HECM Counseling Client Survey

Documents and Forms

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

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	HECM Counseling Client Survey	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:

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 %

	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

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.