseling Session Evalu HUD-92911.docx	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 24 CFR 214

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Sample Letter			Sample Client Survey Letter.docx		No		Paper Only
Form	HUD-92911	Home Equity Conversion Mortgage Counseling Session Evaluation	HUD-92911.docx		No		Fillable Printable

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 5 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	300	0	300
Annual IC Time Burden (Hours)	75	25	50
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.