Rev. 1. If a tenant is denied assistance for this reason, the O/A must follow the procedures set out in the lease. Conditions No action can be taken to terminate, deny, suspend or reduce the assistance your household receives based on information obtained about you under this consent until the O/A has independently 1) verified the information you have provided with respect to your eligibility and level of benefits and 2) with respect to income (including both earned and unearned income), the O/A has verified whether you actually have (or had) access to such income for your own use, and verified the period or periods when, or with respect to which you actually received such income, wages, or benefits. stances, the O/A may document the file as to the reason for the delay and the specific plans to obtain the proper signature as soon as possible. Individual consents to the release of information expire 15 months after they are signed. The O/A may use these individual consent forms during the 120 days preceding the certification period. The O/A may also use these forms during the certification period, but only in cases where the O/A receives information indicating that the information you have provided may be incorrect. Other uses are prohibited. The O/A may not make inquiries into information that is older than 12 months unless he/she has received inconsistent information and has reason to believe that the information that you have supplied is incorrect. If this occurs, the O/A may obtain information within the last 5 years when you have received assistance. I have read and understand this information on the purposes and uses of information that is verified and consent to the release of information for these purposes and uses. A photocopy of the signed consent may be used to request the information authorized by your signature on the individual consent forms. This would occur if the O/A does not have another
Appears in 20 contracts
Samples: Application Agreement, Application Agreement, Application Agreement
Rev. 1. If a tenant is denied assistance for this reason, the O/A must follow the procedures set out in the lease. Conditions No action can be taken to terminate, deny, suspend or reduce the assistance your household receives based on information obtained about you under this consent until the O/A has independently 1) verified the information you have provided with respect to your eligibility and level of benefits and 2) with respect to income (including both earned and unearned income), the O/A has verified whether you actually have (or had) access to such income for your own use, and verified the period or periods when, or with respect to which you actually received such income, wages, or benefits. stances, the O/A may document the file as to the reason for the delay and the specific plans to obtain the proper signature as soon as possible. Individual consents to the release of information expire 15 months after they are signed. The O/A may use these individual consent forms during the 120 days preceding the certification period. The O/A may also use these forms during the certification period, but only in cases where the O/A receives information indicating that the information you have provided may be incorrect. Other uses are prohibited. The O/A may not make inquiries into information that is older than 12 months unless he/she has received inconsistent information and has reason to believe that the information that you have supplied is incorrect. If this occurs, the O/A may obtain information within the last 5 years when you have received assistance. I have read and understand this information on the purposes and uses of information that is verified and consent to the release of information for these purposes and uses. A photocopy of the signed consent may be used to request the information authorized by your signature on the individual consent forms. This would occur if the O/A does not have anotheranother individual verification consent with an original signature and the O/A is required to send out another request for verification (for example, the third party fails to respond). If this happens, the O/A Name of Applicant or Tenant (Print) may attach a photocopy of this consent to a photocopy of the individual verification form that you sign. To avoid the use of photocopies, the O/A and the individual may agree to sign more than one consent for each type of verification that is needed. The O/A shall inform you, or a third party which you designate, of the findings made on the basis of information verified under this consent and shall give you an opportunity to contest such findings Signature of Applicant or Tenant & Date I have read and understand the purpose of this consent and its uses and I understand that misuse of this consent can lead to personal penalties to me.
Appears in 7 contracts
Samples: Application Agreement, Application Agreement, Application Agreement