Single Family Application for Insurance Benefits

OMB 2502-0429

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

The latest form for Single Family Application for Insurance Benefits expires 2021-01-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form HUD 91022 Single Family Application for Insurance Benefits Form and Instruction
Supporting Statement A (1).docx Supporting Statement A
24cfr203.350.pdf Supplementary Document
24cfr203.355.pdf Supplementary Document
60-day notice 2023.pdf Supplementary Document
Single Family Application for Insurance Benefits Form and Instruction

All Historical Document Collections

202401-2502-004 Approved without change	Revision of a currently approved collection	2024-01-18
202005-2502-005	Revision of a currently approved collection	2020-09-29
201704-2502-006 Approved without change	Reinstatement with change of a previously approved collection	2017-07-27
201310-2502-012 Approved without change	Extension without change of a currently approved collection	2014-02-24
201104-2502-009 Approved without change	Revision of a currently approved collection	2012-06-19
200905-2502-001 Approved without change	Revision of a currently approved collection	2009-05-11
200611-2502-004 Approved without change	No material or nonsubstantive change to a currently approved collection	2006-11-30
200610-2502-008 Approved without change	Revision of a currently approved collection	2006-10-25
200606-2502-006 Approved without change	No material or nonsubstantive change to a currently approved collection	2006-06-13
200510-2502-004 Approved without change	No material or nonsubstantive change to a currently approved collection	2005-10-03
200308-2502-006 Approved without change	Extension without change of a currently approved collection	2003-08-27
200003-2502-003 Approved without change	Reinstatement without change of a previously approved collection	2000-03-28
199503-2502-004 Approved without change	Extension without change of a currently approved collection	1995-03-27
199209-2502-005 Approved without change	Reinstatement with change of a previously approved collection	1992-09-23
199001-2502-010 Approved without change	Revision of a currently approved collection	1990-01-03