SAMPLE TENANT CONSENT TO DISCLOSE EIV INCOME INFORMATION
Quarterly Wage File
HUD Handbook 4350.3 REV-1 — Occupancy Requirements of Subsidized Multifamily Housing Programs · 2026 edition · updated 2026-10-05 · United States
Employee SSN
Employee Name
Employer Name
Employer Address
Quarterly employee wage amount
Date quarterly wage record processed by NDNH
Federal Employee Identification Number (EIN) (optional for an employer to report)
State EIN (optional for an employer to report)
Department of Defense indicator, if any
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