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 | |
| Alimony or child support. (See Chapter 5, Paragraphs 5-6.F and 5-10.F) |
Copy of separation or divorce agreement provided by ex- spouse or court indicating type of support, amount, and payment schedule. Written statement provided by ex- spouse or income source indicating all of above. If applicable, written statement from court/ payments are not being received and anticipated date of resumption of payments. |
Recent original letters from the court. |
Telephone or in- person contact with ex-spouse or income source documented in file by the owner. |
Copy of most recent check, recording date, amount, and check number. |
Notarized statement or affidavit signed by applicant indicating amount received. If applicable, notarized statement or affidavit from applicant indicating that payments are not being received and describing efforts to collect amounts due. |
Amounts awarded but not received can be excluded from annual income only when applicants have made reasonable efforts to collect amounts due, including filing with courts or agencies responsible for enforcing payments. |
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 2 Appendix 3: Acceptable Forms of Verification
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Appendix 3
4350.3 REV-1
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