Acknowledgement Receipt of Required Docs AR (Pre HOTMA)
$20
Use this form to document that all required forms have been provided at AR. This version of the Acknowledgement includes the requirement for residents to sign a new 9887 at each AR. The 9887 WILL NOT BE REQUIRED AT EACH AR ONCE HUD RELEASES and RESIDENTS EXECUTE THE NEW 9887.
Acknowledgement Receipt of Required Docs AR HOTMA
$20
Updated for HOTMA and/or TRACS 2.0.3.A Use this form to document that all required forms have been provided at AR. HUD has not yet provided the new 9887 Package. Once the new 9887 is released, owner/agents will be required to provide the 9887 1) when an applicant is at the top of the waiting list (eligibility interview), 2) when a new adult is added, 3) when a minor turns 18 and 4) if subsidy is terminated then reinstated. The 9887 WILL NOT BE REQUIRED AT EACH AR ONCE HUD RELEASES and RESIDENTS EXECUTE THE NEW 9887.
Checklist EIV 90 Day Post Move In (Pre HOTMA)
$20
Previous to implementation of HOTMA, the requirement is to review EIV Income Reports within 90 days of submission of a Move-in/IC or an IR adding a new member. Use this checklist to document review of EIV reports within 90 days of submitting a Move-in/IC or an IR adding a new member. Owner/agents must review the Income Report and the Income Discrepancy Report.
Checklist EIV AR/IR (Pre HOTMA)
$20
Pre-HOTMA, review of the EIV Income Reports is required at AR and IR, regardless of the reason for the IR. Owner/agents are required to review the EIV Income Discrepancy Reports. This checklist includes the EIV Discrepancy Workbook.
Checklist EIV Recertification
$20
Updated for HOTMA. With the implementation of HOTMA, use of EIV Income Reports at IR will be optional. In addition, use of the EIV Income Discrepancy Report will be optional. Use this checklist to document review of EIV reports at AR and IR. Sites should not implement new EIV rules until HOTMA compliant site software is available.
Checklist EIV Recertification HOTMA
$20
Updated for HOTMA and/or TRACS 2.0.3.A Owner/agents must not implement HOTMA EIV Changes until HOTMA compliant site software is available and implemented.With the implementation of HOTMA, use of EIV Income Reports at IR will be optional. In addition, use of the EIV Income Discrepancy Report is not required until HUD updates the algorithm used to identify a discrepancy. Use this checklist to document review of EIV reports at AR.
Checklist File AR
$20
HUD does not provide a “HUD approved” File Checklist. This is a sample. It should be edited to conform to your management company’s policy and procedure.
Checklist Unit Inspection Annual
$20
This checklist was created to help prepare for the MOR and to assist in documenting the unit inspection process. Be sure to review and modify to reflect your company’s process. HUD also provides a different unit inspection form.
Checklist Unit Inspection Follow Up
$20
This is used when the owner/agent need to complete a follow up to a previous inspection.
Citizen Declaration
$20
HUD does provide a Sample Citizenship Declaration in HUD Handbook 4350.3, Exhibit 3-5.This form was created using the sample as a model. We have opted to remove inquiries about gender. We have also removed the inquiry re: relationship to HOH since this information is gathered on the application.
Citizen Eligibility Verification Consent
$20
HUD does provide a Sample Citizenship Verification Consent Form in HUD Handbook 4350.3 Exhibit 3-6. This form was created using the sample as a model.
Citizen Family Summary
$20
HUD does provide a Sample Family Summary in HUD Handbook 4350.3 Exhibit 3-4. This form has been designed to conform to that sample. We have opted to remove inquiries about gender. We have also removed the inquiry re: relationship to HOH since this information is gathered on the application.
Citizen Family/Owner Summary
$20
This form combines the Family Summary and the Owner Summary in to one form. Residents complete and sign and the property staff adds verification information.
Citizen Owner Summary
$20
HUD does provide a Sample Owner Summary in HUD Handbook 4350.3. This form has been designed to conform to that sample. We have opted to remove inquiries about gender. We have also removed the inquiry re: relationship to HOH since this information is gathered on the application.
Consent Contact Electronic
$20
This document can be used to obtain alternative contact information for each resident. Alternative contact information could be cell phone numbers, email addresses, etc. This allows you to email or text information to each resident and to provide documents in electronic format versus paper except as required by regulation..
Consent HUD Disclosure of EIV Information
$20
In HUD Notice 13-06, HUD clarified that EIV information can only be disclosed 1) to people participating in the certification process 2) only with written permission. HUD added a sample form with the release of the HUD Notice 11-21. Subsequently, this form was added to HH 4350.3 Exhibit 9-4 in December 2013. This requirement applies to adult household members. We have taken the PDF version in the notice and converted it to Microsoft Word. Please note that this version is available for free on our RBD EIV Resource Page.
Consent Release General
$20
HUD does not provide a “HUD approved” general release document. HUD Form 9887 and 9887A provide some provisions for release of information. This is a sample general release form. It should be edited to conform to your management company’s policy and procedure. It is STRONGLY recommended that you seek legal counsel before implementing this form. State laws must be considered.
Consent Release Utility Usage Information
$20
HUD released a sample consent as part of HUD Notice 2015-04. This is a modified sample. It should be edited to conform to your management company’s policy and procedure.
Consent Utility Reimbursement to Utility Provider
$20
This form may be used to document a resident's consent to send any Utility Reimbursement to the Utility Provider
Notice AR 120 Day (Pre HOTMA)
$20
This is an alternative to the sample 120 Day AR Reminder Notice provided in HH 4350.3. This version includes fair housing language describing residents' rights (e.g. LEP, S504, etc.). The list of required documents is a Pre-HOTMA list and includes things like six statements for a checking account, 4 pay stubs, etc. The list of required documents is a Pre-HOTMA list and includes things like six statements for a checking account, 4 pay stubs, etc. Please note: Owner/agents are not required to implement HOTMA changes until HOTMA compliant site software is available and implemented.
Notice AR 120 Day HOTMA
$20
Updated for HOTMA and/or TRACS 2.0.3.A This is an alternative to the sample 120 Day AR Reminder Notice provided in HH 4350.3. This version includes fair housing language describing residents' rights (e.g. LEP, S504, etc.) The list of required documents has been updated for HOTMA list and includes things like one statements for a checking account, 2 pay stubs, etc. Please note: Owner/agents are not required to implement HOTMA changes until HOTMA compliant site software is available and implemented.
Notice AR 120Day with Questionnaire AR (Pre HOTMA)
$70
This is a new 120-Day Reminder Notice updated to include new documentation requirements and new Asset and Income Self-Certifications. This form is designed to be completed by each adult household member to ensure the most accurate reporting. If an owner/agent opts to adopt Streamlined Verification of Assets, Streamlined Verification of Fixed Income, or Streamlined Certification for Fixed Income Families the associated AR Questionnaire is formatted to facilitate implementation. The list of required documents is a Pre-HOTMA list and includes things like six statements for a checking account, 4 pay stubs, etc. Please note: Owner/agents are not required to implement HOTMA changes until HOTMA compliant site software is available and implemented.
Notice AR 120Day with Questionnaire AR HOTMA
$70
Updated for HOTMA and/or TRACS 2.0.3.A This is a new 120-Day Reminder Notice updated to include new documentation requirements and new Asset and Income Self-Certifications. This form is designed to be completed by each adult household member to ensure the most accurate reporting. If an owner/agent opts to adopt Streamlined Verification of Assets, Streamlined Verification of Fixed Income, or Streamlined Certification for Fixed Income Families the associated AR Questionnaire is formatted to facilitate implementation. The list of required documents has been updated for HOTMA list and includes things like one statements for a checking account, 2 pay stubs, etc. Please note: Owner/agents are not required to implement HOTMA changes until HOTMA compliant site software is available and implemented.
Notice AR 60 Day (Pre HOTMA)
$20
This is an alternative to the sample 60 Day AR Reminder Notice provided in HH 4350.3. This version includes fair housing language describing residents' rights (e.g. LEP, S504, etc.) This Notice also includes a list of forms that will be needed to submitted to enable the owner/agent to complete the AR. Please note that the submission form on this version of the 3rd AR Reminder does not include HOTMA changes. The list of required documents is a Pre-HOTMA list and includes things like six statements for a checking account, 4 pay stubs, etc. Please note: Owner/agents are not required to implement HOTMA changes until HOTMA compliant site software is available and implemented.
Notice AR 60 Day HOTMA
$20
Updated for HOTMA and/or TRACS 2.0.3.A This is an alternative to the sample 60 Day AR Reminder Notice provided in HH 4350.3. This version includes fair housing language describing residents' rights (e.g. LEP, S504, etc.) This Notice also includes a list of forms that will be needed to complete the AR once HOTMA is implemented. The list of required documents has been updated for HOTMA and includes things like one statements for a checking account, 2 pay stubs, etc. Please note: Owner/agents are not required to implement HOTMA changes until HOTMA compliant site software is available and implemented.
Notice AR 60 Day Incomplete (Pre HOTMA)
$20
This notice is an alternative to HUD's 60 Day Notice. This is used when at least one resident has met with the owner/agent, but information is still missing, and the owner/agent cannot complete the AR until information or missing signatures are provided. The list of required documents is a Pre-HOTMA list and includes things like six statements for a checking account, 4 pay stubs, etc. Please note: Owner/agents are not required to implement HOTMA changes until HOTMA compliant site software is available and implemented.
Notice AR 60 Day Incomplete HOTMA
$20
Updated for HOTMA and/or TRACS 2.0.3.A This notice is an alternative to HUD's 60 Day Notice. This is used when at least one resident has met with the owner/agent, but information is still missing, and the owner/agent cannot complete the AR until information or missing signatures are provided. The list of required documents has been updated for HOTMA and includes things like one statements for a checking account, 2 pay stubs, etc. Please note: Owner/agents are not required to implement HOTMA changes until HOTMA compliant site software is available and implemented.
Notice AR 90 Day (Pre HOTMA)
$20
This is an alternative to the sample 90 Day AR Reminder Notice provided in HH 4350.3. This version includes fair housing language describing residents' rights (e.g. LEP, S504, etc.). The list of required documents is a Pre-HOTMA list and includes things like six statements for a checking account, 4 pay stubs, etc. The list of required documents has been not updated for HOTMA and includes things like six statements for a checking account, 4 pay stubs, etc. Please note: Owner/agents are not required to implement HOTMA changes until HOTMA compliant site software is available and implemented.
Notice AR 90 Day HOTMA
$20
Updated for HOTMA and/or TRACS 2.0.3.A This is an alternative to the sample 90 Day AR Reminder Notice provided in HH 4350.3. This version includes fair housing language describing residents' rights (e.g. LEP, S504, etc.). The list of required documents has been updated for HOTMA and includes things like one statements for a checking account, 2 pay stubs, etc. Please note: Owner/agents are not required to implement HOTMA changes until HOTMA compliant site software is available and implemented.
Notice AR 90 Day Incomplete (Pre HOTMA)
$20
This notice is an alternative to HUD's 90 Day Notice. This is used when at least one resident has met with the owner/agent, but information is still missing, and the owner/agent cannot complete the AR until information or missing signatures are provided. The list of required documents is a Pre-HOTMA list and includes things like six statements for a checking account, 4 pay stubs, etc. Please note: Owner/agents are not required to implement HOTMA changes until HOTMA compliant site software is available and implemented.
Notice AR 90 Day Incomplete HOTMA
$20
Updated for HOTMA and/or TRACS 2.0.3.A Updated for HOTMA. This notice is an alternative to HUD's 90 Day Notice. This is used when at least one resident has met with the owner/agent, but information is still missing, and the owner/agent cannot complete the AR until information or missing signatures are provided. The list of required documents has been updated for HOTMA and includes things like one statements for a checking account, 2 pay stubs, etc. Please note: Owner/agents are not required to implement HOTMA changes until HOTMA compliant site software is available and implemented.
Notice AR HUD 120 Day
$20
(These are documents from HH 4350.3 Change 4 - Exhibit 7. While HUD has provided samples, these samples no longer comply with current fair housing requirements related to LEP and Section 504.) This is an alternative to the sample 120 Day AR Reminder Notice provided in HH 4350.3. This version includes fair housing language describing residents' rights (e.g. LEP, S504, etc.) Please note: Owner/agents are not required to implement HOTMA changes until HOTMA compliant site software is available and implemented.
Notice AR HUD 60 Day
$20
(These are documents from HH 4350.3 Change 4 - Exhibit 7. While HUD has provided samples, these samples no longer comply with current fair housing requirements related to LEP and Section 504.) This is an alternative to the sample 60 Day AR Reminder Notice provided in HH 4350.3. This version includes fair housing language describing residents' rights (e.g. LEP, S504, etc.)
Notice AR HUD 90 Day
$20
(These are documents from HH 4350.3 Change 4 - Exhibit 7. While HUD has provided samples, these samples no longer comply with current fair housing requirements related to LEP and Section 504.) This notice is an alternative to HUD's 90 Day Notice. This is used when at least one resident has met with the owner/agent but information is still missing and the owner/agent cannot complete the AR until information or missing signatures are provided.
Notice AR Income Seasonal
$20
Updated for HOTMA and/or TRACS 2.0.3.A This notice/self-certification was updated to show that the owner/agent will be using teacher's or other seasonal employee's income for the previous 12 months in compliance with new HOTMA requirements. Owner/agents should not implement this change until HOTMA compliant software is available and implemented.
Notice AR Initial Notice
$20
This is a modified version of HUD's Initial Notice of Requirement to Report that includes new required language. Use this at MI/IC and AR to advise tenants of their requirement to report annually for recertification.
Notice AR No Response Alternative Contact
$20
Updated for HOTMA. This is used when AR tasks are completed by somebody other than the resident (e.g. Guardian or POA). Use this form when the alternative contact does not respond and the AR will be sent using the appropriate extenuating circumstance code.
Notice AR Requirement to Sign
$20
Use this notice to advise residents of the requirement to sign the AR.
Notice AR Requirement to Sign Extenuating Circumstances
$20
Use this notice to sign AR when certification was sent without signature due to extenuating circumstances.
Notice AR Requirement to Sign when AR is Late
$20
Use this notice when a resident reports after the deadline BUT BEFORE the anticipated AR date. The resident and family members are given a limited time to sign before assistance is terminated retroactive back to the AR date.
Notice AR Termination/Eviction in Process
$20
Use this notice when a resident is being evicted but the AR is still due and the owner/agent wishes to continue to receive subsidy. CHECK WITH MANAGEMENT AND APPROPRIATE COUNSEL BEFORE USING THIS NOTICE. In some states, sending such a notice would negate the eviction in process.
Notice AR Unable to Sign
$20
Use this notice to advise residents that you are submitting an AR without signature due to extenuating circumstances and that they are required to sign upon return.
Notice Deductions Response for Dispute Regarding Credit Care
$20
Use this notice to assist when responding to a dispute when costs associated with Credit Care are not included on the 50059.
Notice Hardship Exemption Minimum Rent Approval
$20
Section 8 Only. This Notice is used to inform residents that their request for a Hardship Exemption related to the Section 8 $25 Minimum Rent has been approved. This Notice also explains the resident's responsibilities.
Notice Hardship Exemption Minimum Rent Denial
$20
Section 8 Only. This Notice is used to inform residents that their request for a Hardship Exemption related to the Section 8 $25 Minimum Rent has been denied.
Notice Hardship Exemption Minimum Rent End
$20
Section 8 Only. This notice is used to inform residents that their S8 Minimum Rent Hardship Exemption related to the Section 8 $25 Minimum Rent is ending.
Notice Income Dispute Income Calculation
$20
Use this notice to acknowledge that a resident does not agree with the income calculation. This form advises the resident that they must file a dispute with the CA or HUD but the owner/agent cannot change regulations. The resident is still required to complete required paperwork and provide signatures in order to continue to receive housing assistance.
Notice Inspection Annual
$20
Use this notice to advise residents of a pending unit inspection. If you already have unit inspection notices, insert your current versions to show the Reviewer how you notify residents of upcoming inspections. If you wish to use this version, be sure to review and modify to reflect your company’s process.
Notice Inspection Annual Failed
$20
Use this notice to advise residents that they failed unit inspection. If you already have unit inspection notices, insert your current versions to show the Reviewer how you notify residents that they failed their inspection. If you wish to use this version, be sure to review and modify to reflect your company’s process.
Notice Inspection Annual Passed
$20
Use this notice to advise residents that they passed unit inspection. If you already have unit inspection notices, insert your current versions to show the Reviewer how you notify residents that they passed their inspection. If you wish to use this version, be sure to review and modify to reflect your company’s process.
Notice Lease Violation Multiple Repayments
$20
Some owner/agents limit the number of repayment agreements. Use this notice when there is a second or subsequent improper payment and the owner/agent requires full repayment or eviction.
Notice Repayment Requirement to Sign
$20
Use this notice to advise residents that 50059s and repayment agreements are ready for signature. The notice also advises that failure to sign will result in termination of assistance.
Notice Term Assist Missing Signatures
$20
Use this notice to advise residents that you are missing required signatures for a certification other than the AR certification. Do not use for PRAC. There is no termination of assistance for PRAC.
Notice Term Assist S8 Asset Restrictions
$20
New Form To Be Implemented When HOTMA is Implemented. Section 8 Only. Do not use if the owner/agent has implemented Total Non-enforcement. For owner/agents who will implement Enforcement or Limited Enforcement of the S8 Asset Restrictions, use this notice to advise residents that they are no longer qualified for Section 8 assistance based on Asset Restrictions. However, based on owner/agent policy, the OA is delaying termination of assistance for up to six months and allowing the resident to attempt to “cure” ineligibility. Note: Owner/agents may not implement this HOTMA change until HOTMA compliant site software is available and implemented.
Notice Term Assistance Ineligible Student
$20
Section 8 Only. Use this notice to inform a resident that a member is an ineligible student, and the family is no longer qualified for Section 8 assistance based on the Student Rule.
Notice Term Assistance Noncitizen
$20
Use this notice when a resident no longer qualifies for subsidy because of a change in noncitizen eligibility. Do not use this form for a PRAC. PRAC residents are not subject to the Noncitizen Rule.
Notice Term Assistance Revoke Consent
$20
New Form To Be Implemented When HOTMA is Implemented. This form is used to terminate assistance when a family member revokes consent provided via HUD Forms 9887/9887A. The family is no longer eligible for assistance. Owner/agents must make sure this document language is consistent with TSP required language that explains the penalty for revoking consent. Use once HOTMA compliance site software is available and implemented and the new 9887/9887A is released. Do not use for PRAC. There is no termination of assistance for PRAC.
Notice Term Assistance S8 Asset Cap
$20
New Form To Be Implemented When HOTMA is Implemented. Section 8 Only. Do not use if the owner/agent has implemented Total Non-enforcement of the S8 Asset Cap. For owner/agents who have implemented Enforcement or Total Enforcement of the S8 Asset Cap. This Notice is provided to residents who have been notified that the net cash value of all family assets exceeds the current Asset Cap. This notice is sent after any exemption period established by the owner/agent’s policies which cannot exceed six (6) months
Notice Term Assistance S8 Real Property Rule
$20
New Form To Be Implemented When HOTMA is Implemented. Section 8 Only. Do not use if the owner/agent has implemented Total Non-enforcement of the S8 Real Property Rule. For owner/agents who have implemented Enforcement or Total Enforcement of the S8 Real Property Rule. This notice is provided to residents who have been notified that they are no longer eligible because they own Real Property Suitable for Occupancy, and the member has a right to sell such property. This notice is sent after any exemption period established by the owner/agent’s policies which cannot exceed six (6) months.
Notice Term Assistance Zero HAP
$20
Use this sample notice when a resident no longer qualifies for subsidy - usually because of an increase in income. Do not use this form for a PRAC or for a Component 1 PH to PBRA RAD.
Notice Term Ten Unit too Small
$20
While HUD guidance indicates that residents may not be evicted when underhoused, local ordinance may supersede such instruction. Use this notice when you will not renew the lease because the unit is too small for the number of family members. You will need to insert local occupancy guidance before finalizing this form.
Notice Term Tenancy Failure to Sign Repayment Agreement
$20
When an owner/agent discovers that a resident failed to fully and accurately report income and that resulted in an improper payment, the resident may enter into repayment. However, if a resident refuses to sign required documents, the owner/agent must terminate tenancy (all MFH programs). This notice provides the required language to terminate tenancy because residents failed to sign a repayment agreement.
Notice to HUD Resident Failed Report/Repay Improper Payment
$20
If an owner/agent suspects fraud or wishes to report default on a repayment, the owner/agent has the option of notifying HUD. Use this form to notify HUD or the CA when a resident refuses or fails to repay assistance-paid-in-error as required. This letter includes an area to enter an address for a Contract Administrator. Information about HUD’s IG Division can be found at http://portal.hud.gov/portal/page/portal/HUD/program_offices/oig You can also complete a Fraud form online at http://oig.hhs.gov/fraud/hotline/
NTF SSA No EIV
$20
Note to File. Use this form document why EIV was not used as part of SS Income Verification.
Questionnaire AR (Pre HOTMA)
$50
This is a detailed questionnaire. The process, when using this questionnaire, is to have the HOH complete all of the questionnaire and each adult household member must complete appropriate sections, but the document can be edited to allow for multiple family members to complete a single AR Questionnaire. This is a Pre-HOTMA AR Questionnaire and does not include HOTMA changes.
Questionnaire AR HOTMA
$50
Updated for HOTMA and/or TRACS 2.0.3.A This is a detailed questionnaire. The process, when using this questionnaire, is to have the HOH complete all of the questionnaire and each adult household member must complete appropriate sections, but the document can be edited to allow for multiple family members to complete a single AR Questionnaire. HOTMA changes to note. When inquiring about income, the resident is asked to disclose income received in the previous 12 months as applicable. The asset questionnaire no longer asks about Retirement Accounts since that asset is excluded under HOTMA. The questionnaire also asks for verification documents compliant with new HOTMA rules such as one bank statement for a checking account and two current consecutive pay stubs for employment income verification. HOTMA changes are noted on the form. Keep in mind, if HOTMA changes are implemented prior to implementation of HOTMA compliant software, the tenant file must be noted.
Request Hardship Exempt Minimum Rent
$20
Section 8 Only. Minimum Rent applies only to the Section 8 program. Section 8 residents may use this form to Request a Hardship Exemption related to the $25 Section 8 Minimum Rent.
Request Hardship Exemption
$20
New Form To Be Implemented When HOTMA is Implemented. Hardships Exemptions Apply To All Multifamily Housing Programs. This request can be used by residents or applicants to request a Hardship Exemption related to deductions. Hardship Exemptions apply to all HUD MFH Programs
S504 Coordinator Contact
$20
Use this form to post information or provide an electronic notification about your Section 504 Coordinator. You are required to assign a Section 504 Coordinator if you employ 15 or more people regardless of their locations or duties. See HH 4350.3 R1, Paragraph 2-29 for additional information.
Self Certification Anticipated Child
$20
This form can be used by a resident to self-certify the upcoming addition of a child as a result of pregnancy, adoption or fostering. Per HH 4350.3 family self-certifications must be notarized or witnessed.
Self Certification Assets (Pre HOTMA)
$25
This Asset Self Certification can be used as a general questionnaire or on properties that have implemented Streamlined Verification of Assets. Use to gather information about the value of assets and income from assets. This form includes self-certification of assets disposed of for less than fair market value. This form is part of the applications and AR Questionnaire. This questionnaire does allow for owner/agents to use the Pre-HOTMA Asset Threshold ($5000) or HOTMA Asset Thresholds (2024=$$50,000/2025=$51,600) If implementing any HOTMA changes prior to implementation of HOTMA compliant site software, the tenant file must be noted. Per HH 4350.3 Paragraph 5-13, family self-certifications must be notarized or witnessed.
Self Certification Assets Collection
$20
Use this self-certification in years where assets and income from assets must be verified. Since collections are hard to value, self-certification may be the only way to obtain information about the value of a collection or the potential income. This form serves two purposes. 1) collect information to help you verify the value/income associated with a collection and 2) collect self-certification when no third party can be used to verify value/income associated with a collection.
Self Certification Assets HOTMA
$25
Updated for HOTMA and/or TRACS 2.0.3.A This Asset Self Certification can be used as a general questionnaire or on properties that have implemented Streamlined Verification of Assets. Use to gather information about the value of assets and income from assets. This form includes self-certification of assets disposed of for less than fair market value. This form is part of each application and part of the AR Questionnaire. This form has been updated for HOTMA and does not inquire about Retirement Accounts which are excluded under HOTMA. The form also asks about federal tax refunds and tax credits that will be used to reduce the cash value of Included Assets when HOTMA is implemented. If implementing any HOTMA changes prior to implementation of HOTMA compliant site software, the tenant file must be noted.
Self Certification Divestiture of Assets
$20
This stand-alone form can be used by resident to certify whether or not any resident has disposed on any assets for less than fair market value. This document is already part of the Self-certification Assets and the AR Questionnaire.
Self Certification EIV Employment/Income Accuracy
$20
This form is used when the EIV Income Report includes unknown information about Employment. Per HH 4350.3 Paragraph 5-13, family self-certifications must be notarized or witnessed.
Self Certification EIV SS Income Accuracy
$20
The form is used to document residents' response to inquiries about Social Security income listed on various EIV income reports. This can also be used as self-certification of income when investigating income discrepancies. Per HH 4350.3 Paragraph 5-13, family self-certifications must be notarized or witnessed.
Self Certification Fixed Income Family
$25
When using Streamlined Determination of Fixed Income and Streamlined Certification for Fixed Income Families, this form can be used by residents to provide information and self-certification of income. We have also included these questions as part of the AR Questionnaire. Per HH 4350.3 Paragraph 5-13, family self-certifications must be notarized or witnessed.
Self Certification Income Irregular Income
$25
Updated for HOTMA. The RBD EIV Policy Template allows owner/agents to use historical information in EIV to estimate income when a resident has irregular income. With HOTMA, if EIV is used to verify income, the resident must also self-certify. Please note that, owner/agents should not implement HOTMA changes to the use of EIV until HOTMA compliant site software is available and implemented.
Self Certification Income No 3rd Party Emp
$20
The form is used to document applicant’s response to inquiries about new employment when the employer will not respond to verification requests and the tenant cannot provide the required documentation and there is no appropriate income information in EIV.
Self Certification Income Self Employment Ride Hailing
$20
Use this form to gather information necessary to verify self-employment when a resident or applicant works for a Ride Hailing Service. Per HH 4350.3 Paragraph 5-13, family self-certifications must be notarized or witnessed.
Self Certification Joint Custody
$20
This form is used when two families share custody of one child AND BOTH FAMILIES RECEIVE HUD HOUSING ASSISTANCE. This form helps property managers gather the information needed to correctly calculate the assistance payment including the percentage of time the child lives in your unit, unearned income and appropriate deduction information.
Self Certification Need for Hardship Exemption
$20
Use this form to document a residents request for your to waive the $25 minimum rent. Section 8 only.
Self Certification New Employment
$20
The form is used to document residents' response when there is new employment, the employer will not respond to verification requests and the resident does not have proper documentation (not enough pay stubs). This advises the resident that the owner/agent will not delay IR. Per HH 4350.3 Paragraph 5-13, family self-certifications must be notarized or witnessed.
Self Certification No Child Support
$20
This form can be used as an affidavit that the resident does not receive awarded child support. Per HH 4350.3 Paragraph 5-13, family self-certifications must be notarized or witnessed.
Self Certification No SSN (Pre HOTMA)
$25
Anytime a member cannot provide an SSN or adequate documentation to verify the SSN, owner/agents should advise the member of the requirements. This form can be used to communicate HUD's rule. This is very important when a minor under the age of six is added to a household because the family has 90 days to provide the SSN and adequate documentation to verify the SSN. Failure to do so will result in termination. Per HH 4350.3 Paragraph 5-13, family self-certifications must be notarized or witnessed. This Pre-HOTMA version calls for termination of tenancy when required SSNs are not produced.
Self Certification No SSN HOTMA
$25
Updated for HOTMA and/or TRACS 2.0.3.A Anytime a member cannot provide an SSN or adequate documentation to verify the SSN, owner/agents should advise the member of the requirements. This includes the new requirement for owner/agents to accept self-certification with accompanying documents. This form can be used to communicate HUD's rule. This is very important when a minor under the age of six is added to a household because the family has 90 days to provide the SSN and adequate documentation to verify the SSN. Failure to do so will result in termination of assistance for all programs except PRAC and termination of tenancy for the PRAC program. Per HH 4350.3 Paragraph 5-13, family self-certifications must be notarized or witnessed.
Self Certification of Employment Income New Employment
$20
The form is used to document residents' response when there is new employment, the employer will not respond to verification requests and the resident does not have proper documentation (not enough pay stubs). This advises the resident that the owner/agent will not delay IR.
Self Certification Real Property
$20
New Form To Be Implemented When HOTMA is Implemented. Section 8 only. Under HOTMA, Section 8 residents must disclose if they own Real Property Suitable for Occupancy that a Member Has a Right to Sell. If so, an applicant family is not eligible to receive Section 8 housing assistance. There are some exceptions. For owner/agents implement Total Non-enforcement of the Section 8 Asset Restrictions, this rule does not apply to existing assisted residents. If an owner/agent is implementing Enforcement or Limited Enforcement of the Section 8 Asset Restrictions, then this rule will apply to existing assisted residents. If a resident or applicant owns real property but feels they are exempt under the rules, this form can be used to obtain self-certification and other information about the exemption. Eligibility review based on the Section 8 Asset Restrictions (Asset Cap and ownership of Real Property) are mandatory at application. Owner/agents must decide whether or not to enforce these restrictions after move-in
Self Certification Receipt of Required Documents at AR
$25
Use this form to document that all required forms have been provided at AR. As of 9/1/2024, HUD has not provided the new 9887 Package or the new HUD FACT Sheet – How Your Rent is Determined. Once those forms are released, owner/agents will update the FACT Sheet but still distribute each year at AR. Once the new 9887 is released, owner/agents will be required to provide this document 1) when an applicant is at the top of the waiting list (eligibility interview), 2) when a new adult is added, 3) when a minor turns 18 and 4) if subsidy is terminated then reinstated. This form will not be required at each AR ONCE HUD RELEASES THE NEW 9887 – EXPECTED IN LATE 2023 OR EARLY 2024)
Self Certification Remove Adult Member
$20
Use this form to document a resident’s request to remove an adult from the lease and the 50059. Per HH 4350.3 Paragraph 5-13, family self-certifications must be notarized or witnessed.
Self Certification Rent Credit
$20
This is an attachment to the Notification of Rent Credit, but if the resident does not complete the attachment, this is a separate form that can be used for the same purpose.
Self Certification Separation
$20
Use this form when there is no legal separation agreement, yet married residents no longer live together. Per HH 4350.3 Paragraph 5-13, family self-certifications must be notarized or witnessed.
Self Certification Termination of Employment
$20
Use this form when an employer will not respond to verification requests regarding termination of employment. Per HH 4350.3 Paragraph 5-13, family self-certifications must be notarized or witnessed.
Self Certification Unexplained SS Deductions
$20
In some cases, EIV will not provide enough detail to explain the difference between Gross SSA awards and Net SSA awards. Use this form when the resident must provide additional information about unexplained SSA deductions. Per HH 4350.3 Paragraph 5-13, family self-certifications must be notarized or witnessed.
Self Certification Use of Funds Representative Payee
$20
Owner/agents may use this form when a resident receives benefits, but those benefits are paid to a Representative Payee. The income must be associated with the recipient (not the Representative Payee) and the asset where the money is deposited is essentially owned by the recipient (not the Representative Payee). When a minor is part of a joint custody arrangement, the income and the asset are associated with the family taking advantage of the $480 Dependent Deduction. Per HH 4350.3 Paragraph 5-13, family self-certifications must be notarized or witnessed
Student Certification NonS8
$25
Owner/agents are required to ask all adults if they are a student enrolled in an institute of higher education (full time or part time). If the answer is yes, student eligibility must be determined. The questionnaire is a tool created by the owner/agent. There is no HUD requirement to have a questionnaire. This form is for use on all HUD MFH programs except Section 8 which has different eligibility criteria.
Student Certification S8
$25
Owner/agents are required to ask all adults if they are a student enrolled in an institute of higher education (full time or part time). If the answer is yes, student eligibility must be determined. The questionnaire is a tool created by the owner/agent. There is no HUD requirement to have a questionnaire. This form is for use on all HUD MFH Section 8 properties which have specific eligibility criteria.
Verification Assets Annuity
$20
Use this form to verify information about the asset value of or income generated by an annuity.
Verification Assets Bank Account (Pre HOTMA)
$20
Use this form to request information about accounts and account balances directly from a bank. This form still asks for an average balance over six months for checking accounts and asks for the current balance for all other accounts.
Verification Assets Bank Account HOTMA
$20
Updated for HOTMA and/or TRACS 2.0.3.A Use this form to request information about accounts and account balances directly from a bank. Owner/agents may use current statements to verify the cash value of bank accounts. That is the preferred method. Under HOTMA, sending a verification directly to the bank is done when the resident cannot provide adequate statements. With the implementation of HOTMA owner/agents are to use current balances for checking accounts rather than a six month average. If you implement any HOTMA changes before HOTMA compliant software is available, you must document the tenant file.
Verification Assets Direct Express
$20
Use this form to verify the balance for a Direct Express Debit Card when the owner/agent does not wish to copy the card.
Verification Assets Life Insurance
$20
Use this form when a resident owns a life insurance policy and information is needed to determine the cash value of the policy and the income from the asset.
Verification Assets on Deposit
$20
Use this form to inquire about types of assets on deposit from any financial institute. This Pre-HOTMA version asks for a six month average balance for checking accounts and asks about the current value of retirement accounts.
Verification Assets on Deposit HOTMA
$20
Updated for HOTMA and/or TRACS 2.0.3.A Use this form to inquire about types of assets on deposit from any financial institute. This HOTMA version asks for a current balance for checking accounts and allows for exclusion of retirement accounts.
Verification Assets Real Estate Holdings
$20
Use this form to verify the value of real property and the cost to sell the property.
Verification Assets Whole or Universal Life Insurance
$20
Use this form to verify the cash value of any whole life insurance policy or any universal life insurance policy.
Verification Deduction Child Care/Attendant Care
$20
Use this form to verify Childcare Expenses or Attendant Care used for the Disability Assistance Expense (Attendant Care & Auxiliary Apparatus Expense under HOTMA) when a disabled person requires care/supervision to enable an adult household member to work.
Verification Deduction Medical Expense
$20
Use this generic medical expense verification form to request record of expenses for the last year.
Verification Deduction Medical Expense Caregiver
$20
Use this form to verify the medical expense deduction for a caregiver.
Verification Deduction Medical Over the Counter Products (Pre HOTMA)
$20
Use this form to verify that over-the-counter products are used to treat a specific medical condition. Costs of items used for general good health are not included when determining the Medical Expense Deduction.
Verification Deduction Medical Over the Counter Products HOTMA
$20
Updated for HOTMA and/or TRACS 2.0.3.A Use this form to verify that over-the-counter products are used to diagnose, prevent or treat a specific medical condition which is the new requirement under HOTMA. Costs of items used for general good health are not included when determining the Medical Expense Deduction. If you implement any HOTMA changes before HOTMA compliant software is available, you must document the tenant file.
Verification Eligibility Disability 811 PRAC
$20
Use this form as an alternative to HUD’s form to verify eligibility based on disability for HUD's 811 PRAC properties. See HH 4350.3 R1, Paragraph 3-28 for acceptable alternatives for this form.
Verification Eligibility Disability S8
$20
Use this form to verify eligibility based on disability for HUD's Section 8 Elderly and HUD's 202/8 properties. Please refer to HH 4350.3 Revision 1, Paragraph 3-17 to obtain more information about disability eligibility for the Section 8 family and elderly program (not 202/8). Also see HH 4350.3 R1, Paragraph 3-28 for acceptable alternatives for this form.
Verification Eligibility HUD Assistance
$20
Use this form to request verification from the landlord indicated in EIV, if the EIV Existing Tenant Search indicates that an applicant is receiving assistance in another residence that was not disclosed.
Verification Employment Income Dispute EIV
$20
When a resident disputes employment records displayed in EIV, owner/agents must attempt to conduct third-party verification with the employer. This verification can be used to notify an employer that they may have keyed an employee’s Social Security incorrectly or that an employee may be using your resident’s Social Security Number.
Verification GR Utility Expenses
$20
Use this document to obtain verification of utility expenses for an existing resident.
Verification Income Employment
$20
Use this form to contact an employer directly and verify date of hire and income.
Verification Income Gifts or Regular Contributions
$20
Use this form to obtain third-party verification from a person or organization who is providing gifting income or regular contributions to a resident.
Verification Income Personal Loan
$20
Use this form to verify regular contributions that should be treated as a loan instead of income.
Verification Income Work Study
$20
Use this form to verify if income from a “work study” or Job Training program should be excluded from the family’s income calculation. If the verifier answers “yes” to any of the clarification questions, then the income should be excluded based on guidance provided in HH 4350.3 R1, Exhibit 5-1.
Verification IR Permanent Address
$20
Use this form to verify that a current resident has moved out of a unit. This form is commonly used when the owner/agent has evidence that the resident has not truly moved out of the unit. See HH 4350.3 Paragraph 3-27 for additional information about verifying housing composition.
Verification IR Permanent Address Unit
$20
This verification is used when a resident requests to add a minor, already living in the unit, to the lease/50059. This is used to verify the unit is the primary address for a minor. Verification can be conducted with a medical provider, a school, a parole officer, etc. This should conform to your policy. See HH 4350.3 Paragraph 3-27 for additional information about verifying housing composition.
Verification Move Out
$20
Some owner/agents are struggling to keep new residents compliant with single subsidy requirements. This document may help assist with the effort. If an applicant is currently receiving assistance in another HUD assisted residence, owner/agents may want to verify move-out before allowing the resident to move into the new unit. This will help ensure compliance with the single subsidy rule and may assist in resolving disputes that may come up in the future.
Verification Oral Phone
$20
If you conduct oral/phone verification, you must do so in compliance with HH 4350.3 R1, Paragraph 5-18. This form helps you document phone verification in compliance with HUD requirements.
Verification Oral Phone Investment
$20
Use this form when collecting verification information by phone by contacting the bank or financial institution in charge of managing a resident’s IRA or 401K account.
Verification Review of Documents
$20
If you conduct verification but you cannot copy the verification documents, you must note the file in a manner that is in compliance with HH 4350.3 R1, Paragraph 3-13. This form helps you document verification in compliance with HUD requirements.
Verification Student Certification Parent Income
$20
Section 8 Only. HUD does not provide a “HUD approved” student verification form. It is not necessary to use this form if the student is otherwise eligible. This form is used to when the student is only eligible because the parent/guardian income is no higher than low income limit where he/she lives. There is no requirement to verify the parent’s/guardian’s income other than self-certification unless the owner/agent suspects misrepresentation.
Verification Student Parent Financial Support
$20
Use this form to verify if the parents are providing financial support to a student.
Verification Student Status/Financial Aide
$20
HUD does not provide a “HUD approved” student verification form. This form is used to verify full-time student status and amount of financial assistance provided. This form was completely revised based on recent changes and customer comments.
Worksheet Assets Rate of Return
$25
Use this worksheet to calculate the projected rate of return for investments that earn income based on the stock market performance. Options are to 1) use the current year rate of return and project for a full year, 2) use the average rate of return for the two years prior to the year of the certification or 3) use the average rate of return for the three years prior to the year of the certification. Calculations are included and property management professionals only need to include values noted in green.
Worksheet EIV Income Discrepancy Calculation
$25
Use this Excel worksheet to document review of EIV Discrepancy Report at AR and IR.
Worksheet Medical Mileage
$25
Use this Excel Worksheet to calculate and document medical mileage amounts used as part of the Medical Expense Deduction for qualified families. This form currently shows the 2025 IRS mileage rate of 21 cents per mile. This rate should be updated annually. https://www.irs.gov/tax-professionals/standard-mileage-rates
Worksheet Repayment Calc
$30
Use this worksheet to document your method used to determine a Repayment Agreement amount.
