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 | |
| Income maintenance payments, benefits, income other than wages (i.e., welfare, Social Security [SS], Supplemental Security Income [SSI], Disability Income, Pensions). (See Chapter 5, Paragraph 5-6) |
* EIV Income Report for Social Security benefits (mandatory) * Award or benefit notification letters prepared and signed by authorizing agency. |
Current or recent check stubs with date, amount, and check number recorded by the owner. Award or benefit letters or computer printout from court or public agency. Most recent quarterly pension account statement. |
Telephone or in- person contact with income source, documented in file by the owner. **NOTE:**For all oral verification, file documentation must include facts, time and date of contact, and name and title of third party. |
Copies of validated bank deposit slips or bank statements, with identification by bank. |
Notarized statement of income received other than wages. |
It is mandatory that the EIV Income Report be used as third-party verification of the Social Security benefit income received (24 CFR 5.233). Checks or automatic bank deposit slips may not provide gross amounts of benefits if applicant has deductions made for Medicare Insurance. Pay stubs for the most recent four to six weeks should be obtained. Copying of U.S. Treasury checks is not permitted. Award letters/ from court or public agency may be out of date; telephone verification of letter/ recommended. |
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 14 Appendix 3: Acceptable Forms of Verification
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Appendix 3
4350.3 REV-1
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