Single Family Application for Insurance Benefits

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form HUD-27011 Single Family Application for Insurance Benefits	Form and Instruction	Modified	Available
Form HUD-9519a Property Inspection Report	Form and Instruction	Modified	Available
Form HUD 09539 Request for Occupied Conveyance	Form and Instruction	Modified	Available
Form HUD 50002 Request to Exceed Cost Limits for Preservaiton and Protection	Form and Instruction	Modified	Available
Form HUD 50012 Mortgagee's Request fo Extension of Time Requirments	Form and Instruction	Modified	Available
Form HUD 91022 Mortgagee Notice of Foreclosure	Form and Instruction	Modified	Available
Form HUD 91022 Single Family Application for Insurance Benefits	Form and Instruction	Modified	Repair queued
Supporting Statement A (1).docx	Supporting Statement A	Uploaded 2024-01-16	Repair queued
24cfr203.350.pdf	Supplementary Document	Uploaded 2024-01-05	Repair queued
24cfr203.355.pdf	Supplementary Document	Uploaded 2024-01-05	Repair queued
60-day notice 2023.pdf	Supplementary Document	Uploaded 2024-01-05	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
42065	Single Family Application for Insurance Benefits	Form and Instruction	Modified	Single Family Application for Insurance Benefits
42065	Single Family Application for Insurance Benefits	Form and Instruction	Modified	Property Inspection Report
42065	Single Family Application for Insurance Benefits	Form and Instruction	Modified	Request for Occupied Conveyance
42065	Single Family Application for Insurance Benefits	Form and Instruction	Modified	Request to Exceed Cost Limits for Preservaiton and Protection
42065	Single Family Application for Insurance Benefits	Form and Instruction	Modified	Mortgagee's Request fo Extension of Time Requirments
42065	Single Family Application for Insurance Benefits	Form and Instruction	Modified	Mortgagee Notice of Foreclosure
42065	Single Family Application for Insurance Benefits	Form and Instruction	Modified

ICR Details

OMB Control No: 2502-0429	ICR Reference No: 202401-2502-004
Status: Active	Previous ICR Reference No: 202005-2502-005
Agency/Subagency: HUD/OH	Agency Tracking No:
Title: Single Family Application for Insurance Benefits
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/28/2024
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/18/2024
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2027	36 Months From Approved	02/29/2024
Responses	10,062,965	0	1,125,455
Time Burden (Hours)	1,885,241	0	933,416
Cost Burden (Dollars)	0	0	0

---

Abstract: This information collection is used to provide HUD the information needed to process and pay claims on defaulted FHA-insured home mortgage loans.

---

Authorizing Statute(s): None

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:
	88 FR 59938	08/30/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 219	11/15/2023
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Single Family Application for Insurance Benefits	HUD 91022, HUD 50012, HUD 09539, HUD 50002, HUD-9519a, HUD-27011	Mortgagee Notice of Foreclosure ,   Mortgagee's Request fo Extension of Time Requirments ,   Request to Exceed Cost Limits for Preservaiton and Protection ,   Request for Occupied Conveyance ,   Property Inspection Report ,   Single Family Application for Insurance Benefits

---

ICR Summary of Burden

table that charts list 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	10,062,965	1,125,455	0	0	8,937,510	0
Annual Time Burden (Hours)	1,885,241	933,416	0	0	951,825	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: This is a revision of a currently approved information collection. The collection of information has been updated with new figures to represent the Department’s current claims activity. As a result of this activity, an increase in the number of respondents and annual burden hours occurred, decrease in the number of responses, particularly since most claims are filed electronically. The reporting of the HUD-27011 for the HECM loans has previously been captured on OMB Control Number 2502-0611, but is being incorporated into this collection as it a claim process and more closely aligns with this collection. Four forms were updated as indicated with the following minor edits and the HUD-9519-A is being retired. Form Number Minor Edits

---

Annual Cost to Federal Government: $247,156

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

---

Common Form ICR:  No

---

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: 01/18/2024

---