Ross Business Development

Agreement Repayment

$20

Residents who have received improper payments due to failure to report, must return assistance-paid-in-error to HUD. This sample agreement outlines the requirements and payment plan and penalties for failure to meet the terms of the agreement. This form has been updated based on customer comment.

Agreement Repayment Agreement Policy Template

$20

If you want to establish a policy to reduce the number of repayment agreements for a single family, it is best to make sure you can prove that you have explained the policy. Use this Memorandum of Understanding to document conversations with your residents.

Agreement Repayment Zero Income

$20

Residents who have received housing assistance in error, due to failure to report, must return assistance-paid-in-error to HUD. This sample agreement outlines the requirements when a person has zero income and explains penalties for failure to meet the terms of the agreement. This form has been updated based on customer comment.

Checklist EIV 120 Day Post Move In

$20

Use this checklist to document review of EIV reports 120 days after the submission of a move-in 50059 or an IR adding a new household member.

Checklist EIV for the Deceased Tenant Report

$20

This checklist is used to track compliance with HUD’s EIV Master File review requirements. Use this checklist to ensure complete and consistent review and response to data provided on the EIV Deceased Tenant report.

Checklist EIV for the Failed Pre-Screening Report

$20

This checklist is used to track compliance with HUD’s EIV Master File review requirements. Use this checklist to ensure complete and consistent review and response to data provided on the EIV Failed Pre-Screening report.

Checklist EIV for the Failed Verification Report

$20

This checklist is used to track compliance with HUD’s EIV Master File review requirements. Use this checklist to ensure complete and consistent review and response to data provided on the EIV Failed Verification report.

Checklist EIV Monthly Quarterly Reporting

$20

These reporting logs assist with monitoring compliance with EIV requirements. Property managers can use these logs to document that EIV reports are run in compliance with HUD requirements and the property’s EIV Use Policy. If you change reporting requirements in the sample use policy and you plan to use reporting logs, you must change the reporting logs to coincide.

Checklist EIV Monthly Reporting

$20

These reporting logs assist with monitoring compliance with EIV requirements. Property managers can use these logs to document that EIV reports are run in compliance with HUD requirements and the property’s EIV Use Policy. If you change reporting requirements in the EIV Policy Template and you plan to use reporting logs, you must change the reporting logs to coincide.

Checklist EIV Multiple Subsidy

$20

The Sample EIV Multiple Subsidy Report Checklist is a checklist used to track compliance with HUD’s EIV Master File review requirements. Use this checklist to ensure complete and consistent review and response to data provided on the EIV Multiple Subsidy report.

Checklist EIV New Hires

$20

This checklist is used to track compliance with HUD’s EIV Master File review requirements. Use this checklist to ensure complete and consistent review and response to data provided on the EIV New Hires report.

Checklist EIV Recertification

$20

Use this checklist to document review of EIV reports at Recertification.

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 R1, C4, 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.

Consent to Disclose Tenant File to a 3rd Party

$20

The Privacy Act requires that you obtain consent if you are going to disclose the applicant/tenant file to any other person. This sample consent can be used if the applicant or resident wants to complete a form rather than write out their own consent.

EIV Income Discrepancy Calculation Worksheet

$30

Use this Excel worksheet to document review of EIV Discrepancy Report at AR and IR.

Notice Application Existing Tenant Search Conflict

$20

Use this notice if EIV indicates that the household may be receiving assistance on a property that has not been disclosed at application.

Notice EIV Disability Conflict

$20

This notice is used to advise residents that they have not specified that they are disabled, yet the EIV Disability Indicator shows that they are disabled. YOU MAY NOT USE EIV TO VERIFY DISABILITY. SEE HH 4350.3 R1, PARAGRAPH 3-28.

Notice Lease Violation Failure to Report a Change in Employment or Income

$20

This is a sample notice used to advise residents when you suspect that they have not disclosed a change in income or family composition. The notice must be in compliance with HH 4350.3 R1, Paragraph 7-12. This notice also contains information about the penalty for failure to report which includes termination of assistance and possible eviction.

Notice Requirement to Sign 9887

$20

Use this notice to notify residents who are turning 18 of their requirement to sign HUD Form 9887/9887A.

Notice Termination of Tenancy Deceased Tenant

$20

Use this sample notice to notify remaining household members of their requirement to meet when a member appears on the Deceased Tenant Report.

Notice Termination of Tenancy Lease Violation Material

$20

Use this sample notice when a resident commits a material lease violation.

Notice to HUD - Resident Failed to Report or 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/

Policy EIV Reporting Summary

$50

This document provides staff with a summary of your EIV reporting process. It must be modified to match your policy before implementing.

Policy EIV Use Template

$300

This is a comprehensive EIV Use and Security Policy which incorporates sample policies based on HUD instruction. In this policy, all EIV Master File Identity Verification Reports are reviewed every month and other Master File Reports are reviewed quarterly. The option to print all the Master File Reports monthly is available as well. You MUST edit these policies before implementation. The policy must reflect how you really use EIV.

Security Data File Destruction Log

$20

Use this spreadsheet to track when information is destroyed.

Security EIV Owner Authorization

$20

EIV Coordinators must receive written permission from property owners before attempting to establish EIV Coordinator access for any property. This is a sample memo that can be completed and sent to the owner for signature. This notice should be provided on owner letterhead. An owner/authorization letter must be available for review at HUD’s request.
DO NOT SEND THIS LETTER TO HUD UNLESS SPECIFICALLY ASKED TO DO SO. Failure to produce an owner authorization at MOR will result in a finding. In addition, EIV access will be terminated until such authorization can be produced.

Security Employee Forms Checklist WASS

$20

Use this spreadsheet to make sure you have all documents required for the management and occupancy review.

Self Certification EIV Employment New Hire

$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 EIV Income Accuracy

$20

When reviewing EIV Income Reports, owner/agents may want residents to verify whether or not the income reported in EIV is correct. This form can be used when a resident agrees or when a resident disagrees with the information provided in EIV for employment, unemployment and Social Security benefits.

Self Certification Income

$20

Streamlined Certification for Fixed Income Families has been available for HUD’s MFH programs since 2019. This is not new with the implementation of HOTMA. This self-certification allows residents to disclose any and all income for family members. If an owner/agent has adopted Streamlined Certification for Fixed Income Families, owner/agents have the option of accepting self-certification for any income that is not fixed.

Note from RBD: We do not expect additional revisions to this rule.

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 of EIV Employment Discrepancy

$20

Use this self-certification when a resident will self-certify that the employment income information displayed in the EIV Income Report is correct and will be used to correct a prior cert or insert a retroactive certification. Generally, employment income information in EIV may only be used as a verification source when an owner/agent is investigating an income discrepancy. See HSG Notice 13-06 Attachment 5.

Self Certification Payee - Use of Funds

$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 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.

Self-Certification – Dispute EIV Unemployment Income Accuracy

$20

Use this form when unemployment information is reflected in EIV and the resident did not report the unemployment income. In the case of fraud, this form can be used to provide resident with required information about identity theft.

Verification EIV No EIV SSA

$20

Use this form document why EIV was not used as part of SS Income Verification.

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 MO

$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 in to 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 of 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.

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