Form HUD-9834, Tenant File Review Worksheet Instructions
This form contains 322 fields organized into 89 sections. Below is a complete list of every field, its type, and what information is expected.
| Field Name | Type | Description |
|---|---|---|
| 401K/Keogh/Retirement Accounts Income | ||
| Yes | Checkbox |
Check this box if there is actual income from 401K/Keogh/Retirement Accounts.
|
| No | Checkbox |
Check this box if there is no actual income from 401K/Keogh/Retirement Accounts.
|
| N/A | Checkbox |
Check this box if information regarding 401K/Keogh/Retirement Accounts income is not applicable or unavailable.
|
| Actual Income from Assets Comments | ||
| Actual Income from Assets Comments | Text |
Provide any additional comments or details regarding the actual income from assets.
|
| Actual Income from Assets Headers | ||
| Income Received Status Header | Text |
Provide a header for the column indicating whether income was received from assets.
|
| Actual Income Header | Text |
Provide a header for the column specifying the actual income from assets.
|
| Cash Value Header | Text |
Provide a header for the column indicating the cash value of assets.
|
| Additional Charges Paid by Tenant | ||
| Yes | Checkbox |
Check this box if additional charges were paid by the tenant. Fill only if 'Type of Review' is 'Tenant Move-Out'.
Depends on:
Tenant Move-Out
|
| No | Checkbox |
Check this box if no additional charges were paid by the tenant. Fill only if 'Type of Review' is 'Tenant Move-Out'.
Depends on:
Tenant Move-Out
|
| N/A | Checkbox |
Check this box if the question about additional charges paid by the tenant is not applicable. Fill only if 'Type of Review' is 'Tenant Move-Out'.
Depends on:
Tenant Move-Out
|
| Additional Charges Comment | Text |
Provide any additional comments regarding charges paid by the tenant. Fill only if 'Type of Review' is 'Tenant Move-Out'.
Depends on:
Tenant Move-Out
|
| Ages of Occupants Verification | ||
| Ages of Occupants Verified: Yes | Checkbox |
Check this box if the ages of all occupants have been properly verified.
|
| Ages of Occupants Verified: No | Checkbox |
Check this box if the ages of all occupants have not been properly verified.
|
| Ages of Occupants Verified: N/A | Checkbox |
Check this box if the verification of occupants' ages is not applicable.
|
| Allowances/Expenses Comments | ||
| Allowances and Expenses Comments | Text |
Provide any additional comments or explanations regarding the allowances and expenses listed in section 11.
|
| Appeal Process and Notification Timeline | ||
| Yes | Checkbox |
Check this box if the appeal was processed and the applicant was notified of the appeal decision within five days of the meeting. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| No | Checkbox |
Check this box if the appeal was not processed or the applicant was not notified of the appeal decision within five days of the meeting. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| N/A | Checkbox |
Check this box if an appeal was not made or this question is not applicable to the current situation. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Applicant Rejection Review Comments | Text |
Provide any additional comments or details regarding the applicant rejection review process and notification timeline. Fill only if 'Type of Review' is 'Applicant Rejection'.
Depends on:
Applicant Rejection
|
| Appeal Review Independence | ||
| Yes | Checkbox |
Check this box if the applicant appealed and the appeal was reviewed by someone other than the person who made the original decision. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| No | Checkbox |
Check this box if the applicant appealed but the appeal was not reviewed by someone other than the person who made the original decision. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| N/A | Checkbox |
Check this box if the applicant did not appeal, so this question is not applicable. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Appeal Review Independence Comments | Text |
Provide any additional comments or details regarding the independence of the appeal review process. Fill only if 'Type of Review' is 'Applicant Rejection'.
Depends on:
Applicant Rejection
|
| Application Completeness | ||
| Yes | Checkbox |
Check this box if the application is complete, including the date and time received by the owner/agent.
|
| No | Checkbox |
Check this box if the application is not complete, including the date and time received by the owner/agent.
|
| Application Completeness Comments | Text |
Provide any additional comments or details regarding the completeness of the application or related household information documents.
|
| Asset Disposal Certification | ||
| No314 | CheckBox | |
| NA131 | CheckBox | |
| ChkBox384 | CheckBox | |
| Asset Disposal Details | Text |
Provide detailed information regarding any assets disposed of by the household during the past two years, as certified.
|
| Assistance Payment Agreement | ||
| Yes | Checkbox |
Check this box if the assistance payment requested on the monthly billing (HUD-52670-A, Part 1) agrees with the assistance payment on the applicable form HUD-50059.
|
| No | Checkbox |
Check this box if the assistance payment requested on the monthly billing (HUD-52670-A, Part 1) does not agree with the assistance payment on the applicable form HUD-50059.
|
| N/A | Checkbox |
Check this box if the question regarding the agreement of assistance payments is not applicable.
|
| Assistance Payment Agreement Comments | Text |
Provide comments regarding whether the assistance payment requested on the monthly billing (HUD-52670-A, Part 1) agrees with the assistance payment on form HUD-50059.
|
| Bedroom Size | ||
| 0 Bedroom | Checkbox |
Check this box if the unit has 0 bedrooms (e.g., a studio or efficiency).
|
| 1 Bedroom | Checkbox |
Check this box if the unit has 1 bedroom.
|
| 2 Bedroom | Checkbox |
Check this box if the unit has 2 bedrooms.
|
| 3 Bedroom | Checkbox |
Check this box if the unit has 3 bedrooms.
|
| 4 Bedroom | Checkbox |
Check this box if the unit has 4 bedrooms.
|
| 5 or more Bedrooms | Checkbox |
Check this box if the unit has 5 or more bedrooms.
|
| Certificates of Deposit Income | ||
| Certificates of Deposit - Yes | Checkbox |
Check this box if there is actual income from Certificates of Deposit.
|
| Certificates of Deposit - No | Checkbox |
Check this box if there is no actual income from Certificates of Deposit.
|
| Certificates of Deposit - N/A | Checkbox |
Check this box if Certificates of Deposit are not applicable for income assessment.
|
| Certification Signing | ||
| Yes | Checkbox |
Check this box if the certification is signed and dated by the appropriate parties. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| No | Checkbox |
Check this box if the certification is not signed and dated by the appropriate parties. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Certification Signing Comments | Text |
Provide any relevant comments regarding whether the certification is signed and dated by the appropriate parties. Fill only if 'No' is 'No'.
Depends on:
No
|
| Certification Type | ||
| Initial | Checkbox |
Check this box if the certification type is an initial certification. Fill only if 'Certification/Recertification' is 'Yes'.
Depends on:
Certification/Recertification
|
| Annual | Checkbox |
Check this box if the certification type is an annual certification. Fill only if 'Certification/Recertification' is 'Yes'.
Depends on:
Certification/Recertification
|
| Interim | Checkbox |
Check this box if the certification type is an interim certification. Fill only if 'Certification/Recertification' is 'Yes'.
Depends on:
Certification/Recertification
|
| Corrections | Checkbox |
Check this box if the certification type is for corrections. Fill only if 'Certification/Recertification' is 'Yes'.
Depends on:
Certification/Recertification
|
| Other | Checkbox |
Check this box if the certification type is not initial, annual, interim, or corrections. Fill only if 'Certification/Recertification' is 'Yes'.
Depends on:
Certification/Recertification
|
| Checking Account Income | ||
| Checking Account - Yes | Checkbox |
Check this box if there is actual income from the checking account.
|
| Checking Account - No | Checkbox |
Check this box if there is no actual income from the checking account.
|
| Checking Account - N/A | Checkbox |
Check this box if income from a checking account is not applicable to this review.
|
| Childcare Expenses | ||
| Yes | Checkbox |
Check this box if childcare expenses are applicable and have been accounted for.
|
| No | Checkbox |
Check this box if childcare expenses are not applicable or have not been accounted for.
|
| N/A | Checkbox |
Check this box if information regarding childcare expenses is not available or not applicable in this context.
|
| Clarity of Rejection Reason | ||
| Yes | Checkbox |
Check this box if the reason for rejection was provided in specific terms and plain language. Fill only if 'Type of Review' is 'Applicant Rejection'.
Depends on:
Applicant Rejection
|
| No | Checkbox |
Check this box if the reason for rejection was NOT provided in specific terms and plain language. Fill only if 'Type of Review' is 'Applicant Rejection'.
Depends on:
Applicant Rejection
|
| N/A | Checkbox |
Check this box if this question regarding the clarity of the rejection reason is not applicable. Fill only if 'Type of Review' is 'Applicant Rejection'.
Depends on:
Applicant Rejection
|
| Clarity of Rejection Reason Comments | Text |
Please provide any additional comments or details regarding the clarity and plain language of the rejection reason provided to the applicant. Fill only if 'Type of Review' is 'Applicant Rejection'.
Depends on:
Applicant Rejection
|
| Correct Amount | ||
| Yes | Checkbox |
Check this box if the amount is correct. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| No | Checkbox |
Check this box if the amount is not correct. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| N/A | Checkbox |
Check this box if the question about the correct amount is not applicable. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Correct Amount | Number |
Please provide the correct monetary amount. Fill only if 'No' is 'No'.
Depends on:
No
|
| Correct Unit Rent Determination | ||
| Yes | Checkbox |
The user should check this box if the correct unit rent is being used for subsidy determination.
|
| No | Checkbox |
The user should check this box if the correct unit rent is NOT being used for subsidy determination.
|
| Unit Rent Determination Discrepancy Comment | Text |
Provide a comment detailing any discrepancies identified if the income information on the 50059 does not agree with the verified file information regarding unit rent determination.
|
| Criminal and Drug Screening | ||
| Yes | Checkbox |
Check this box if criminal and drug screening has been performed and documented.
|
| No | Checkbox |
Check this box if criminal and drug screening has not been performed or documented.
|
| Criminal and Drug Screening Details | Text |
Provide any additional details or comments regarding the criminal and drug screening results or process. Fill only if 'No' is 'No'.
Depends on:
No
|
| Dependent Allowance | ||
| Dependent Allowance - Yes | Checkbox |
Check this box if a dependent allowance is applicable for this tenant.
|
| Dependent Allowance - No | Checkbox |
Check this box if a dependent allowance is not applicable for this tenant.
|
| Dependent Allowance - N/A | Checkbox |
Check this box if information regarding a dependent allowance is not available or not applicable for this assessment.
|
| Disability Expenses | ||
| Yes | Checkbox |
Check this box if there are disability expenses to be considered.
|
| No | Checkbox |
Check this box if there are no disability expenses to be considered.
|
| N/A | Checkbox |
Check this box if the question regarding disability expenses is not applicable.
|
| Disability Status Verification | ||
| Yes | Checkbox |
Check this box if disability status has been verified.
|
| No | Checkbox |
Check this box if disability status has not been verified.
|
| N/A | Checkbox |
Check this box if disability status verification is not applicable.
|
| Discrepancy Documentation Comments | ||
| Discrepancy Documentation Comments | Text |
Provide any comments or additional details regarding the documentation to verify discrepant personal identifiers and/or subsidy paid. Fill only if 'EIV Multiple Subsidy Report Verification No', 'EIV Deceased Tenant Report - No' is 'No', any.
Depends on:
EIV Multiple Subsidy Report Verification No, EIV Deceased Tenant Report - No
|
| Effective date of certification(s) reviewed | ||
| Effective Date of Certification(s) Reviewed | Date |
Provide the effective date when the certification(s) were reviewed.
|
| EIV & You Brochure Tenant Receipt | ||
| EIV & You Brochure Acknowledged - Yes | Checkbox |
Check this box if there is an acknowledgement or signed document in the file indicating the tenant received the EIV & You Brochure.
|
| EIV & You Brochure Acknowledged - No | Checkbox |
Check this box if there is no acknowledgement or signed document in the file indicating the tenant received the EIV & You Brochure.
|
| EIV Deceased Tenant Report Verification | ||
| EIV Deceased Tenant Report - Yes | Checkbox |
Check this box if the file contains documentation to verify the EIV Deceased Tenant Report.
|
| EIV Deceased Tenant Report - No | Checkbox |
Check this box if the file does not contain documentation to verify the EIV Deceased Tenant Report.
|
| EIV Deceased Tenant Report - N/A | Checkbox |
Check this box if an EIV Deceased Tenant Report is not applicable or not available for verification.
|
| EIV Existing Tenant Search Results | ||
| Yes | Checkbox |
Check this box if the EIV Existing Tenant Search results are in the file along with contacts made as a result of the search, applicable to move-ins after January 31, 2010. Fill only if 'Move-in Date' is after January 31, 2010.
Depends on:
Move-in Date
|
| No | Checkbox |
Check this box if the EIV Existing Tenant Search results are not in the file or contacts were not made as a result of the search, applicable to move-ins after January 31, 2010. Fill only if 'Move-in Date' is after January 31, 2010.
Depends on:
Move-in Date
|
| N/A | Checkbox |
Check this box if the EIV Existing Tenant Search results are not applicable, such as for move-ins before January 31, 2010. Fill only if 'Move-in Date' is after January 31, 2010.
Depends on:
Move-in Date
|
| EIV Existing Tenant Search Results Comments | Text |
Provide comments regarding whether the EIV Existing Tenant Search results are in the file along with contacts made as a result of the search, applicable to move-ins after January 31, 2010. Fill only if 'Move-in Date' is after January 31, 2010.
Depends on:
Move-in Date
|
| EIV Multiple Subsidies Action | ||
| Yes | Checkbox |
Check this box if the tenant file indicates that the owner/agent has taken necessary steps to address any EIV reported receipt of multiple subsidies.
|
| No | Checkbox |
Check this box if the tenant file does not indicate that the owner/agent has taken necessary steps to address any EIV reported receipt of multiple subsidies.
|
| N/A | Checkbox |
Check this box if the question regarding necessary steps to address EIV reported receipt of multiple subsidies is not applicable to this tenant file.
|
| Multiple Subsidies Action Details | Text |
Provide a detailed explanation of the steps taken to address EIV reported multiple subsidies. Fill only if 'No' is 'No'.
Depends on:
No
|
| EIV Multiple Subsidy Report Verification | ||
| EIV Multiple Subsidy Report Verification Yes | Checkbox |
Check this box if the file contains documentation to verify discrepant personal identifiers and/or subsidy paid as reported on an EIV Multiple Subsidy report.
|
| EIV Multiple Subsidy Report Verification No | Checkbox |
Check this box if the file does not contain documentation to verify discrepant personal identifiers and/or subsidy paid as reported on an EIV Multiple Subsidy report.
|
| EIV Multiple Subsidy Report Verification N/A | Checkbox |
Check this box if an EIV Multiple Subsidy report is not applicable or not relevant for verification.
|
| EIV Summary Report for SSN Validation | ||
| EIV Summary Report in file - Yes | Checkbox |
Check this box if an EIV Summary Report is present in the file to validate SSNs.
|
| EIV Summary Report in file - No | Checkbox |
Check this box if an EIV Summary Report is not present in the file to validate SSNs.
|
| EIV Summary Report in file - N/A | Checkbox |
Check this box if the EIV Summary Report is not applicable for validating SSNs.
|
| Elderly/Disabled Household Allowance | ||
| Elderly/Disabled Household Allowance - Yes | Checkbox |
Check this box if the household is eligible for the Elderly/Disabled Household Allowance.
|
| Elderly/Disabled Household Allowance - No | Checkbox |
Check this box if the household is not eligible for the Elderly/Disabled Household Allowance.
|
| Elderly/Disabled Household Allowance - N/A | Checkbox |
Check this box if the Elderly/Disabled Household Allowance is not applicable to this household.
|
| Ethnicity and Racial Data Certification | ||
| Yes | Checkbox |
Check this box if the tenant file contains the ethnicity and racial data certification as provided to the owner/agent.
|
| No | Checkbox |
Check this box if the tenant file does not contain the ethnicity and racial data certification as provided to the owner/agent.
|
| Certification Comments | Text |
Provide any additional comments regarding the ethnicity and racial data certification for the tenant file.
|
| Exemption from SSN Disclosure | ||
| Yes | Checkbox |
Check this box if an exemption from Social Security Number disclosure applies.
|
| No | Checkbox |
Check this box if an exemption from Social Security Number disclosure does not apply.
|
| N/A | Checkbox |
Check this box if the question regarding exemption from Social Security Number disclosure is not applicable.
|
| Expense and Allowance Eligibility | ||
| Yes | Checkbox |
Check this box if all claimed expenses and allowances are eligible under the HUD Handbook 4350.3 REV-1.
|
| No | Checkbox |
Check this box if not all claimed expenses and allowances are eligible under the HUD Handbook 4350.3 REV-1.
|
| N/A | Checkbox |
Check this box if the question regarding expense and allowance eligibility is not applicable.
|
| Expense Eligibility Explanation | Text |
Provide a detailed explanation regarding the eligibility of all claimed expenses and allowances under the HUD Handbook 4350.3 REV-1.
|
| File Inspections | ||
| Move-in Inspection Yes | Checkbox |
Check this box if a move-in inspection, dated and signed by the tenant and owner/agent, is present in the file. Fill only if 'Type of Review' is 'Tenant Move-In'.
Depends on:
Tenant Move-In
|
| Move-in Inspection No | Checkbox |
Check this box if a move-in inspection, dated and signed by the tenant and owner/agent, is not present in the file. Fill only if 'Type of Review' is 'Tenant Move-In'.
Depends on:
Tenant Move-In
|
| Annual Unit Inspections Yes | Checkbox |
Check this box if records of annual unit inspections are present in the file. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Annual Unit Inspections No | Checkbox |
Check this box if records of annual unit inspections are not present in the file. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Annual Unit Inspections N/A | Checkbox |
Check this box if annual unit inspections are not applicable or required. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Inspection Comments | Text |
Enter any additional comments or details regarding the file inspections. Fill only if 'Move-in Inspection No', 'Annual Unit Inspections No' is 'No' for any.
Depends on:
Move-in Inspection No, Annual Unit Inspections No
|
| Household Member Identification | ||
| Yes | Checkbox |
Check this box if all household members (head, spouse, dependent, co-head, other adult(s), live-in aide, foster child, and foster adult) are identified correctly.
|
| No | Checkbox |
Check this box if any household member (head, spouse, dependent, co-head, other adult(s), live-in aide, foster child, and foster adult) is not identified correctly.
|
| Household Member Identification Comments | Text |
Provide any additional comments or details regarding the correct identification of household members.
|
| HUD 9887/9887A Consent Form | ||
| Yes | Checkbox |
Check this box if there is a current HUD 9887/9887A Consent Form signed and dated by the head, spouse, co-head (regardless of age), and family members at least 18 years of age.
|
| No | Checkbox |
Check this box if there is not a current HUD 9887/9887A Consent Form signed and dated by the head, spouse, co-head (regardless of age), and family members at least 18 years of age.
|
| Comments for HUD 9887/9887A Consent Form | Text |
Provide any additional comments regarding the HUD 9887/9887A Consent Form.
|
| HUD Model Lease Usage | ||
| No | Checkbox |
Check this box if the correct HUD model lease was not used for the tenant. Fill only if 'Type of Review' is 'Tenant Move-In'
Depends on:
Tenant Move-In
|
| No (Alternate) | Checkbox |
Check this box if the correct HUD model lease was not used, serving as an alternative or additional 'No' option for the tenant's lease. Fill only if 'Type of Review' is 'Tenant Move-In'
Depends on:
Tenant Move-In
|
| Yes | Checkbox |
Check this box if the correct HUD model lease was used for the tenant. Fill only if 'Type of Review' is 'Tenant Move-In'
Depends on:
Tenant Move-In
|
| HUD Model Lease Usage Comments | Text |
Provide any additional comments or explanations regarding the use of the correct HUD model lease. Fill only if 'No (Alternate)' is 'No'.
Depends on:
No (Alternate)
|
| HUD-92006 Form Presence | ||
| Yes | Checkbox |
Check this box if form HUD-92006, 'Supplement to Application for Federally Assisted Housing,' is present in the files for tenants who applied after 12/14/2009.
|
| No | Checkbox |
Check this box if form HUD-92006, 'Supplement to Application for Federally Assisted Housing,' is not present in the files for tenants who applied after 12/14/2009.
|
| N/A | Checkbox |
Check this box if the question regarding the presence of form HUD-92006 is not applicable.
|
| Comments on HUD-92006 Form Presence | Text |
Provide any relevant comments regarding the presence or absence of the HUD-92006 form for tenants who applied after 12/14/2009.
|
| Immigration or Citizenship Status Verification | ||
| Eligible Immigration Status Verified (Yes) | Checkbox |
Check this box if the eligible immigration status or citizenship status has been properly verified and documented.
|
| Eligible Immigration Status Not Verified (No) | Checkbox |
Check this box if the eligible immigration status or citizenship status has NOT been properly verified and documented.
|
| Eligible Immigration Status Not Applicable (N/A) | Checkbox |
Check this box if the verification of eligible immigration status or citizenship status is not applicable.
|
| Immigration or Citizenship Status Verification Comments | Text |
Provide any comments or additional information regarding the verification of eligible immigration status or citizenship status. Fill only if 'Eligible Immigration Status Not Verified (No)' is 'No'.
Depends on:
Eligible Immigration Status Not Verified (No)
|
| Imputed Income Details | ||
| Imputed Income Yes | Checkbox |
Check this box if there is imputed income because the tenant's assets are greater than $5,000.
|
| Imputed Income No | Checkbox |
Check this box if there is no imputed income because the tenant's assets are not greater than $5,000, or for other reasons.
|
| Imputed Income N/A | Checkbox |
Check this box if the question regarding imputed income when assets are greater than $5,000 is not applicable.
|
| Imputed Income Amount | Number |
Please provide the imputed income amount when assets are greater than $5,000. Fill only if 'Imputed Income Yes' is 'Yes'.
Depends on:
Imputed Income Yes
|
| Additional Imputed Income Amount | Number |
Please provide any additional imputed income amount based on assets greater than $5,000.
|
| Income Discrepancy Report Details | ||
| Yes | Checkbox |
Check this box if income discrepancies reported on the EIV Income Discrepancy Report were investigated, resolved, and file documented.
|
| No | Checkbox |
Check this box if income discrepancies reported on the EIV Income Discrepancy Report were not investigated, resolved, or file documented.
|
| N/A | Checkbox |
Check this box if the question regarding income discrepancies reported on the EIV Income Discrepancy Report is not applicable.
|
| Income Discrepancy Comments | Text |
Provide comments on any discrepancies identified if the income information on the 50059 did not agree with the verified file information.
|
| Income Ineligibility Exception | ||
| Yes | Checkbox |
Check this box if an exception or waiver was granted for a household that was not income eligible at move-in. Fill only if 'Income Eligible at Move-in - No' is 'Yes'.
Depends on:
Income Eligible at Move-in - No
|
| No | Checkbox |
Check this box if an exception or waiver was not granted for a household that was not income eligible at move-in. Fill only if 'Income Eligible at Move-in - No' is 'Yes'.
Depends on:
Income Eligible at Move-in - No
|
| N/A | Checkbox |
Check this box if the household was income eligible at move-in, making an exception or waiver unnecessary. Fill only if 'Income Eligible at Move-in - No' is 'Yes'.
Depends on:
Income Eligible at Move-in - No
|
| Income Ineligibility Exception Details | Text |
Provide details regarding the exception or waiver granted if the household was not income eligible at move-in. Fill only if 'Income Eligible at Move-in - No' is 'Yes'.
Depends on:
Income Eligible at Move-in - No
|
| Itemized List of Damages and Charges | ||
| Yes | Checkbox |
Check this box if an itemized list of damages and charges was provided to the tenant. Fill only if 'Type of Review' is 'Tenant Move-Out'.
Depends on:
Tenant Move-Out
|
| No | Checkbox |
Check this box if an itemized list of damages and charges was NOT provided to the tenant. Fill only if 'Type of Review' is 'Tenant Move-Out'.
Depends on:
Tenant Move-Out
|
| N/A | Checkbox |
Check this box if the question regarding an itemized list of damages and charges is not applicable. Fill only if 'Type of Review' is 'Tenant Move-Out'.
Depends on:
Tenant Move-Out
|
| Itemized List Comments | Text |
Please provide any comments or additional details regarding the itemized list of damages and charges provided to the tenant. Fill only if 'Type of Review' is 'Tenant Move-Out'.
Depends on:
Tenant Move-Out
|
| Lead Based Paint Tenant Receipt | ||
| Lead-Based Paint Acknowledged (Yes) | Checkbox |
Check this box if there is an acknowledgement and/or signed document in the file indicating the tenant received the Lead-Based Paint disclosure.
|
| Lead-Based Paint Acknowledged (No) | Checkbox |
Check this box if there is no acknowledgement and/or signed document in the file indicating the tenant received the Lead-Based Paint disclosure.
|
| Lead-Based Paint Acknowledged (N/A) | Checkbox |
Check this box if the Lead-Based Paint disclosure is not applicable to this tenant or property.
|
| Lease Attachments Verification | ||
| Yes | Checkbox |
Check this box if all applicable attachments, such as house rules, pet rules, and unit inspection report, are attached to the lease. Fill only if 'Type of Review' is 'Tenant Move-In'
Depends on:
Tenant Move-In
|
| No | Checkbox |
Check this box if all applicable attachments, such as house rules, pet rules, and unit inspection report, are NOT attached to the lease. Fill only if 'Type of Review' is 'Tenant Move-In'
Depends on:
Tenant Move-In
|
| Lease Attachments Comments | Text |
Provide any additional comments or explanations regarding the verification of applicable attachments attached to the lease, such as house rules, pet rules, or unit inspection reports. Fill only if 'No' is 'No'.
Depends on:
No
|
| Lease Signature Verification | ||
| Yes | Checkbox |
Check this box if the original lease and any subsequent leases or addenda are signed and dated by the owner/agent, head, spouse, co-head, and all other adult members of the household. Fill only if 'Type of Review' is 'Tenant Move-In'
Depends on:
Tenant Move-In
|
| No | Checkbox |
Check this box if the original lease and any subsequent leases or addenda are NOT signed and dated by the owner/agent, head, spouse, co-head, and all other adult members of the household. Fill only if 'Type of Review' is 'Tenant Move-In'
Depends on:
Tenant Move-In
|
| Lease Signature Verification Comments | Text |
Provide any relevant comments regarding whether the original lease and subsequent leases or addenda are signed and dated by the owner/agent, head, spouse, co-head, and all other adult members of the household. Fill only if 'No' is 'No'.
Depends on:
No
|
| Medical Expenses | ||
| Medical Expenses Yes | Checkbox |
Check this box if there are medical expenses to be considered for allowances.
|
| Medical Expenses No | Checkbox |
Check this box if there are no medical expenses to be considered for allowances.
|
| Medical Expenses N/A | Checkbox |
Check this box if medical expenses are not applicable for allowances.
|
| Monthly Billing Adjustments | ||
| Yes | Checkbox |
Check this box if adjustments were required and have been made to the monthly billing.
|
| No | Checkbox |
Check this box if adjustments were required but have not been made to the monthly billing.
|
| N/A | Checkbox |
Check this box if adjustments to the monthly billing were not required.
|
| Comments on Adjustments | Text |
Provide details and explanations regarding any adjustments made to the monthly billing.
|
| Move-in Income Eligibility | ||
| Income Eligible at Move-in - Yes | Checkbox |
Check this box if the household's income was eligible at the time of move-in. Fill only if 'Tenant Move-In' is 'Yes'.
Depends on:
Tenant Move-In
|
| Income Eligible at Move-in - No | Checkbox |
Check this box if the household's income was not eligible at the time of move-in. Fill only if 'Tenant Move-In' is 'Yes'.
Depends on:
Tenant Move-In
|
| Income Eligible at Move-in - N/A | Checkbox |
Check this box if income eligibility for the household is not applicable for this move-in review. Fill only if 'Tenant Move-In' is 'Yes'.
Depends on:
Tenant Move-In
|
| Income Eligibility Comments (Over/Very Low) | Text |
Enter comments explaining why the household was over income or classified as very low income at move-in. Fill only if the 'Was this household’s income eligible at move-in?' is 'No'.
|
| Income Eligibility Comments (Low/Extremely Low) | Text |
Enter comments explaining why the household was low income or classified as extremely low income at move-in. Fill only if the 'Was this household’s income eligible at move-in?' is 'No'.
|
| Over income | Checkbox |
Check this box if the household's income was determined to be over the income limits for eligibility. Fill only if 'Income Eligible at Move-in - No' is 'Yes'.
Depends on:
Income Eligible at Move-in - No
|
| Low income | Checkbox |
Check this box if the household's income was determined to be within the low income limits for eligibility. Fill only if 'Income Eligible at Move-in - Yes' is 'Yes'.
Depends on:
Income Eligible at Move-in - Yes
|
| Very low income | Checkbox |
Check this box if the household's income was determined to be within the very low income limits for eligibility. Fill only if 'Income Eligible at Move-in - Yes' is 'Yes'.
Depends on:
Income Eligible at Move-in - Yes
|
| Extremely low income | Checkbox |
Check this box if the household's income was determined to be within the extremely low income limits for eligibility. Fill only if 'Income Eligible at Move-in - Yes' is 'Yes'.
Depends on:
Income Eligible at Move-in - Yes
|
| Move-Out Date Verification | ||
| Yes | Checkbox |
Check this box if the tenant move-out date on the voucher matches the date the tenant vacated. Fill only if 'Type of Review' is 'Tenant Move-Out'.
Depends on:
Tenant Move-Out
|
| No | Checkbox |
Check this box if the tenant move-out date on the voucher does not match the date the tenant vacated. Fill only if 'Type of Review' is 'Tenant Move-Out'.
Depends on:
Tenant Move-Out
|
| Move-Out Date Voucher Match Comments | Text |
Provide any comments regarding whether the tenant move-out date on the voucher matches the date the tenant vacated. Fill only if 'Type of Review' is 'Tenant Move-Out'.
Depends on:
Tenant Move-Out
|
| Move-Out Inspection | ||
| Inspection Performed - Yes | Checkbox |
Check this box if a move-out inspection was performed for the tenant. Fill only if 'Type of Review' is 'Tenant Move-Out'.
Depends on:
Tenant Move-Out
|
| Inspection Performed - No | Checkbox |
Check this box if a move-out inspection was not performed for the tenant. Fill only if 'Type of Review' is 'Tenant Move-Out'.
Depends on:
Tenant Move-Out
|
| Move-Out Inspection Comments | Text |
Provide any additional comments or details regarding the move-out inspection. Fill only if 'Type of Review' is 'Tenant Move-Out'.
Depends on:
Tenant Move-Out
|
| Move-Out Inspection Date | Date |
Please provide the date when the move-out inspection occurred. Fill only if 'Inspection Performed - Yes' is 'Yes'.
Depends on:
Inspection Performed - Yes
|
| Date of Inspection Entered - Yes | Checkbox |
If a move-out inspection was performed, check this box if the date of the inspection has been entered in the corresponding field. Fill only if 'Type of Review' is 'Tenant Move-Out'.
Depends on:
Tenant Move-Out
|
| Date of Inspection Entered - No | Checkbox |
If a move-out inspection was performed, check this box if the date of the inspection has not been entered in the corresponding field. Fill only if 'Type of Review' is 'Tenant Move-Out'.
Depends on:
Tenant Move-Out
|
| Move-Out Notice | ||
| Yes | Checkbox |
Check this box if there is a move-out notice from the tenant. Fill only if 'Type of Review' is 'Tenant Move-Out'.
Depends on:
Tenant Move-Out
|
| No | Checkbox |
Check this box if there is no move-out notice from the tenant. Fill only if 'Type of Review' is 'Tenant Move-Out'.
Depends on:
Tenant Move-Out
|
| Move-Out Notice Comments | Text |
Provide any additional comments or details regarding the tenant's move-out notice. Fill only if 'Type of Review' is 'Tenant Move-Out'.
Depends on:
Tenant Move-Out
|
| Move-Out Date | Date |
Enter the date the tenant moved out. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Date of Notice | Date |
Enter the date the move-out notice was provided by the tenant. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Name of Reviewer | ||
| Reviewer Name | Text |
Provide the full name of the individual who conducted the review.
|
| Other Asset Description | ||
| Other Asset Description | Text |
Provide a detailed description for any asset not listed in the categories above.
|
| Other Income Details | ||
| Welfare/Public Assistance/TANF Yes | Checkbox |
Check this box if Welfare/Public Assistance/TANF income has been verified and calculated correctly. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Welfare/Public Assistance/TANF No | Checkbox |
Check this box if Welfare/Public Assistance/TANF income has not been verified or calculated correctly. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Welfare/Public Assistance/TANF N/A | Checkbox |
Check this box if Welfare/Public Assistance/TANF income is not applicable. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Child Support Yes | Checkbox |
Check this box if Child Support income has been verified and calculated correctly. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Child Support No | Checkbox |
Check this box if Child Support income has not been verified or calculated correctly. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Child Support N/A | Checkbox |
Check this box if Child Support income is not applicable. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Pensions Yes | Checkbox |
Check this box if Pensions income has been verified and calculated correctly. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Pensions No | Checkbox |
Check this box if Pensions income has not been verified or calculated correctly. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Pensions N/A | Checkbox |
Check this box if Pensions income is not applicable. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Other Income Yes | Checkbox |
Check this box if other specified income has been verified and calculated correctly. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Other Income No | Checkbox |
Check this box if other specified income has not been verified or calculated correctly. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Other Income N/A | Checkbox |
Check this box if other specified income is not applicable. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Other Income Discrepancy Comments | Text |
Provide a detailed explanation if the other income information reported on form 50059 does not match the verified file information. Fill only if 'Welfare/Public Assistance/TANF Yes', 'Child Support Yes', 'Pensions Yes', 'Other Income Yes' is 'Yes' for any.
Depends on:
Welfare/Public Assistance/TANF Yes, Child Support Yes, Pensions Yes, Other Income Yes
|
| Other Screening as per Tenant Selection Plan | ||
| Yes | Checkbox |
Check this box if other screening as disclosed in the Tenant Selection Plan was conducted.
|
| No | Checkbox |
Check this box if other screening as disclosed in the Tenant Selection Plan was not conducted.
|
| N/A | Checkbox |
Check this box if other screening as disclosed in the Tenant Selection Plan is not applicable.
|
| Other Screening Comments | Text |
Please provide any comments or details related to other screenings conducted as disclosed in the Tenant Selection Plan. Fill only if 'No' is 'No'.
Depends on:
No
|
| Pet Deposit Amount | ||
| Yes | Checkbox |
Check this box if the required pet deposit is in the correct amount.
|
| No | Checkbox |
Check this box if the required pet deposit is not in the correct amount.
|
| N/A | Checkbox |
Check this box if a pet deposit is not required for the tenant.
|
| Required Pet Deposit Amount | Number |
Please provide the required pet deposit amount. Fill only if 'No' is 'No'.
Depends on:
No
|
| Pet Deposit Installments | ||
| Yes | Checkbox |
Check this box if the pet deposit was paid in installments and the payment schedule was in accordance with pet regulations.
|
| No | Checkbox |
Check this box if the pet deposit was paid in installments, but the payment schedule was not in accordance with pet regulations.
|
| N/A | Checkbox |
Check this box if the pet deposit was not paid in installments, making the question about payment schedule compliance not applicable.
|
| Installment Payment Schedule Comments | Text |
Provide additional comments or details regarding the pet deposit installment payment schedule and its compliance with regulations. Fill only if 'No' is 'No'.
Depends on:
No
|
| Re-certification Completion | ||
| Yes | Checkbox |
Check this box if re-certifications were completed on time. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| No | Checkbox |
Check this box if re-certifications were not completed on time. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Re-certification Completion Comments | Text |
Provide any additional comments or details regarding the timely completion of re-certifications. Fill only if 'No' is 'No'.
Depends on:
No
|
| Re-certification Due to New Employment | ||
| Re-certification Due to New Employment - Yes | Checkbox |
Check this box if the tenant's file contains a re-certification that was initiated as a result of new employment reported on the EIV New Hires Report.
|
| Re-certification Due to New Employment - No | Checkbox |
Check this box if the tenant's file does not contain a re-certification that was initiated as a result of new employment reported on the EIV New Hires Report.
|
| Re-certification Due to New Employment - N/A | Checkbox |
Check this box if the question regarding re-certification due to new employment is not applicable to the tenant's file.
|
| New Employment Income Included - Yes | Checkbox |
Check this box if the new employment income is included in the tenant's reported annual income, assuming a re-certification due to new employment was present. Fill only if 'Re-certification Due to New Employment - Yes' is 'Yes'.
Depends on:
Re-certification Due to New Employment - Yes
|
| New Employment Income Included - No | Checkbox |
Check this box if the new employment income is not included in the tenant's reported annual income, assuming a re-certification due to new employment was present. Fill only if 'Re-certification Due to New Employment - Yes' is 'Yes'.
Depends on:
Re-certification Due to New Employment - Yes
|
| New Employment Income Included - N/A | Checkbox |
Check this box if the question about new employment income being included in reported annual income is not applicable. Fill only if 'Re-certification Due to New Employment - Yes' is 'Yes'.
Depends on:
Re-certification Due to New Employment - Yes
|
| Re-certification Comments | Text |
Provide any additional comments related to the re-certification due to new employment or new employment income.
|
| Re-certification Notices | ||
| Yes | Checkbox |
Check this box if re-certification notices were provided within the required timeframes. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| No | Checkbox |
Check this box if re-certification notices were not provided within the required timeframes. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Re-certification Notices Provision Comment | Text |
Provide any additional comments or details regarding whether re-certification notices were provided within the required timeframes. Fill only if 'No' is 'No'.
Depends on:
No
|
| Real Estate Income | ||
| Real Estate Income - Yes | Checkbox |
Check this box if there is actual income from real estate assets.
|
| Real Estate Income - No | Checkbox |
Check this box if there is no actual income from real estate assets.
|
| Real Estate Income - N/A | Checkbox |
Check this box if information regarding actual income from real estate assets is not applicable.
|
| Reason for Denial Consistency | ||
| Yes | Checkbox |
Check this box if the reason the applicant was denied admittance was in accordance with the Tenant Selection Plan. Fill only if 'Type of Review' is 'Applicant Rejection'.
Depends on:
Applicant Rejection
|
| No | Checkbox |
Check this box if the reason the applicant was denied admittance was not in accordance with the Tenant Selection Plan. Fill only if 'Type of Review' is 'Applicant Rejection'.
Depends on:
Applicant Rejection
|
| Reason for Denial Comments | Text |
Please provide any additional comments related to the reason for denial consistency during the applicant rejection review. Fill only if 'Type of Review' is 'Applicant Rejection'.
Depends on:
Applicant Rejection
|
| Rent Determination Fact Sheet Tenant Receipt | ||
| Yes | Checkbox |
Check this box if there is an acknowledgement and/or signed document in the file indicating the tenant received the 'Fact Sheet on How Your Rent is Determined'.
|
| No | Checkbox |
Check this box if there is no acknowledgement and/or signed document in the file indicating the tenant received the 'Fact Sheet on How Your Rent is Determined'.
|
| Rent Increase Notice | ||
| Notice Provided (Yes) | Checkbox |
Check this box if a 30-day notice of rent increase has been provided to the tenant. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Notice Provided (No) | Checkbox |
Check this box if a 30-day notice of rent increase has not been provided to the tenant. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Notice Provided (N/A) | Checkbox |
Check this box if a 30-day notice of rent increase is not applicable to the tenant's situation. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Rent Increase Notice Comments | Text |
Provide any additional comments regarding the 30-day notice of increase in rent. Fill only if 'Notice Provided (No)' is 'No'.
Depends on:
Notice Provided (No)
|
| Repayment Agreement Details | ||
| Repayment Agreement Exists Yes | Checkbox |
Check this box if the tenant HAS entered into a written repayment agreement for monies due to the project.
|
| Repayment Agreement Exists No | Checkbox |
Check this box if the tenant HAS NOT entered into a written repayment agreement for monies due to the project.
|
| Repayment Agreement Exists N/A | Checkbox |
Check this box if the question about a tenant entering into a written repayment agreement is not applicable.
|
| Plan Has Required Info Yes | Checkbox |
Check this box if a repayment agreement was entered, and the plan contains the required information. Fill only if 'Repayment Agreement Exists Yes' is 'Yes'.
Depends on:
Repayment Agreement Exists Yes
|
| Plan Has Required Info No | Checkbox |
Check this box if a repayment agreement was entered, but the plan does not contain the required information. Fill only if 'Repayment Agreement Exists Yes' is 'Yes'.
Depends on:
Repayment Agreement Exists Yes
|
| Plan Has Required Info N/A | Checkbox |
Check this box if the question about whether the repayment agreement plan contains the required information is not applicable. Fill only if 'Repayment Agreement Exists Yes' is 'Yes'.
Depends on:
Repayment Agreement Exists Yes
|
| Income Discrepancy Comments | Text |
Provide comments on any discrepancies identified between the income information on the 50059 and the verified file information. Fill only if 'Repayment Agreement Exists Yes' is 'Yes'.
Depends on:
Repayment Agreement Exists Yes
|
| Resident Rights Brochure Tenant Receipt | ||
| Resident Rights Brochure Received - Yes | Checkbox |
Check this box if there is an acknowledgement and/or signed document in the file indicating the tenant received the Resident Rights and Responsibilities Brochure.
|
| Resident Rights Brochure Received - No | Checkbox |
Check this box if there is no acknowledgement and/or signed document in the file indicating the tenant received the Resident Rights and Responsibilities Brochure.
|
| Right to Appeal Information | ||
| Yes | Checkbox |
Check this box if the rejection letter provided the applicant the right to appeal. Fill only if 'Type of Review' is 'Applicant Rejection'.
Depends on:
Applicant Rejection
|
| No | Checkbox |
Check this box if the rejection letter did not provide the applicant the right to appeal. Fill only if 'Type of Review' is 'Applicant Rejection'.
Depends on:
Applicant Rejection
|
| Rejection Letter Appeal Right Comments | Text |
Provide any additional comments or details regarding whether the rejection letter provided the applicant the right to appeal. Fill only if 'Type of Review' is 'Applicant Rejection'.
Depends on:
Applicant Rejection
|
| Savings Account Income | ||
| Savings Account Yes | Checkbox |
Check this box if there is actual income from a savings account.
|
| Savings Account No | Checkbox |
Check this box if there is no actual income from a savings account.
|
| Savings Account N/A | Checkbox |
Check this box if a savings account is not applicable for income assessment.
|
| Security Deposit Refund | ||
| Yes | Checkbox |
Check this box if the security deposit was refunded to the tenant within 30 days, or in accordance with state or local laws, whichever is shorter. Fill only if 'Type of Review' is 'Tenant Move-Out'.
Depends on:
Tenant Move-Out
|
| No | Checkbox |
Check this box if the security deposit was not refunded to the tenant within 30 days, or in accordance with state or local laws, whichever is shorter. Fill only if 'Type of Review' is 'Tenant Move-Out'.
Depends on:
Tenant Move-Out
|
| N/A | Checkbox |
Check this box if the question regarding the security deposit refund is not applicable. Fill only if 'Type of Review' is 'Tenant Move-Out'.
Depends on:
Tenant Move-Out
|
| Security Deposit Refund Comments | Text |
Please provide any additional comments or details regarding whether the security deposit was refunded to the tenant within the specified timeframe or in accordance with applicable laws. Fill only if 'Type of Review' is 'Tenant Move-Out'.
Depends on:
Tenant Move-Out
|
| Social Security Benefits Verification | ||
| Social Security Benefits Third Party Verification Details | Text |
Provide additional details regarding the third-party verification for social security benefits. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| EIV Income Report | Checkbox |
Check this box if Social Security benefits were verified using the EIV (Enterprise Income Verification) Income Report. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Traditional 3rd party | Checkbox |
Check this box if Social Security benefits were verified through a traditional third-party source. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Other | Checkbox |
Check this box if Social Security benefits were verified by an other third-party source not explicitly listed. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Not verified | Checkbox |
Check this box if Social Security benefits could not be verified. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| N/A | Checkbox |
Check this box if verification of Social Security benefits is not applicable. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Social Security Benefits Amount on 50059 | Number |
Enter the amount of social security benefits reported on form 50059. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Social Security Benefits Discrepancy Comments | Text |
Provide comments on any discrepancies identified between the social security benefits income information on form 50059 and verified file information. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Social Security Number Verification | ||
| Yes | Checkbox |
Check this box if Social Security numbers have been properly verified and documented (except for those exempted by 24 CFR 5.216).
|
| No | Checkbox |
Check this box if Social Security numbers have not been properly verified and documented (except for those exempted by 24 CFR 5.216).
|
| SSN Verification Comments | ||
| SSN Verification Comments | Text |
Provide any relevant comments regarding the verification of Social Security numbers, including any exemptions or issues encountered. Fill only if 'No', 'EIV Summary Report in file - No', 'No' is 'No', any.
Depends on:
No, EIV Summary Report in file - No, No
|
| State Lifetime Sex Offender Registration Check | ||
| Yes | Checkbox |
Check this box if a state lifetime sex offender registration check has been conducted for all household members in every state they resided, using a database that checks against all state registries.
|
| No | Checkbox |
Check this box if a state lifetime sex offender registration check has not been conducted for all household members as required.
|
| Comments on Sex Offender Registration Check | Text |
Provide any additional comments or details regarding the state lifetime sex offender registration check. Fill only if 'No' is 'No'.
Depends on:
No
|
| Status Verification Comments | ||
| Status Verification Comments | Text |
Provide any necessary comments or additional details regarding the verification of disability status, student status, or ages of occupants. Fill only if 'No', 'No', 'Ages of Occupants Verified: No' is 'No', any.
Depends on:
No, No, Ages of Occupants Verified: No
|
| Student Status Verification | ||
| Yes | Checkbox |
Check this box if the student status has been verified.
|
| No | Checkbox |
Check this box if the student status has not been verified.
|
| N/A | Checkbox |
Check this box if student status verification is not applicable.
|
| Tenant File Review Continued Header | ||
| Continuation Page Identifier | Text |
Enter the identifier for this continued section of the tenant file review.
|
| Tenant Information | ||
| Family Name | Text |
Please enter the family name of the tenant.
|
| Unit Number | Text |
Please provide the unit number assigned to the tenant.
|
| Move-in Date | Date |
Please enter the date the tenant moved into the unit.
|
| Tenant Minimum Rent and Hardship Exception | ||
| Is the tenant paying minimum rent? - Yes | Checkbox |
Check this box if the tenant is currently paying minimum rent.
|
| Is the tenant paying minimum rent? - No | Checkbox |
Check this box if the tenant is not currently paying minimum rent.
|
| Is the tenant paying minimum rent? - N/A | Checkbox |
Check this box if the question about the tenant paying minimum rent is not applicable.
|
| Hardship Exception Details | Text |
Provide details if a hardship exception was granted for the tenant's minimum rent. Fill only if 'Is the tenant paying minimum rent? - Yes' is 'Yes'.
Depends on:
Is the tenant paying minimum rent? - Yes
|
| Hardship exception granted? - Yes | Checkbox |
Check this box if a hardship exception was granted for the minimum rent. Fill only if 'Is the tenant paying minimum rent? - Yes' is 'Yes'.
Depends on:
Is the tenant paying minimum rent? - Yes
|
| Hardship exception granted? - No | Checkbox |
Check this box if a hardship exception was not granted for the minimum rent. Fill only if 'Is the tenant paying minimum rent? - Yes' is 'Yes'.
Depends on:
Is the tenant paying minimum rent? - Yes
|
| Hardship exception granted? - N/A | Checkbox |
Check this box if the question about a hardship exception being granted is not applicable, or if the tenant is not paying minimum rent. Fill only if 'Is the tenant paying minimum rent? - Yes' is 'Yes'.
Depends on:
Is the tenant paying minimum rent? - Yes
|
| Tenant Receipt Comments | ||
| Tenant Receipt Comments | Text |
Provide any additional comments or details regarding the tenant's acknowledgment and signed documents for receipt of various materials. Fill only if 'Lead-Based Paint Acknowledged (No)', 'Resident Rights Brochure Received - No', 'EIV & You Brochure Acknowledged - No', 'No' is 'No', any.
Depends on:
Lead-Based Paint Acknowledged (No), Resident Rights Brochure Received - No, EIV & You Brochure Acknowledged - No, No
|
| Type of Review | ||
| Applicant Rejection | Checkbox |
Check this box if the review type is for an applicant rejection.
|
| Tenant Move-In | Checkbox |
Check this box if the review type is for a tenant move-in.
|
| Tenant Move-Out | Checkbox |
Check this box if the review type is for a tenant move-out.
|
| Certification/Recertification | Checkbox |
Check this box if the review type is for a tenant's certification or recertification.
|
| Unemployment Benefits Verification | ||
| Unemployment Benefits Other Verification Method | Text |
Please provide the specific method used for verifying unemployment benefits if it is not EIV Income Report or Traditional 3rd party. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| EIV Income Report | Checkbox |
Check this box if unemployment benefits were verified using the Enterprise Income Verification (EIV) Income Report. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Traditional 3rd Party | Checkbox |
Check this box if unemployment benefits were verified through a traditional third-party source. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Other | Checkbox |
Check this box if unemployment benefits were verified using a method other than EIV Income Report or traditional third-party verification. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| Not Verified | Checkbox |
Check this box if unemployment benefits could not be verified. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
|
| N/A (Unemployment Benefits) | Checkbox |
Check this box if the unemployment benefits verification is not applicable. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
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| Unemployment Benefits Reported Amount | Number |
Enter the total amount of unemployment benefits reported on form 50059. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
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| Unemployment Benefits Verification Comments | Text |
Provide comments on whether the unemployment benefits income information on form 50059 agreed with verified file information, and note any discrepancies. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
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| Unit Size Appropriateness | ||
| Unit Size Appropriate | Checkbox |
Check this box if the unit size is appropriate for the household.
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| Unit Size Not Appropriate | Checkbox |
Check this box if the unit size is not appropriate for the household.
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| Unit Size Appropriateness Comments | Text |
Provide any relevant comments or details regarding the appropriateness of the unit size for the household.
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| Unlabeled Asset Income | ||
| Checking Account - Yes | Checkbox |
Check this box if there is actual income from a checking account.
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| Checking Account - No | Checkbox |
Check this box if there is no actual income from a checking account.
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| Checking Account - N/A | Checkbox |
Check this box if a checking account is not applicable for actual income assessment.
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| Verified Amounts Discrepancy Comments | ||
| Discrepancy Comments | Text |
Provide comments on any discrepancies identified between the income information on the 50059 and the verified file information. Fill only if 'Did income information on the 50059 agree with verified file information?' is 'No'.
Depends on:
No
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| Wages Verification | ||
| Wages Verification Details | Text |
Provide details on how the wages were verified and if they were calculated correctly. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
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| EIV Income Report | Checkbox |
Check this box if wages verification was performed using an EIV Income Report. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
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| Traditional 3rd party | Checkbox |
Check this box if wages verification was performed using traditional third-party methods. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
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| Other | Checkbox |
Check this box if wages verification was performed using an 'Other' method not listed. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
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| Not verified | Checkbox |
Check this box if wages were not verified. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
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| N/A | Checkbox |
Check this box if wages verification is not applicable. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
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| Wages Amount Reported on 50059 | Number |
Enter the amount of wages reported on the Form 50059. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
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| Wages Discrepancy Comments | Text |
Provide comments on any discrepancies found between the income information on Form 50059 and the verified file information for wages. Fill only if 'Type of Review' is 'Certification/Recertification'.
Depends on:
Certification/Recertification
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