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SAMPLE TENANT CONSENT TO DISCLOSE EIV INCOME INFORMATION

Multifamily Housing

HUD Handbook 4350.3 REV-1 — Occupancy Requirements of Subsidized Multifamily Housing Programs · 2026 edition · updated 2026-10-05 · United States

  • 1a. Project Name & Address (including City, County, State & Zip Code)

1b. Project Contract Number

1c. No. of Units

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1d. Census Tract 1e . Housing/Expanded Housing Marketing 1f. Managing Agent Name, Address (including City, State & Zip Code), Telephone Number & Email Address 1g. Applicant/Owner/Developer Name, Address (including City, State & Zip Code), Telephone Number & Email Address 1h. Entity Responsible for Marketing (check all that apply) Owner Agent Other (specify) Position, Name (if known), Address (including City, State & Zip Code), Telephone Number & Email Address 1i. To whom should approval and other correspondence concerning this AFHM Plan be sent? Indicate Address (including City, State & Zip Code), Telephone Number & Email Address in addition to Name. 2a. Affirmative Fair Housing Marketing Plan Plan Type Updated Plan / Date: Please Select Plan Type Reason(s) for current update: 2b. HUD-Approved Occupancy of the Project (check all that apply) Elderly Family Mixed (Elderly/Disabled) Disabled 2c. Date of Initial Occupancy 2d. Advertising Start Date Advertising must begin at least 90 days prior to initial or renewed occupancy. Date advertising began or will begin: For existing projects, select below the reason advertising will be used: To add to waiting list (which currently has individuals) To reopen closed waiting list (which currently has individuals) form HUD­935.2A (2/2011)

Previous editions are obsolete Page 1 of 8

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▸Contents — HUD Handbook 4350.3 REV-1 — Occupancy Requirements of Subsidized Multifamily Housing Programs

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