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 | |
| Auxiliary apparatus. (See Chapter 5, Paragraph 5-10.C) |
Written verification from source of costs and purpose of apparatus. Written certification from doctor or rehabilitation agency that use of apparatus is necessary to employment of any family member. In a case where the disabled person is employed, statement from employer that apparatus is necessary for employment. |
Copies of receipts. | Telephone or in- person contact with these sources documented in file by the owner. |
Evidence of periodic payments for apparatus. |
Not appropriate. | The owner must determine if the expense is to be considered a medical or disability assistance. |
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 4 Appendix 3: Acceptable Forms of Verification
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Appendix 3
4350.3 REV-1
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