Rev. 1. If a tenant is denied assistance for this reason, the owner or managing agent must follow the procedures set out in the lease. _ Consent: I consent to allow HUD, the O/A, or the PHA to request and obtain income information from the federal and state agencies listed on the back of this form for the purpose of verifying my eligibility and level of benefits under HUD’s assisted housing programs. Signatures: Additional Signatures, if needed: Head of Household Date Other Family Members 18 and Over Date Spouse Date Other Family Members 18 and Over Date Other Family Members 18 and Over Date Other Family Members 18 and Over Date Other Family Members 18 and Over Date Other Family Members 18 and Over Date Original is retained on file at the project site ref. Handbooks 4350.3 Rev-1, 4571.1, 4571/2 & form HUD-9887 (02/2007) 4571.3 and HOPE II Notice of Program Guidelines Agencies To Provide Information State Wage Information Collection Agencies. (HUD and PHA). This consent is limited to wages and unemployment compensation you have received during period(s) within the last 5 years when you have received assisted housing benefits.
Appears in 27 contracts
Samples: Application Agreement, Application Agreement, Application Agreement