D. Certifications: — HUD Handbook 4350.3 REV-1

I hereby authorize the third party listed on this consent to view and/or discuss the EIV information identified above for the sole purpose of assisting in the recertification of my housing assistance in accordance with the rights afforded to me by the Privacy Act of 1974. I understand further use of such information is prohibited by the Privacy Act and Social Security Act, and that it may not be disclosed, redisclosed, copied, duplicated, or removed from the property for any reason. I also have read and understand the penalties for such misuse of the information, as provided on this form.

__________________________________ __________________________________ ____________________ Signature of tenant authorizing release Printed name of tenant authorizing release Date_

I hereby acknowledge and certify that I am permitted to view and discuss tenant information pertaining to the above named individual for the sole purpose of assisting the tenant in the recertification of his/her subsidy. I understand further use of such information is prohibited by the Privacy Act and Social Security Act, and that it may not be disclosed, redisclosed, copied, duplicated, or removed from the property for any reason. I also have read and understand the penalties for such misuse of the information, as provided on this form.

Signature of authorized third party Printed name of authorized third party

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Date

HUD Occupancy Handbook Exhibit 9-4

8/13

Exhibit 9-5

4350.3 REV-1

			USE OF EIV REPORTS
REPORT	*UPDATE		REPORT USE	FILE DOCUMENTATION	RETENTION
	TSP	P&P
Summary Report Summary of household information from the current, active certification in the TRACS file at the time of the income match. Provides Identity Verification Status by identifying tenants whose personal identifiers: Match the SSA database - “Verified” Does not match the SSA database – “Failed” Have not been sent by HUD to SSA for validation or have not yet been matched by SSA for validation – “Not Verified” SSA’s records indicate the person is deceased – “Deceased” See Paragraph 9-12.A		X	Must be used at recertification (annual and interim) To validate a tenant’s SSN To review and resolve discrepant or invalid personal identifiers of tenants with a “failed” or “deceased” status Note: Nothing has to be done at the time of recertification with those tenants with an Identity Verification Status of “Not Verified”. However, the Failed SSA Identity Test report must be checked monthly as a change in the Identity Verification Status may occur.	Summary Report(s) as verification of the SSN for all household members whose Identity Verification Status is “Verified”. Correspondence or documentation received to resolve a tenant’s “Failed” or “Deceased” status. Documentation for household members identified as exempt from disclosing and providing verification of a SSN: Tenants who were 62 years of age or older as of January 31, 2010, and whose initial determination of eligibility was begun before January 31, 2010; and Individuals who do not contend eligible immigration status If the Summary Report in the tenant file shows an Identity Verification Status of “Verified” for all household members required to have a SSN, the Owner does not have to continue to print out the Summary Report at recertification unless there is a change in household composition or in a household member’s identity verification status	Tenant file Summary Report and supporting documentation must be retained in the tenant’s file for term of tenancy plus 3 years. Note:O/As may remove and destroy copies of verification documentation received from the tenant to verify their SSN once the Identity Verification Status shows “Verified”. O/As are encouraged to minimize the number of tenant records that contain documents that display the full nine-digit SSN.

*TSP = Tenant Selection Plan P&P = Policies and Procedures

HUD Occupancy Handbook Exhibit 9-5

8/13

Exhibit 9-5

4350.3 REV-1

			USE OF EIV REPORTS
REPORT	*UPDATE		O/A REPORT USE	FILE DOCUMENTATION	RETENTION
	TSP	P&P
INCOME REPORTS Note: A current, signed form HUD-9887 must be on file to view and/or use the income reports. Acurrent, signed form HUD-9887-A must be on file to obtainwritten third party verification of					income.
Income Report Provides employment and income reported by HHS and SSA for each household member that passes the SSA identity test. Identifies tenants who: May not have reported complete and accurate income information May be receiving multiple subsidies See Paragraph 9-12.B		X	Mandatory use at Recertification - Annual and Interim May be used at other times as indicated in O/A’s policies and procedures. Serves as third party verification of employment and income. New Admissions: Review new admissions within 90 days after the move-in information is transmitted to TRACS to confirm/validate the income reported by the household. Resolve discrepancies in reported income with the family within 30 days of the EIV Income Report date.	No Dispute of EIV Information: EIV Income Report Current, acceptable tenant provided documents Third party verification from the source, if necessary Disputed EIV Information: EIV Income Report Third party verification from the source for the disputed information Tenant-reported income not verified through the EIV system: EIV Income Report Current, acceptable tenant- provided documents, and/or Third party verification from the source Any correspondence with/from tenant relating to disputes of the employment or income reported in EIV. Form HUD-50059(s)	Tenant File Retain copy of Income Report and supporting documentation with applicable form HUD- 50059 for term of tenancy plus 3 years. Note:The O/A must make copies of any tenant provided documents and return the originals to the tenant.

*TSP = Tenant Selection Plan P&P = Policies and Procedures

HUD Occupancy Handbook Exhibit 9-5

8/13

Exhibit 9-5

4350.3 REV-1

			USE OF EIV REPORTS
REPORT	*UPDATE		O/A REPORT USE	FILE DOCUMENTATION	RETENTION
	TSP	P&P
INCOME REPORTS Cont’d. Note: A current, signed form HUD-9887 must be on file to view and/or use the income reports. Acurrent, signed form HUD-9887-A must be on file to obtainwritten third party verification of					income.
Income Discrepancy Report Identifies households where there is a difference of $2,400 or more in the wage, unemployment and SSA benefit information reported in EIV and wage, unemployment and SSA benefit information reported in TRACS for the period of income used for discrepancy analysis. The report serves as a tool to alert O/As that there may be a discrepancy in the income reported by the tenant during the period of income used for the discrepancy analysis. See Paragraph 9-12.C		X	Mandatory use at Recertification - Annual and Interim Report may be used at other times as indicated in O/A’s policies and procedures. Must print the report at the same time the Income Report is printed. Discrepancies must be reviewed and resolved at the time of recertification or within 30 days of the EIV Income Report date. Review data in TRACS to make sure it agrees with the form HUD-50059 data. Correct any discrepant data in the TRACS database.	All correspondence to/from the tenant regarding the income discrepancy. Documentation received to resolve the discrepancy, including written third party verification of income, if applicable. The file must be documented regardless of whether the O/A determines the discrepancy to be valid or invalid. Corrected form HUD-50059(s), if applicable. Repayment Agreement, if applicable.	Tenant file Retain copy of Income Discrepancy Report and any documentation related to the resolution of the discrepancy, including any repayment agreements for term of tenancy plus 3 years.

*TSP = Tenant Selection Plan P&P = Policies and Procedures

HUD Occupancy Handbook Exhibit 9-5

8/13

Exhibit 9-5

4350.3 REV-1