View Information Collection Request (ICR) Package
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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
2502-0605
ICR Reference No:
202112-2502-001
Status:
Historical Active
Previous ICR Reference No:
202108-2502-001
Agency/Subagency:
HUD/OH
Agency Tracking No:
Title:
Comprehensive Listing of Transactional Documents for Mortgagors, Mortgagees and Contractors
Type of Information Collection:
No material or nonsubstantive change to a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
01/28/2022
Retrieve Notice of Action (NOA)
Date Received in OIRA:
12/01/2021
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
11/30/2022
11/30/2022
11/30/2022
Responses
26,125
0
26,125
Time Burden (Hours)
49,226
0
49,226
Cost Burden (Dollars)
0
0
0
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).
Authorizing Statute(s):
US Code:
12 USC 1715n
Name of Law: Misc Housing Insurance
US Code:
12 USC 1713
Name of Law: Rental Housing Insurance
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
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:
86 FR 35523
07/06/2021
30-day Notice:
Federal Register Citation:
Citation Date:
86 FR 50150
09/07/2021
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
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, 94000-ORCF-ADD, 94000-ORCF-ADD, 92341-ORCF, 94000-ORCF-ADD, 94000-ORCF-ADD, 94000-ORCF-ADD, 94001-ORCF-RI, 2537-ORCF, 90029-ORCF, 92266-ORCF, 94001-ORCF-RI, 93334-ORCF, 91116A-ORCF, 92338A-ORCF, 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, 92414-ORCF, 95379-ORCF, 9443-ORCF, 91128-ORCF, 92464-ORCF, 92476-ORCF, 92476B-ORCF, 9001-ORCF, 9003-ORCF, 9002-ORCF, 9004-ORCF, 9005-ORCF, 9005a-ORCF, 92554-ORCF, 93305-ORCF, 92450-ORCF, 9442-ORCF, 91123-ORCF, 9006-ORCF, 9007-ORCF, 9007a-OCRF, 9009-ORCF, 9444-ORCF, 90010-ORCF, 90011-ORCF, 92211-ORCF, 92331-ORCF, 92333-ORCF, 92335-ORCF, 9445-ORCF, 92337-ORCF, 92339-ORCF, 92340-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, 91124-ORCF, 92023-ORCF, 92415-ORCF, 941-ORCF, 90014-ORCF, 92455-ORCF, 91725-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, 92343-ORCF, 90023-ORCF, 92336-ORCF, 94000-ORCF-ADD, 94000-ORCF-ADD, 92334-ORCF, 92435-ORCF, 94000-ORCF-ADD, 92468-ORCF, 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, 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, 92333A-ORCF, 92211A-ORCF, 94001-ORCF-RI, 92080-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, 94001A-ORCF, 94000-ORCF-ADD, 92334A-ORCF, 94000-ORCF-ADD, 92467-ORCF, 94000-ORCF-ADD, 94000-ORCF-ADD, 94000-ORCF-ADD, 94000-ORCF-ADD, 94000-ORCF-ADD, 94000-ORCF-ADD, 94000-ORCF-ADD
Accounts Receivable Financing Certification
,
Intercreditor Agreement
,
Operator Estoppel Certificate
,
Guide for Opinion of Borrowers Counsel
,
Exhibit A to Opinion of Borrowers Counsel - Certification
,
Instructions to Guide for Opinion of Borrowers and Operators Counsel
,
Guide for Opinion of Operators Counsel, and Certification
,
Request for Waiver of Housing Directive
,
Lenders FHA Number Request
,
Borrowers Certificate of Actual Cost
,
Management Certification—Residential Care Facility
,
Contact Sheet
,
Subordination, Non-Disturbance and Attornment Agreement of Operating Lease (SNDA)
,
Survey Instructions and Borrower's Certification
,
Refund Request for Overpayment of Firm Application Exam Fee
,
Addendum to Operating Lease
,
Financial Statement Certification-Borrower
,
Residual Receipts Note (Nonprofit Borrowers)
,
Lease Addendum
,
Surplus Cash Note
,
Maximum Insurable Loan Calculation
,
Operator Security Agreement
,
Subordination Agreement Financing
,
Healthcare Regulatory Agreement Borrower
,
Healthcare Regulatory Agreement Operator
,
Security Instrument/ Mortgage/Deed of Trust
,
Healthcare - Facility Note
,
Funds Authorization
,
Borrowers 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 Exigent Health & Safety (EH&S) Issues
,
Certification of Physical Condition Compliance
,
Monthly Report for Establishing Net Income
,
Schedule B - Schedule of Disbursements
,
Schedule C - Schedule of Accounts Payable
,
Computation of Surplus Cash, Distributions and Residual Receipts
,
Memo Requesting Post-Commitment Early Start of Construction
,
Design Professionals Certification of Liability Insurance
,
Design Architects Certification
,
Forecasted Staffing Schedule
,
Financial Statement Certification-General Contractor
,
Lender Certification for New Construction, Cost Certifications
,
Request for Final Endorsement of Credit Instrument
,
HUD Amendment to AIA Document B108
,
Escrow Agreement for Working Capital
,
Request for Permission to Commence Construction
,
Building Loan Agreement
,
Building Loan Agreement Supplemental
,
Construction Contract
,
Performance Bond - Dual Obligee
,
Payment Bond
,
Request for Endorsement of Credit Instrument & Certificate of Lender, Borrower & General Contractor
,
Escrow Agreement for Incomplete Construction
,
Off-Site Bond Dual Obligee
,
Supplementary Conditions of the Contract for Construction
,
Agreement and Certification
,
HUD Representatives 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 232/223(f) Refinance
,
Lender Narrative Section 232/241(a)
,
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 Tenants 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 Principal of 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
,
Lenders Certificate
,
Completion of Assurance
,
Previous Participation Certification – Controlling Participant
,
Early Commencement/Early Start – Borrower Certification
,
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
,
Master Tenant Assignment of Leases and Rents
,
Subordinate Cross-Default Guaranty of Subtenants
,
Termination and Release of Cross-Default Guaranty of Subtenants
,
Amendment to HUD Master Lease (Partial Termination and Release)
,
Limited Guaranty and Security Agreement
,
Management Agreement Addendum
,
Operator Assignment of Leases and Rents
,
Mortgagor's Certificate of Actual Cost
,
Contractor's Certificate of Actual Cost
,
Lender's Certification - Insurance Coverage
,
Healthcare Regulatory Agreement – Fire Safety
,
Rider to Security Instrument - LIHTC
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - AK)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - AL)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - AR)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - AZ)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - CA)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - CNM)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - CO)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - DE)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - FL)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - GA)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - GU)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - HI)
,
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 - IN)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - KS)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - LA)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - MA)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - MD)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - ME)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - MI)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - MN)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - MO)
,
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 - NC)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - NE)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - NH)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - NJ)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - NM)
,
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 - OH)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - OK)
,
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 - RI)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - SC)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - SD)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - TN)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states -TX)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - UT)
,
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 - VT)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - WA)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - WI)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - WV)
,
Security Instrument/Mortgage/Deed of Trust Addenda (various states - WY)
,
Healthcare Facility Note - Rider (various states - AK)
,
Healthcare Facility Note - Rider (various states - LA)
,
Healthcare Facility Note - Rider (various states - ME)
,
Healthcare Facility Note - Rider (various states - OR)
,
Healthcare Facility Note - Rider (various states - VT)
,
Healthcare Facility Note - Rider (various states - WA)
,
Escrow Agreement for Off-site Facilities
,
Escrow Agreement for Debt Service Reserves
,
Consolidated Operator Opinion [Single State]
,
Multifamily Insurance Branch Claim
,
Application for Insurance Benefits
,
Mortgagee's Application for Partial Settlement
,
Insurance Termination Request
,
232 Healthcare Portal Access
,
Lender Narrative, Requests to Release or Modify Original Loan Collateral
,
Lender Narrative, Accounts Receivable
,
Lender Narrative, Loan Modification
,
Loan Modification Lender Certification
,
Mortgage Record Change - 232
,
Application for Change of Ownership
,
Lender Narrative, Change of Operator/Lessee
,
Lender Narrative, Change of Management Agent
,
Servicer's Notification to HUD of Risks to Healthcare Project
,
Operator's Notification to HUD of Threats to Permits and Approvals
,
Supplemental Addendum to Operating Lease
,
Supplemental Master Lease Addendum
,
Supplemental Operator Security Agreement
,
Supplemental Operator Assignment of Leases and Rents
,
Supplemental Master Lease SNDA
,
Supplemental Master Tenant Assignment of Leases and Rents
,
Supplemental Healthcare Regulatory Agreement – Master Tenant
,
Supplemental Master Tenant Security Agreement
,
Supplemental Lender's Certificate for 241(a)
,
Supplemental Building Loan Agreement for 241(a)
,
Supplemental Healthcare Regulatory Agreement – Borrower
,
Supplemental Healthcare Regulatory Agreement – Operator
,
Supplemental Security Instrument/Mortgage/Deed of Trust
,
Supplemental Healthcare Facility Note
ICR Summary 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
26,125
26,125
0
0
0
0
Annual Time Burden (Hours)
49,226
49,226
0
0
0
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:
Annual Cost to Federal Government:
$5,960,472
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
Agency Contact:
Emmanuel Yeow 865 474-8208
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:
12/01/2021
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