Appendix 3: Acceptable Forms of Verification

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 22 Appendix 3: Acceptable Forms of Verification

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MODEL LEASE FOR SUBSIDIZED PROGRAMS

(A)

1.  Parties and        The parties to this Agreement are ________
    Dwelling           ____________________, referred to as the
 Unit:              Landlord, and
(B)
__________________________________________________________,
                       referred to as the Tenant.  The Landlord leases
(C)
                       to the Tenant(S) unit number ______, located
    at

(D)
__________________________(E)_______________________________________
    in the project known as_____________________________________.
2.  Length of Time     The initial term of this Agreement shall begin
(F)(G)
      (Term):          on _________ and end on _________.  After
                       the initial term ends, the Agreement will
(H)
    continue for successive terms of one ___________ each unless
    automatically terminated as permitted by paragraph 23 of this
    Agreement.

(I)
3.  Rent:              The Tenant agrees to pay $______ for the
(J)
                       partial month ending on ___________.  After
(K)
                       that, Tenant agrees to pay a rent of $__ per
    month.  This amount is due on the ____(L)____ day of the month at
    ____________________(M)___________________________________________

    __________________________________________________________________.
    The Tenant understands that this monthly rent is less than the
    market (unsubsidized) rent due on this unit.  This lower rent is
    available either because the mortgage on this project is subsidized
    by the Department of Housing and Urban Development (HUD) and/or
    because HUD makes monthly payments to the Landlord on behalf of the
    Tenant.  The amount, if any, that HUD makes available monthly on
    behalf of the Tenant is called the tenant assistance payment and is
    shown on the "Assistance Payment" line of the Owner’s
    Certification of Compliance with HUD’s Tenant Eligibility and Rent
    Procedures form which is Attachment No. 1 to this Agreement.

4. Changes in the The Tenant agrees that the amount of rent the Tenant's Share Tenant pays and/or the amount of assistance that of the Rent: HUD pays on behalf of the Tenant may be changed during the term of this Agreement if:

• a. HUD or the Contract Administrator (such as a Public Housing Agency) determines, in accordance with HUD procedures, that an increase in rents is needed;

• b. HUD or the Contract Administrator changes any allowance for utilities or services considered in computing the Tenant's share of the rent;

• c. the income, the number of persons in the Tenant's household or other factors considered in calculating the Tenant's rent change and HUD procedures provide that the Tenant's rent or assistance payment be adjusted to reflect the change;

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• d. changes in the Tenant's rent or assistance payment are required by HUD's recertification or subsidy termination procedures

• e. HUD's procedures for computing the Tenant's assistance payment or rent change; or

• f. the Tenant fails to provide information on his/her income, family composition or other factors as required by the Landlord.

    The Landlord agrees to implement changes in the Tenant's rent or
    tenant assistance payment only in accordance with the time frames
    and administrative procedures set forth in HUD's handbooks,
    instructions and regulations related to administration of
    multifamily subsidy programs.  The Landlord agrees to give the
    Tenant at least 30 days advance written notice of any increase in
    the Tenant's rent except as noted in paragraphs 11, 15 or 17.  The
    Notice will state the new amount the Tenant is required to pay, the
    date the new amount is effective, and the reasons for the change in
    rent.  The Notice will also advise the Tenant that he/she may meet
    with the Landlord to discuss the rent change.

5. Charges for Late If the Tenant does not pay the full amount of Payments and the rent shown in paragraph 3 by the end of Returned Checks: the 5th day of the month, the Landlord may Collect a fee of $5 on the 6th day of the month. Thereafter, the Landlord may collect $1 for each additional day the rent remains

unpaid during the month it is due. The Landlord may not terminate this Agreement for failure to pay late charges, but may terminate this Agreement for non-payment of rent, as explained in paragraph 23. The Landlord may (N)

collect a fee of $__ ___ on the second or any additional time a check is not honored for payment (bounces). The charges discussed in this paragraph are in addition to the regular monthly rent payable by the Tenant.

6. Condition of By signing this Agreement, the Tenant Dwelling acknowledges that the unit is safe, clean and Unit in good condition. The Tenant agrees that all Appliances and equipment in the unit are in good working order, except as described on the Unit Inspection Report which is Attachment No. 2 to this Agreement. The Tenant also agrees that the Landlord has made no promises to decorate, alter, repair or improve the unit, except as listed on the Unit Inspection Report.

7. Charges for The following charts describe how the cost of Utilities and utilities and services related to occupancy Services: of the unit will be paid. The Tenant agrees

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that these charts accurately describe the
utilities and services paid by the Landlord and
those paid by the Tenant.

• a. The Tenant must pay for the utilities in column (1). Payments should be made directly to the appropriate utility company. The items in column (2) are included in the Tenant's rent.

            (1)                                           (2)
        Put  "x" by any      Type of                  Put "x" by any
        Utility Tenant       Utility                  Utility Included
        pays directly                                 in Tenant Rent
           ___(O)___          Heat                       ___(O)____
           _________          Lights, Electric           __________
           _________          Cooking                    __________
           _________          Water                      __________
                              Other (Specify.
           _________          ____________               __________
           _________          ____________               __________

• b. The Tenant agrees to pay the Landlord the amount shown in column (3) on the date the rent is due. The Landlord certifies that HUD had authorized him/her to collect the type of charges shown in column (3) and that the amounts shown in column (3) do not exceed the amounts authorized by HUD.

                                            (3)

                                      Show $ Amount Tenant
                                      Pays to Landlord in
                                      Addition to Rent
(O)
               Parking                   $_______
               Other (Specify.)
               _______________           $__________
               _______________           $__________
(P)
8.  Security Deposits:   The Tenant has deposited $____ with the
                         Landlord.  The Landlord will hold this
                         security deposit for the period the Tenant
                         occupies the unit.  After the Tenant has moved
                         from the unit, the Landlord will determine
 whether the Tenant is eligible for a refund of
any or all of the security deposit.  The amount
of the refund will be determined in accordance
with the following conditions and procedures.

• a. The Tenant will be eligible for a refund of the security Deposit only if the Tenant provided the Landlord with the 30day written notice of intent to move required by paragraph 23, unless the Tenant was unable to give the notice for reasons beyond his/her control.

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• b. After the Tenant has moved from the unit, the Landlord will inspect the unit and complete another Unit Inspection Report. The Landlord will permit the Tenant to participate in the inspection, if the Tenant so requests.

• b. The Landlord will refund to the Tenant the amount of the (Q)

• security deposit plus interest computed at _ _%, beginning

• (R) ___ ___ ,less any amount needed to pay the cost of:

• (1) unpaid rent;

• (2) damages that are not due to normal wear and tear and are not listed on the Unit Inspection Report;

• (3) charges for late payment of rent and returned checks, as described in paragraph 5; and

• (4) charges for unreturned keys, as described in paragraph 9.

• d. The Landlord agrees to refund the amount computed in paragraph 8c within _ (S) _ days after the Tenant has permanently moved out of the unit, returned possession of the unit to the Landlord, and given his/her new address to the Landlord. The Landlord will also give the Tenant a written list of charges that were subtracted from the deposit. If the Tenant disagrees with the Landlord concerning the amounts deducted and asks to meet with the Landlord, the Landlord agrees to meet with the Tenant and informally discuss the disputed charges.

• e. If the unit is rented by more than one person, the Tenants

• agree that they will work out the details of dividing any refund among themselves. The Landlord may pay the refund to any Tenant identified in Paragraph 1 of this Agreement.

• f. The Tenant understands that the Landlord will not count the Security Deposit towards the last month's rent or towards repair charges owed by the Tenant in accordance with paragraph 11.

9. Keys and Locks: The Tenant agrees not to install additional or different locks or gates on any doors or windows of the unit without the written permission of the Landlord. If the Landlord approves the Tenant's request to install such locks, the Tenant agrees to provide the Landlord with a key for each lock. When this Agreement ends, the Tenant agrees to return all keys to the dwelling unit to the Landlord. The Landlord may charge the Tenant (T)

$ ___ _ for each key not returned.

Maintenance:

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• a. The Landlord agrees to:

• (1) regularly clean all common areas of the project;

• (2) maintain the common areas and facilities in a safe condition;

• (3) arrange for collection and removal of trash and garbage;

• (4) maintain all equipment and appliances in safe and working order;

• (5) make necessary repairs with reasonable promptness;

• (6) maintain exterior lighting in good working order:

• (7) provide extermination services, as necessary; and

• (8) maintain grounds and shrubs.

• b. The Tenant agrees to:

• (1) keep the unit clean;

  • (2) use all appliances, fixtures and equipment in a safe manner and only for the purposes for which they are intended;

• (3) not litter the grounds or common areas of the project;

• (4) not destroy, deface, damage or remove any part of the unit, common areas, or project grounds;

• (5) give the Landlord prompt notice of any defects in the plumbing, fixtures, appliances, heating and cooling equipment or any other part of the unit or related facilities; and

  • (6) remove garbage and other waste from the unit in a clean and safe manner.

11. Damages: Whenever damage is caused by carelessness, misuse, or neglect on the part of the Tenant, his/her family or visitors, the Tenant agrees to pay:

• a. the cost of all repairs and do so within 30 days after receipt of the Landlord's demand for the repair charges; and

• b. rent for the period the unit is damaged whether or not the unit is habitable. The Tenant understands that HUD will not make assistance payments for any period in which the unit is not habitable. For any such period, the Tenant agrees to pay the HUD-approved market rent rather than the Tenant rent

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shown in paragraph 3 of this agreement.

12. Restrictions on No alteration, addition, or improvements shall Alterations: be made in or to the premises without the prior consent of the Landlord in writing. The Landlord agrees to provide reasonable accommodation to an otherwise eligible tenant’s disability, including making changes to rules, policies, or procedures, and making and paying for structural alterations to a unit or common areas. The Landlord is not required to provide accommodations that constitute a fundamental alteration to the Landlord’s program or which would pose a substantial financial and administrative hardship. See the regulations at 24 CFR Part 8. In addition, if a requested structural modification does pose a substantial financial and administrative hardship, the Landlord must then allow the tenant to make and pay for the modification in accordance with the Fair Housing Act.

13. General The Tenant must live in the unit and the Restrictions: unit must be the Tenant's only place of residence. The Tenant shall use the premises only as a private dwelling for himself/herself and the individuals listed on the Owner’s Certification of Compliance with HUD’s Tenant Eligibility and Rent Procedures, Attachment 1. The Tenant agrees to permit other individuals to reside in the unit only after obtaining the prior written approval of the Landlord. The Tenant agrees not to:

• a. sublet or assign the unit, or any part of the unit;

• b. use the unit for unlawful purposes;

• c. engage in or permit unlawful activities in the unit, in the common areas or on the project grounds;

• d. have pets or animals of any kind in the unit without the prior

  • written permission of the Landlord, but the landlord will allow the tenant to keep an animal needed as a reasonable accommodation to the tenant’s disability, and will allow animals to accompany visitors with disabilities who need such animals as an accommodation to their disabilities; or

• e. make or permit noises or acts that will disturb the rights or comfort of neighbors. The Tenant agrees to keep the volume of any radio, phonograph, television or musical instrument at a level which will not disturb the neighbors.

14. Rules: The Tenant agrees to obey the House Rules which are

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Attachment No. 3 to this Agreement.  The tenant agrees
               to obey additional rules established after the effective
        date of this Agreement if:

• a. the rules are reasonably related to the safety, care and cleanliness of the building and the safety, comfort and convenience of the Tenants; and

• b. the Tenant receives written notice of the proposed rule at least 30 days before the rule is enforced.

• (U) (V)

• 15. Regularly Scheduled Every year around the __ ___ day of _ _, Recertifications: the Landlord will request the

• Tenant to report the income and composition of the Tenant's household and to supply any other information required by HUD for the purposes of determining the Tenant's rent and assistance payment, if any. The Tenant agrees to provide accurate statements of this

  • information and to do so by the date specified in the Landlord's request. The landlord will verify the information supplied

  • by the Tenant and use the verified

  • information to recompute the amount of the Tenant's rent and assistance payment, if any.

• a. If the Tenant does not submit the required recertification information by the date specified in the Landlord's request, the Landlord may impose the following penalties. The Landlord may implement these penalties only in accordance with the administrative procedures and time frames specified in HUD's regulations, handbooks and instructions related to the administration of multifamily subsidy programs.

  • (1) Require the Tenant to pay the higher, HUD-approved market rent for the unit.

• (2) Implement any increase in rent resulting from the recertification processing without providing the 30-day notice otherwise required by paragraph 4 of this Agreement.

• b. The Tenant may request to meet with the Landlord to discuss any change in rent or assistance payment resulting from the

• recertification processing. If the Tenant requests such a meeting, the Landlord agrees to meet with the Tenant and discuss how the Tenant's rent and assistance payment, if any, were computed.

16. Reporting Changes Between Regularly Scheduled Recertifications:

• a. If any of the following changes occur, the Tenant agrees to advise the Landlord immediately.

• (1) Any household member moves out of the unit.

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(2)  An adult member of the household who was reported

                as unemployed on the most recent certification or
                recertification obtains employment.

• (3) The household's income cumulatively increases by $200 or more a month.

• b. The Tenant may report any decrease in income or any change in other factors considered in calculating the Tenant's rent. Unless the Landlord has confirmation that the decrease in income or change in other factors will last less than one month, the Landlord will verify the information and make the appropriate rent reduction. However, if the Tenant's income will be partially or fully restored within two months, the Landlord may delay the certification process until the new income is known, but the rent reduction will be retroactive and the Landlord may not evict the Tenant for nonpayment of rent due during the period of the reported decrease and the completion of the certification process. The Tenant has thirty days after receiving written notice of any rent due for the above described time period to pay or the Landlord can evict for nonpayment of rent. (Revised 3/22/89)

• c. If the Tenant does not advise the Landlord of these interim changes, the Landlord may increase the Tenant's rent to the HUD-approved market rent. The Landlord may do so only in accordance with the time frames and administrative procedures set forth in HUD's regulations, handbooks and instructions on the administration of multifamily subsidy programs.

• d. The Tenant may request to meet with the Landlord to discuss how any change in income or other factors affected his/her rent or assistance payment, if any. If the Tenant requests such a meeting, the Landlord agrees to meet with the Tenant and explain how the Tenant's rent or assistance payment, if any, was computed.