SAMPLE TENANT CONSENT TO DISCLOSE EIV INCOME INFORMATION
Appendix 3: Acceptable Forms of Verification
HUD Handbook 4350.3 REV-1 — Occupancy Requirements of Subsidized Multifamily Housing Programs · 2026 edition · updated 2026-10-05 · United States
| ACCEPTABLESOURCES | ||||||
|---|---|---|---|---|---|---|
| Third Party |
**Verification Tips ** | |||||
| Factor to be Verified | Written |
Provided by Applicant~~*e**~~ | Oral |
*Provided by Applicant | Self-Declaration | |
| Family type. (Information verified only to determine eligibility for project, preferences, and allowances.) (See Chapter 3, Paragraph 3-28) |
Disability Status: statement from physician or other reliable source, if benefits documenting status are not received. See paragraph 3.25 B.1 for restrictions on this form of verification. Displacement Status: Written statement or certificate of displacement by the appropriate governmental authority. |
Telephone or in- person contact with source documented in file by the owner. |
Elderly Status (when there is reasonable doubt that applicant is at least 62): birth certificate, baptismal certificate, social security records, driver’s license, census record, official record of birth or other authoritative document or receipt of SSI old age benefits or SS benefits. Disabled, blind: evidence of receipt of SSI or Disability benefits. |
Elderly Status: Applicant’s signature on application is generally sufficient. |
When the applicant receives income or benefits for which elderly or disabled status is a requirement, such status must be verified. Status of disabled family members must be verified for entitlement to $480 dependent deduction and disability assistance allowance. Owner may not ask the nature/ disability. |
|
| Full-time student status (of family member 18 or older, excluding head, spouse, or foster children). (See Chapter 5, Paragraph 5-6.A.3) |
Verification from the Admissions or Registrar’s Office or dean, counselor, advisor, etc., or from VA Office. |
Telephone or in- person contact with these sources documented in file by the owner. |
School records, such as paid fee statements that show a sufficient number of credits to be considered a full-time student by the educational institution attended. |
Not appropriate. |
aNOTE : Requests for verification from a third party source must be accompanied by a Consent to Release form HUD-9887-A.
bNOTE : If the original document is witnessed but is a document that should not be copied, the owner should record the type of document, any control or serial numbers, and the issuer. The owner should also initial and date this notation in the file.
cNOTE : For all oral verification, file documentation must include facts, time and date of contact, and name and title of the third party.
d*NOTE: For use of EIV Income Reports as third party verification of employment and income a current Consent for Release form HUD-9887 must be on file.* c[*] NOTE: See examples and requirements found in Paragraph 5-13.B.1
HUD Occupancy Handbook 12 Appendix 3: Acceptable Forms of Verification
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Appendix 3
4350.3 REV-1
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