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Federal forms, ICRs, and supporting documents

Information Collection Request

A) APPLICATION FOR MORTGAGE OR RENTAL PAYMENT ASSISTANCE B) MORTGAGOR/LANDLORD VERIFICATION STATEMENT C) RECERTIFICATION FOR MORTGAGE OR RENTAL PAYMENT ASSISTANCE

ICR 198310-3067-002 · OMB 3067-0004 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
151716 A) APPLICATION FOR MORTGAGE OR RENTAL PAYMENT ASSISTANCE B) MORTGAGOR/LANDLORD VERIFICATION STATEMENT C) RECERTIFICATION FOR MORTGAGE OR RENTAL PAYMENT ASSISTANCE Form Migrated
ICR Details
3067-0004 198310-3067-002
Historical Active 198208-3067-019
FEMA
A) APPLICATION FOR MORTGAGE OR RENTAL PAYMENT ASSISTANCE B) MORTGAGOR/LANDLORD VERIFICATION STATEMENT C) RECERTIFICATION FOR MORTGAGE OR RENTAL PAYMENT ASSISTANCE
Revision of a currently approved collection   No
Regular
Approved without change 12/14/1983
Retrieve Notice of Action (NOA) 10/25/1983
  Inventory as of this Action Requested Previously Approved
10/31/1986 10/31/1986 12/31/1983
175 0 25
52 0 8
0 0 0
FORMS ARE USED TO ESTABLISH THE REQUEST AND NEED OF A VICTIM OF A PRESIDENTIALLY DECLARED DISASTER FOR MORTGAGE OR RENTAL PAYMENT ASSISTANCE. INFORMATION IS USED IN CONTACT AND IDENTIFICATION OF NEED TO DETERMINE ELIGIBILITY AND CONTINUING NEED FOR ASSISTANCE AND VERIFICATION OF DATA OBTAINED FROM THE APPLICANT BY CONTACT WITH EMPLOYERS, LENDING INSTITUTIONS AND LANDLORDS.
None
None
No
  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 175 25 0 0 150 0
Annual Time Burden (Hours) 52 8 0 0 44 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
10/25/1983