Appendix 3: Acceptable Forms — HUD Handbook 4350.3 REV-1

			ACCEPTABLESOURCES
		Third Partya				Verification Tips
Factor to be Verified	Written~~b and d~~	Provided by Applicant~~e*~~	Oralc	*Provided by Applicant	Self-Declaration
Dividend income and savings account interest income. (See Chapter 5, Paragraph 5-7)	Verification form completed by bank.	Copies of current statements, bank passbooks, certificates of deposit, if they show required information (i.e., current rate of interest). Copies of Form 1099 from the financial institution, and verification of projected income for the next 12 months. Broker’s quarterly statements showing value of stocks/bonds and earnings credited to the applicant.	Telephone or in- person contact with appropriate party, documented in file by the owner.		Notarized statement or signed affidavit stating dividend income and savings account interest income.	The owner must obtain enough information to accurately project income over next 12 months. Verify interest rate as well as asset value.

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 9 Appendix 3: Acceptable Forms of Verification

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Appendix 3

4350.3 REV-1