Information Collection

Land Mortgage Lender Loan Checklist

IC 239944 under ICR 202212-1076-002 · OMB 1076-0195.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1076-0195 can be found here:

Documents and Forms

Document Name Document Type
Land Mortgage Lender Loan Checklist Form and Instruction
Land Mortgage Lender Loan Checklist Lender Loan Checklist edited.docx www.bia.gov/policy-forms/online-forms Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Land Mortgage Lender Loan Checklist	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 25 CFR 152.34

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A	Land Mortgage Lender Loan Checklist	Lender Loan Checklist edited.docx	https://www.bia.gov/policy-forms/online-forms	Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Homeownership Promotion

Privacy Act System of Records
Title: BIA-12: Indian Trust Land Mortgages	FR Citation: 48 FR 41105

Number of Respondents: 25	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 50 %

	Requested	Previously Approved
Annual Number of Responses for this IC	70	70
Annual IC Time Burden (Hours)	1,400	1,400
Annual IC Cost Burden (Dollars)	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.