Section 236 — HUD Handbook 4350.3 REV-1

HOPE 2 Homeownership of Multifamily Units

Failure to Sign Consent Form: Your failure to sign the consent form may result in the denial of assistance or termination of assisted housing benefits. If an applicant is denied assistance for this reason, the owner must follow the notification procedures in Handbook 4350.3 Rev. 1. If a tenant is denied assistance for this reason, the owner or managing agent must follow the procedures set out in the lease.

________________________________________________________________________________________________________________________________ Consent: I consent to allow HUD, the O/A, or the PHA to request and obtain income information from the federal and state agencies listed on the back of this form for the purpose of verifying my eligibility and level of benefits under HUD's assisted housing programs.

Signatures:

Additional Signatures, if needed:

Head of Household Spouse Other Family Members 18 and Over Other Family Members 18 and Over	Date Date Date Date	Other Family Members 18 and Over Other Family Members 18 and Over Other Family Members 18 and Over Other Family Members 18 and Over	Date
			Date
			Date
			Date

Original is retained on file at the project site ref. Handbooks 4350.3 Rev-1, 4571.1, 4571/2 & form HUD-9887 (02/2007) 4571.3 and HOPE II Notice of Program Guidelines