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 | |
| Care attendant for disabled family members. (Paragraph 5-10.C) |
Written verification from attendant stating amount received, frequency of payments, hours of care. Written certification from doctor or rehabilitation agency that care is necessary to employment of family member. |
Copies of receipts. | Telephone or in- person contact with source documented in file by the owner. |
Cancelled checks indicating payment amount and frequency. |
Notarized statement or signed affidavit attesting to amounts paid. |
The owner must determine if this 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 5 Appendix 3: Acceptable Forms of Verification
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Appendix 3
4350.3 REV-1
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