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SAMPLE TENANT CONSENT TO DISCLOSE EIV INCOME INFORMATION

25. Removal of Subsidy:

HUD Handbook 4350.3 REV-1 — Occupancy Requirements of Subsidized Multifamily Housing Programs · 2026 edition · updated 2026-10-05 · United States

(a) The Tenant understands that assistance made available on his/her behalf may be terminated if events in either item 1 or 2 below occur. Termination of assistance means that the Landlord may make the assistance available to another Tenant and the Tenant’s rent will be recomputed. In addition, if the Tenant’s assistance is terminated because of criterion (1) below, the Tenant will be required to pay the HUD-approved market rent for the unit.

(1) The Tenant does not provide the Landlord with the information or reports required by paragraph 10 or 24 within 10 calendar days after receipt of the Landlord’s notice of intent to terminate the Tenant’s assistance payment.

(2) The amount the Tenant would be required to pay towards rent and utilities under HUD rules and regulations equals the Family Gross Rent shown on Attachment 1.

  • (b) The Landlord agrees to give the Tenant written notice of the proposed termination. The notice will advise the Tenant that, during the ten calendar days following the date of the notice, he/she may request to meet with the Landlord to discuss the proposed termination of assistance.

form HUD-90105-b 12/2007

OMB Approval No. 2502-0204 (Exp. 03/31/2014)

If the Tenant requests a discussion of the proposed termination, the
Landlord agrees to meet with the Tenant.

(c) Termination of assistance shall not affect the Tenant’s other rights under this Agreementincluding the right to occupy the unit. Assistance may subsequently be reinstated if the Tenant submits the income or other data required by HUD procedures, the Landlord determines the Tenant is eligible for assistance, and assistance is available.

  1. Failure of the LANDLORD to insist upon the strict performance of the terms, covenants, agreements and conditions herein contained, or any of them, shall not constitute or be construed as a waiver or relinquishment of the LANDLORD's right thereafter to enforce any such term, covenant, agreement, or condition, but the same shall continue in full force and effect.

  2. In return for the TENANT's continued fulfillment of the terms and conditions of this Agreement, the LANDLORD covenants that the TENANT may at all times, while this Agreement remains in effect, have and enjoy for his/her sole use and benefit the above described property.

  3. The lease agreement will terminate automatically, if the Section 8 Housing Assistance contract terminates for any reason.

  4. Attachments to the Agreement: The Tenant certifies that he/she has received a copy of the Agreement and the following attachments to the Agreement and understands that these attachments are part of the Agreement.

  • a. Attachment No. 1 – Owner’s Certification of Compliance with HUD’s Tenant Eligibility and Rent Procedures, form HUD-50059

  • b. Attachment No. 2 – Unit Inspection Report.

  • c. Attachment No. 3 – House Rules (if any).

  • d. Attachment No. 4 – Pet Rules.

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WITNESS: ( P)___________ __________LANDLORD _________________________ By: _________________________________________ Date _________________________ (Q) _________________________TENANT Date


Date

form HUD-90105-b 12/2007

OMB Approval No. 2502-0204 (Exp. 03/31/2014)

Public reporting burden – HUD is not requesting approval of any burden hours for
the model leases since use of leases are a standard business practice in the
housing rental industry.  This information is required to obtain benefits.  The
request and required supporting documentation are sent to HUD or the Contract
Administrator (CA) for approval.  The lease is a contract between the owner of
the project and the tenant(s) that explains the terms for residing in the unit.
Leases are a standard business practice in the housing rental industry.  Owners
are required to use the HUD model lease which includes terms normally covered by
leases used in the housing rental industry plus terms required by HUD for the
program under which the project was built and/or the program providing rental
assistance to the tenants.
This information is authorized by 24 CFR 5.360, 236.750, 880.606, 883.701,
884.215, 886.127, 891.425, 891.625 and 891.765 cover lease requirements and
provisions.  This information is considered non-sensitive and does not require
any special protection.

form HUD-90105-b 12/2007

OMB Approval No. 2502-0204 (Exp. 03/31/2014)

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▸Contents — HUD Handbook 4350.3 REV-1 — Occupancy Requirements of Subsidized Multifamily Housing Programs

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