7420 - HUD



7420.8 CHG-1

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Form No. Form Title Page No.

HUD-903 Housing Discrimination Complaint 903-1

(1/93)

HUD-903A Queja De Discriminacion En La 903A-1

Vivienda (1/93)

HUD-916 RESERVED

HUD-920 RESERVED

SF-1199A Direct Deposit Sign-Up Form (6/87) 1199A-1

HUD-9886 Authorization for the Release of 9886-1

Information/Privacy Act Notice (7/94)

HUD-50058-A&B Family Report (6/93) 50058A&B-1

HUD-50058-FSS Family Self-Sufficiency Addendum to 50058FSS-1

Form HUD-50058 (9/93)

HUD-50060 RESERVED

HUD-51999 General Depository Agreement (6/91) 51999-1

HUD-52508 Section 8 Housing Assistance 52508-1

Payments Program - Existing

Housing, Field Office

Recommendation For Revising Fair

Market Rent (FMR) Schedules (8/81)

HUD-52510 Retroactive Housing Assistance Pay- 52510-1

ments Worksheet, Section 8 Moderate

Rehabilitation Program (7/91)

HUD-52515 Funding Application, Section 8 Tenant- 52515-1

Based Assistance, Rental Certificate

and Voucher Programs (1/96)

HUD-52515A Section 8 Housing Assistance Payments 52515A-1

Program, Application for Moderate

Rehabilitation (6/79)

HUD-52517 Request for Lease Approval, Section 8 52517-1

Tenant-Based Assistance, Rental

Certificate and Voucher Programs (9/95)

HUD-52578 Certificate, Section 8 Tenant-Based 52578-1

Assistance, Rental Certificate

Program (9/95)

i 4/96

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Form No. Form Title Page No.

HUD-52578 A Section 8 Moderate Rehabilitation 52578A-1

Program Statement of Family

Responsibility (6/79)

HUD-52578 -B Statement of Family Responsibility, 52578B-1

Section 8 Project-Based Assistance,

Rental Certificate Program (1/96)

HUD-52578-S Certificado, Seccion 8 Asistencia 525788-1

Basada en el Arrendatario, Programa

de Certificado de Arrendamiento (12/95)

HUD-52580 Inspection Checklist, Section 8 52580-1

Tenant-Based Assistance, Rental

Certificate and Voucher Programs (9/95)

HUD-52580-A Inspection Form, Section 8 Tenant- 52580-A-1

Based Assistance, Rental Certificate

and Voucher Programs (9/95)

HUD-52595 Balance Sheet for Section 8 and 52595-1

Public Housing (2/85)

HUD-52646 Voucher, Section 8 Tenant-Based 52646-1

Assistance, Rental Voucher

Program (9/95)

HUD-52646-5 Comprobante, Seccion 8 Asistencia 52646-8-1

Basada en el Arrendatario, Programa

de Comprobante de Arrendamiento (12/95)

HUD-52650 Family Self-Sufficiency Program, 52650-1

Contract of Participation, Section 8,

Public Housing and Indian Housing

Programs (5/93)

HUD-52650-S Programa de Autosuficiencia Familiar 52650-S-1

Contrato de Participacion (6/94)

HUD-52652 Family Self-Sufficiency Program, 52652-1

FSS Escrow Account Credit

Worksheet (5/93)

HUD-52663 Requisition for Partial Payment 52663-1

of Annual Contributions,

Section 8 Housing Assistance Payments

Program (9/94)

4/96 ii

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CHG-2

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Form No. Form Title Page No.

HUD-52665 Family Portability Information 52665-1

Section 8 Tenant-Based Assistance,

Rental Certificate and Voucher

Programs (9/95)

HUD-52667 Allowances for Tenant-Furnished 52667-1

Utilities and Other Services

Section 8 Existing Housing (12/97)

HUD-52672 Supporting Data for Annual 52672-1

Contributions Estimates

Section 8 Housing Assistance

Payments Program (2/85)

HUD-52673 Estimate of Total Required Annual 52673-1

Contributions, Section 8 Housing

Assistance Payments Program (2/85)

HUD-52681 Voucher for Payment of Annual 52681-1

Contributions and Operating

Statement (7/91)

HUD-52683 Report on Program Utilization, 52683-1

Section 8 Tenant-Based Assistance,

Rental Certificate and Voucher

Programs (9/95)

HUD-52685 Report on Program Utilization, 52685-1

Section 8 Moderate Rehabilitation

Program (1/80)

HUD-52686 Report on Program Activity 52686-1

Section 8 Moderate Rehabilitation

Program (5/81)

iii 12/97

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RENTAL CERTIFICATE PROGRAM LEGAL CONTRACTS

Appendix No. Contract Type Contract Title

1 - 2 RESERVED

3 HAP Contract Housing Assistance Payments

Contract, Part A, Basic

Version, Section 8 Tenant-

Based Assistance, Rental

Certificate Program (HUD-

52535.1, 9/95)

HAP Contract Housing Assistance Payments

Contract, Part B, Basic

Version, Section 8 Tenant-

Based Assistance, Rental.

Certificate Program (HUD-

52535.2, 9/95)

4 HAP Contract Housing Assistance Payments

Contract, Part A, Subsidized

Unit Version, Section 8

Tenant-Based Assistance,

Rental Certificate Program

(HUD-52535.4, 10/95)

HAP Contract Housing Assistance Payments

Contract, Part B, Subsidized

Unit Version, Section 8

Tenant Based Assistance,

Rental Certificate Program

(HUD-52535.5, 10/95)

5 HAP Contract Existing Housing,

Housing Assistance Payments

Contract for Assistance on

Behalf of Manufactured Home

Owner Leasing a Manufactured

Home Space (HUD-52535 B, 5/84)

12/97 iv

6 HAP Contract Section 8 Existing Housing

Certificate Program, Housing

Assistance Payments Contract

for Related Lease Shared

Housing (HUD-52535C, 11/87)

7 Lease Addendum Lease Addendum, Basic version,

Section 8 Tenant-Based Assis-

tance, Rental Certificate

Program (HUD-52535.3, 3/96)

v 12/97

PROJECT-BASED CERTIFICATE PROGRAM LEGAL CONTRACTS

Appendix No. Contract Type Contract Title

16 Agreement Section 8 Certificate Program

Project-Based Assistance,

Agreement to Enter into Hous-

ing Assistance Payments

Contract, Part I (HUD-52531A,

4/90)

17 Agreement Section 8 Certificate Program

Project-Based Assistance,

Agreement to Enter into Hous-

ing Assistance Payments

Contract, Part II (HUD-52531B,

12/88)

18 HAP Contract Section 8 Certificate Program

Project-Based Assistance,

Housing Assistance Payments

Contract, Part I (HUD-52530A,

4/90)

19 HAP Contract Section 8 Certificate Program

Project-Based Assistance,

Housing Assistance Payments

Contract, Part II (HUD-52530B,

12/88)

20 Lease Addendum Section 8 Certificate Program

Project-Based Assistance,

Lease Addendum (HUD-52530C,

5/89)

21-25 RESERVED

4/96 vi

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RENTAL VOUCHER PROGRAM LEGAL CONTRACTS

Appendix No. Contract Type Contract Title

10 Consolidated Consolidated Annual

ACC Contributions Contract,

Rental Certificate and Voucher

Programs (HUD-52520, 11/93)

26 - 27 RESERVED

28 HAP Contract Housing Assistance Payments

Contract, Part A, Basic Ver-

sion, Section 8 Tenant-Based

Assistance (HUD-52647.1, 9/95)

Housing Assistance Payments Contract,

Part B, Basic Version, Section 8 Tenant-Based

Assistance (HUD-52647.2, 9/95)

29 Lease Addendum Lease Addendum, Section 8

Tenant-Based Assistance,

Rental voucher Program (HUD-

52647.3, 3/96)

30 - 35 RESERVED

vii 4/96

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MODERATE REHABILITATION PROGRAM LEGAL CONTRACTS

Appendix No. Contract Type Contract Title

36 RESERVED

37 ACC Annual Contributions Contract,

Mod Rehab Moderate Rehabilitation Program,

Part I ACC Part I (HUD-52520-MR, 6/93)

38 ACC Annual Contributions Contract,

Part II Existing Housing and Moderate

Rehabilitation, ACC Part II (HUD

52520-C, 10/79)

39 Agreement Section Moderate Rehabilitation

Program, Agreement to Enter Into

Housing Assistance Payments

Contract, Part I (HUD-52538A,

2/91)

40 Agreement Section Moderate Rehabilitation

Program, Agreement to Enter Into

Housing Assistance Payments

Contract, Part II (HUD-52538B,

11/90)

41 HAP Contract Section 8 Moderate Rehab

Program, Housing Assistance Pay-

ments Contract, Part I (HUD-

52539A, 2/91)

42 HAP Contract Section 8 Moderate Rehab

Program, Housing Assistance Pay-

ments Contract, Part II

(HUD-52539B, 11/90)

43 Lease Section 8 Moderate Rehab

Addendum

Program, Addendum to Lease (HUD

52517-C, 6/79 and HUD 52517-D,

3/96)

4/96 viii

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SECTION 8 PUBLICATIONS

Appendix No. Publication Title

44 Protect Your Family From Lead In Your Home, EPA747- K-94-001 (5/95)

45 A Good Place To Live, HUD-593-PIH (9) (11/95)

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LIST OF REPORTING REQUIREMENTS

Public Use Forms/Reports

Form/Report OMB Clearance

Number Title Number

HUD-903 Housing Discrimination Complaint 2529-0011

(1/93)

HUD-903A Queja De Discriminacion En La 2529-0011

Vivienda (1/93)

SF-1199A Direct Deposit Sign-Up Form (6/87) 1510-0007

HUD-52510 Retroactive Housing Assistance 2502-0442

Payments Worksheet, Moderate

Rehabilitation Program (7/91)

HUD-52515 Funding Application, Section 8 Tenant- 2577-0169

Based Assistance, Rental Certificate

and Rental Voucher Programs (1/96)

HUD-52515A Section 8 Housing Assistance 2577-0147

Payments Program, Application for

Moderate Rehabilitation (6/79)

HUD-52517 Request for Lease Approval, Section 8 2577-0169

Tenant-Based Assistance, Rental

Certificate and Voucher Programs (9/95)

HUD-52578 Certificate, Section 8 Tenant-Based 2577-0169

Assistance, Rental Certificate

Program (9/95)

HUD-52578-B Statement of Family Responsibility, 2577-0169

Section 8 Project-Based Assistance,

Rental Certificate Program (1/96)

HUD-52578-2 Certificado, Seccion 8 Asistencia 2577-0169

Basada en el Arrendatario, Programa

de Certificado de Arrendamiento (12/95)

HUD-52580 Inspection Checklist, Section 8 2577-0169

Tenant-Based Assistance, Rental

Certificate and Voucher Programs (9/95)

HUD-52580-A Inspection Form, Section 8 Tenant- 2577-0169

Based Assistance, Rental Certificate

and Voucher Programs (9/95)

4/96 x

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Public Use Forms/Reports

Form/Report OMB Clearance

Number Title Number

HUD-52595 Balance Sheet for Section 8 and 2577-0067

Public Housing (2/85)

HUD-52646 Voucher, Section 8 Tenant-Based 2577-0169

Assistance, Rental Voucher

Program (9/95)

HUD-52646-S Comprobante, Seccion 8 Asistencia 2577-0169

Basada en el Arrendatario, Programa

de Comprobante de Arrendamiento (12/95)

HUD-52650 Family Self-Sufficiency Program, 2577-0178

Contract of Participation, Section

8, Public Housing and Indian Housing

Programs (5/93)

HUD-52650-S Programa de Autosuficiencia Familiar, 2577-0178

Contrato de Participacion (6/94)

HUD-52652 Family Self-Sufficiency Program, FSS 2577-0178

Escrow Account Credit Worksheet (5/93)

HUD-52663 Requisition for Partial Payment of 2577-0149

Annual Contributions, Section 8

Housing Assistance Payments

Program (9/94)

HUD-52665 Family Portability Information, Sec- 2577-0169

tion 8 Tenant-Based Assistance, Rental

Certificate and Voucher Programs (9/95)

HUD-52667 Allowances for Tenant-Furnished 2502-0161

Utilities and Other Services

Section 8 Existing Housing (4/75)

HUD-52672 Supporting Data for Annual Contribu- 2577-0149

tions Estimates Section 8 Housing

Assistance Payments Program (2/85)

HUD-52673 Estimate of Total Required Annual 2577-0149

Contributions, Section 8 Housing

Assistance Payments Program (2/85)

HUD-52681 Voucher for Payment of Annual 2502-0348

Contributions and Operating

Statement (7/91)

xi 4/96

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Form/Report OMB Clearance

Number Title Number

HUD-52683 Report on Program Utilization, 2577-0169

Section 8 Tenant-Based Assistance,

Rental Certificate and Voucher

Programs (9/95)

HUD-52685 Report on Program Utilization, 2502-0183

Section 8 Moderate Rehabilitation

Program (1/80)

HUD-52686 Report on Program Activity, Section 8 2502-0191

Moderate Rehabilitation Program (5/81)

4/96 xii

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Internal Forms/Reports

Form/Report

Number Title

EPA747-K- Protect Your Family From Lead In Your Home (5/95)

94-001

HUD-PIH-593 A Good Place to Live (11/95)

(9)

HUD-9886 Authorization for the Release of Information (10/92)

HUD-51999 General Depository Agreement (6/91)

HUD-52508 Section 8 Housing Assistance Payments

Program - Existing Housing, Field Office

Recommendation for Revising Fair Market Rent (FMR)

Schedules (8/81)

HUD-52517-C Section 8 Moderate Rehabilitation Program,

Addendum to Lease for HAP Contracts Dated Prior to

November 1983 (6/79)

HUD-52517-B Section 8 Moderate Rehabilitation Program,

Addendum to Lease for Housing Assistance Payments

Contracts Dated November 1983 and Later (3/96)

HUD-52520 Consolidated Annual Contributions Contract, Rental

Certificate and Voucher Programs (11/93)

HUD-52520-MR Annual Contributions Contract, Moderate

Rehabilitation Program, ACC Part I (6/93)

HUD-52520-C Annual Contributions Contract, Existing Housing and

Moderate Rehabilitation, ACC Part II (Supplement)

(10/79)

HUD-52530A Section 8 Certificate Program Project-Based

Assistance, Housing Assistance Payments Contract, Part

I (4/90)

HUD-52530B Section 8 Certificate Program Project-Based

Assistance, Housing Assistance Payments Contract,

Part II (12/88)

HUD-52530C Section 8 Certificate Program

Project-Based Assistance, Lease Addendum (5/89)

xiii 4/96

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Form/Report

Number Title

HUD-52531A Section 8 Certificate Program Project-Based Assistance,

Agreement to Enter into Housing Assistance Payments

Contract, Part I (4/90)

HUD-52531B Section 8 Certificate Program Project-Based Assistance,

Agreement to Enter into Housing Assistance Payments

Contract, Part II (12/88)

HUD-52535.1 Housing Assistance Payments Contract, Part A,

Basic Version, Section 8 Tenant-Based Assistance,

Rental Certificate Program (9/95)

HUD-52535.2 Housing Assistance Payments Contract, Part B,

Basic Version, Section 8 Tenant-Based Assistance,

Rental Certificate Program (9/95)

HUD-52535.4 Housing Assistance Payments Contract, Part A, for

Subsidized Unit Version, Section 8 Tenant-Based

Assistance, Rental Certificate Program (10/95)

HUD-52535.5 Housing Assistance Payments Contract, Part B, for

Subsidized Unit Version, Section 8 Tenant-Based

Assistance, Rental Certificate Program (10/95)

HUD-52535B Existing Housing, Housing Assistance Payments

Contract for Assistance On Behalf of Manufactured

Home Owner Leasing a Manufactured Home Space (5/84)

HUD-52535C Section 8 Existing Housing Certificate Program,

Housing Assistance Payments Contract for Related

Lease Shared Housing (11/87)

HUD-52535.3 Lease Addendum, Basic Version, Section 8 Tenant-Based

Assistance, Rental Certificate Program (3/96)

HUD-52535E Lease Addendum for Assistance on Behalf of

Manufactured Home Owner Leasing a Manufactured

Home Space, Section 8 Existing Housing Certificate

Program (8/87)

HUD-52535F Section 8 Existing Housing Certificate Program,

Lease Addendum for Related Lease Shared Housing (11/87)

4/96 xiv

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Form/Report

Number Title

HUD-52538A Section 8 Moderate Rehabilitation Program,

Agreement to Enter Housing Assistance Payments

Contract, Part I (2/91)

HUD-52538B Section 8 Moderate Rehabilitation Program,

Agreement to Enter Into Housing Assistance Payments

Contract, Part II (11/90)

HUD-52539A Section 8 Moderate Rehabilitation Program, Housing

Assistance Payments Contract, Part I (2/91)

HUD-52539B Section 8 Moderate Rehabilitation Program, Housing

Assistance Payments Contract, Part II (11/90)

HUD-52578A Section 8 Moderate Rehabilitation Program Statement

of Family Responsibility (6/79)

HUD-52578B Section 8 Project-Based Certificate Program Statement

of Family Responsibility (5/89)

HUD-52647.1 Housing Assistance Payments Contract,. Part A,

Basic Version, Section 8 Tenant-Based Assistance,

Rental Voucher Program (9/95)

HUD-52647.2 Housing Assistance Payments Contract, Part B,

Basic Version, Section 8 Tenant-Based Assistance,

Rental Voucher Program (9/95)

HUD-52647.3 Lease Addendum, Basic Version, Section 8 Tenant-

Based Assistance, Rental Voucher Program (3/96)

xv 4/96

7420.8 CHG-1

REMAINDER OF THIS HANDBOOK CHANGE CONTAINS COPIES OF THE FORMS LISTED ON THE

TRANSMITTAL PAGE. THESE FORMS MAY BE OBTAINED BY CALLING HUD'S ON-DEMAND

PRINTING CENTER.

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