Exhibit 5-3: Acceptable Forms of Verification
Appendix 3
Acceptable Forms of Verification
|Appendix 3: Acceptable Forms of Verification |
|Factor to be Verified |Acceptable Sources | |
| | |Verification Tips |
| |Third Partya |Documents Provided by Applicant |Self-Declaration | |
| |Writtenb |Oralc | | | |
| | | | | | |
|Alimony or child support. |Copy of separation or divorce |Telephone or in-person contact |Copy of most recent check, |Notarized statement or affidavit |Amounts awarded but not received can be |
| |agreement provided by ex-spouse|with ex-spouse or income source |recording date, amount, and check |signed by applicant indicating amount|excluded from annual income only when |
| |or court indicating type of |documented in file by the owner. |number. |received. |applicants have made reasonable efforts |
| |support, amount, and payment | |Recent original letters from the |If applicable, notarized statement or|to collect amounts due, including filing |
| |schedule. | |court. |affidavit from applicant indicating |with courts or agencies responsible for |
| |Written statement provided by | | |that payments are not being received |enforcing payments. |
| |ex-spouse or income source | | |and describing efforts to collect | |
| |indicating all of above. | | |amounts due. | |
| |If applicable, written | | | | |
| |statement from court/attorney | | | | |
| |that payments are not being | | | | |
| |received and anticipated date | | | | |
| |of resumption of payments. | | | | |
| Assets disposed of for less than | None required. | None required. | None required. | Certification signed by applicant | Only count assets disposed of within a |
|fair market value. | | | |that no member of family has disposed|two-year period prior to examination or |
| | | | |of assets for less than fair market |re-examination. |
| | | | |value during preceding two years. | |
| | | | |If applicable, certification signed | |
| | | | |by the owner of the asset disposed of| |
| | | | |that shows: | |
| | | | |- Type of assets disposed of; | |
| | | | |- Date disposed of; | |
| | | | |- Amount received; and | |
| | | | |- Market value of asset at the time | |
| | | | |of disposition. | |
| Auxiliary apparatus. | Written verification from | Telephone or in-person contact | Copies of receipts or evidence of| | The owner must determine if expense is |
| |source of costs and purpose of |with these sources documented in |periodic payments for apparatus. | |to be considered medical or disability |
| |apparatus. |file by the owner. | | |assistance. |
| |Written certification from | | | | |
| |doctor or rehabilitation agency| | | | |
| |that use of apparatus is | | | | |
| |necessary to employment of any | | | | |
| |family member. | | | | |
| |In case where the disabled | | | | |
| |person is employed, statement | | | | |
| |from employer that apparatus is| | | | |
| |necessary for employment. | | | | |
| Care attendant for disabled | Written verification from | Telephone or in-person contact | Copies of receipts or cancelled | Notarized statement or signed | The owner must determine if this expense|
|family members. |attendant stating amount |with source documented in file by|checks indicating payment amount |affidavit attesting to amounts paid. |is to be considered medical or disability|
| |received, frequency of |the owner. |and frequency. | |assistance. |
| |payments, hours of care. | | | | |
| |Written certification from | | | | |
| |doctor or rehabilitation agency| | | | |
| |that care is necessary to | | | | |
| |employment of family member. | | | | |
| Child care expenses (including | Written verification from | Telephone or in-person contact | Copies of receipts or cancelled | For verification of “looking for | Allowance provided only for care of |
|verification that a family member |person who provides care |with these sources (child care |checks indicating payments. |work,” details of job search effort |children 12 and younger. |
|who has been relieved of child |indicating amount of payment, |provider, employer, school) |For school attendance, school |as required by owner’s written |When same care provider takes care of |
|care is working, attending school,|hours of care, names of |documented in file by the owner. |records, such as paid fee |policy. |children and disabled person, the owner |
|or looking for employment). |children, frequency of payment,| |statements that show that the time| |must prorate expenses accordingly. |
| |and whether or not care is | |and duration of school attendance | |Owners should keep in mind that costs may|
| |necessary to employment or | |reasonably corresponds to the | |be higher in summer months and during |
| |education. | |period of child care. | |holiday periods. |
| |Verification of employment as | | | |The owner must determine which family |
| |required under Employment | | | |member has been enabled to work. |
| |Income. | | | |Care for employment and education must be|
| |Verification of student status | | | |prorated to compare to earnings. |
| |(full or part-time) as required| | | |Costs must be “reasonable.” |
| |under Full-Time Student Status.| | | | |
|Citizenship | | | | Citizens must sign declaration |Owners may require applicants/residents |
| | | | |certifying U.S. Citizenship. |to provide verification of citizenship. |
| Current net family assets. | Verification forms, letters or| Telephone or in-person contact | Passbooks, checking, or savings | Notarized statement or signed | Use current balance in savings accounts |
| |documents received from |with appropriate source, |account statements, certificates |affidavit stating cash value of |and average monthly balance in checking |
| |financial institutions, stock |documented in file by the owner. |of deposit, property appraisals, |assets or verifying cash held at |accounts for last 6 months. |
| |brokers, real estate agents, | |stock or bond documents, or other |applicant’s home or in safe deposit |Use cash value of all assets (the net |
| |employers indicating the | |financial statements completed by |box. |amount the applicant would receive if the|
| |current value of the assets and| |financial institution. | |asset were converted to cash). |
| |penalties or reasonable costs | |Copies of real estate tax | |NOTE: This information can usually be |
| |to be incurred in order to | |statements, if tax authority uses | |obtained simultaneously when verifying |
| |convert nonliquid assets into | |approximate market value. | |income from assets and employment (e.g., |
| |cash. | |Quotes from attorneys, | |value of pension). |
| | | |stockbrokers, bankers, and real | | |
| | | |estate agents that verify | | |
| | | |penalties and reasonable costs | | |
| | | |incurred to convert asset to cash.| | |
| | | |Copies of real estate closing | | |
| | | |documents that indicate | | |
| | | |distribution of sales proceeds and| | |
| | | |settlement costs. | | |
|Disability status. | Verification from medical | Telephone or in-person contact | |Not appropriate. | If a person receives Social Security |
| |professional stating that |with medical professional | | |Disability solely due to a drug or |
| |individual qualifies under the |verifying qualification under the| | |alcohol problem, the person is not |
| |definition of disability. |federal disability definition and| | |considered disabled under housing law. A|
| | |documentation in the file of the | | |person that does not receive Social |
| | |conversation. | | |Security Disability may still qualify |
| | | | | |under the definition of a person with |
| | | | | |disabilities. |
| | | | | |Owners must not seek to verify |
| | | | | |information about a person’s specific |
| | | | | |disability other than obtaining a |
| | | | | |professional’s opinion of qualification |
| | | | | |under the definition of a person with |
| | | | | |disabilities. |
| Dividend income and savings | Verification form completed by|Telephone or in-person contact | Copies of current statements, | Not appropriate. | The owner must obtain enough information|
|account interest income. |bank. |with appropriate party, |bank passbooks, certificates of | |to accurately project income over next 12|
| | |documented in file by the owner. |deposit, if they show required | |months. |
| | | |information (i.e., current rate of| |Verify interest rate as well as asset |
| | | |interest). | |value. |
| | | |Copies of Form 1099 from the | | |
| | | |financial institution, and | | |
| | | |verification of projected income | | |
| | | |for the next 12 months. | | |
| | | |Broker’s quarterly statements | | |
| | | |showing value of stocks/bonds and | | |
| | | |earnings credited to the | | |
| | | |applicant. | | |
| Employment Income including tips,| Verification form completed by| Telephone or in-person contact | W-2 Forms, if applicant has had | Notarized statements or affidavits | Always verify: frequency of gross pay |
|gratuities, overtime. |employer. |with employer, specifying amount |same employer for at least two |signed by applicant that describe |(i.e., hourly, biweekly, monthly, |
| | |to be paid per pay period and |years and increases can be |amount and source of income. |bimonthly); anticipated increases in pay |
| | |length of pay period. Document in|accurately projected. | |and effective dates; overtime. |
| | |file by the owner. |Paycheck stubs or earning | |Require most recent 6-8 consecutive pay |
| | | |statements. | |stubs; do not use check without stub. |
| | | | | |For a fee, additional information can be |
| | | | | |obtained from The Work Number |
| | | | | |800-996-7556; First American Registry |
| | | | | |800-999-0350; and Verifax 800-969-5100. |
| | | | | |Fees are valid project expenses. |
| | | | | |Information does not replace third-party |
| | | | | |verification. |
| Family composition. | None required. | None required. | Birth certificates | |An owner may seek verification only if |
| | | |Divorce actions | |the owner has clear written policy. |
| | | |Drivers’ licenses | | |
| | | |Employer records | | |
| | | |Income tax returns | | |
| | | |Marriage certificates | | |
| | | |School records | | |
| | | |Social Security Administration | | |
| | | |records | | |
| | | |Social service agency records | | |
| | | |Support payment records | | |
| | | |Utility bills | | |
| | | |Veterans Administration (VA) | | |
| | | |records | | |
| Family type. | Disability Status: statement | Telephone or in-person contact | Elderly Status (when there is | Elderly Status: Applicant’s | Unless the applicant receives income or |
|(Information verified only to |from physician or other |with source documented in file by|reasonable doubt that applicant is|signature on application is generally|benefits for which elderly or disabled |
|determine eligibility for |reliable source, if benefits |the owner. |at least 62): birth certificate, |sufficient. |status is a requirement, such status must|
|project, preferences, and |documenting status are not | |baptismal certificate, social | |be verified. |
|allowances.) |received. See paragraph 3.25 | |security records, driver’s | |Status of disabled family members must be|
| |B.1 for restrictions on this | |license, census record, official | |verified for entitlement to $480 |
| |form of verification. | |record of birth or other | |dependent deduction and disability |
| |Displacement Status: Written | |authoritative document or receipt | |assistance allowance. |
| |statement or certificate of | |of SSI old age benefits or SS | |Owner may not ask the nature/extent of |
| |displacement by the appropriate| |benefits. | |disability. |
| |governmental authority. | |Disabled, blind: evidence of | | |
| | | |receipt of SSI or Disability | | |
| | | |benefits. | | |
| Full-time student status (of | Verification from the | Telephone or in-person contact | School records, such as paid fee | | |
|family member 18 or older, |Admissions or Registrar’s |with these sources documented in |statements that show a sufficient | | |
|excluding head, spouse, or foster |Office or dean, counselor, |file by the owner. |number of credits to be considered| | |
|children). |advisor, etc., or from VA | |a full-time student by the | | |
| |Office. | |educational institution attended. | | |
|Immigration Status. |Verification of eligible |None. |Applicant/resident must provide |Noncitizens must sign declaration | Owners must require noncitizens |
| |immigration status must be | |appropriate immigration documents |certifying the following: |requesting assistance to provide |
| |received from DHS through the | |to initiate verification. |Eligible immigration status; or |verification of eligible immigration |
| |DHS SAVE system or through | | |Decision not to claim eligible |status. |
| |secondary verification using | | |status. | |
| |DHS Form G-845. | | | | |
| Income maintenance payments, | Award or benefit notification | Telephone or in-person contact | Current or recent check stubs | | Checks or automatic bank deposit slips |
|benefits, income other than wages |letters prepared and signed by |with income source, documented in|with date, amount, and check | |may not provide gross amounts of benefits|
|(i.e., welfare, Social Security |authorizing agency. |file by the owner. |number recorded by the owner. | |if applicant has deductions made for |
|[SS], Supplemental Security Income|TRACS or REAC may provide |NOTE: For all oral verification,|Award letters or computer printout| |Medicare Insurance. |
|[SSI], Disability Income, |verification for social |file documentation must include |from court or public agency. | |Pay stubs for the most recent four to six|
|Pensions). |security. |facts, time and date of contact, |Copies of validated bank deposit | |weeks should be obtained. |
| | |and name and title of third |slips, with identification by | |Copying of U.S. Treasury checks is not |
| | |party. |bank. | |permitted. |
| | | |Most recent quarterly pension | |Award letters/printouts from court or |
| | | |account statement. | |public agency may be out of date; |
| | | | | |telephone verification of letter/printout|
| | | | | |is recommended. |
| Interest from sale of real | Verification form completed by| Telephone or in-person contact | Copy of the contract. | | Only the interest income is counted; the|
|property (e.g., contract for deed,|an accountant, attorney, real |with appropriate party, |Copy of the amortization schedule,| |balance of the payment applied to the |
|installment sales contract, etc.) |estate broker, the buyer, or a |documented in file by the owner. |with sufficient information for | |principal is merely a liquidation of the |
| |financial institution which has| |the owner to determine the amount | |asset. |
| |copies of the amortization | |of interest to be earned during | |The owner must get enough information to |
| |schedule from which interest | |the next 12 months. | |compute the actual interest income for |
| |income for the next 12 months | |NOTE: Copy of a check paid by | |the next 12 months. |
| |can be obtained. | |the buyer to the applicant is not | | |
| | | |acceptable. | | |
| Medical expenses. | Verification by a doctor, | Telephone or in-person contact | Copies of cancelled checks that | Notarized statement or signed | Medical expenses are not allowable as |
| |hospital or clinic, dentist, |with these sources, documented in|verify payments on outstanding |affidavit of transportation expenses |deduction unless applicant is an elderly |
| |pharmacist, etc., of estimated |file by the owner. |medical bills that will continue |directly related to medical |or disabled family. Status must be |
| |medical costs to be incurred or| |for all or part of the next 12 |treatment, if there is no other |verified. |
| |regular payments expected to be| |months. |source of verification. | |
| |made on outstanding bills which| |Copies of income tax forms | | |
| |are not covered by insurance. | |(Schedule A, IRS Form 1040) that | | |
| | | |itemize medical expenses, when the| | |
| | | |expenses are not expected to | | |
| | | |change over the next 12 months. | | |
| | | |Receipts, cancelled checks, pay | | |
| | | |stubs, which indicate health | | |
| | | |insurance premium costs, or | | |
| | | |payments to a resident attendant. | | |
| | | |Receipts or ticket stubs that | | |
| | | |verify transportation expenses | | |
| | | |directly related to medical | | |
| | | |expenses. | | |
|Need for an assistive animal. |Letter from medical provider. | | | |If the owner’s policy is to verify this |
| | | | | |need, owner must implement policy |
| | | | | |consistently. |
| Net Income for a business. | Not applicable. | Not applicable. | Form 1040 with Schedule C, E, or | | |
| | | |F. | | |
| | | |Financial Statement(s) of the | | |
| | | |business (audited or unaudited) | | |
| | | |including an accountant’s | | |
| | | |calculation of straight-line | | |
| | | |depreciation expense if | | |
| | | |accelerated depreciation was used | | |
| | | |on the tax return or financial | | |
| | | |statement. | | |
| | | |Any loan application listing | | |
| | | |income derived from business | | |
| | | |during the preceding 12 months. | | |
| | | |For rental property, copies of | | |
| | | |recent rent checks, lease and | | |
| | | |receipts for expenses, or IRS | | |
| | | |Schedule E. | | |
| Recurring contributions and | Notarized statement or | Telephone or in-person contact | Not applicable. | Notarized statement or affidavit | Sporadic contributions and gifts are not|
|gifts. |affidavit signed by the person |with source documented in file by| |signed by applicant stating purpose, |counted as income. |
| |providing the assistance giving|the owner. | |dates, and value of gifts. | |
| |the purpose, dates, and value | | | | |
| |of gifts. | | | | |
| Self-employment, tips, |None available. |None available. | Form 1040/1040A showing amount | Notarized statement or affidavit | |
|gratuities, etc. | | |earned and employment period. |signed by applicant showing amount | |
| | | | |earned and pay period. | |
|Social security number. |None required. |None required. | Original Social Security card |Certification that document is |Individuals who have applied for |
| | | |Driver’s license with SSN |complete/accurate unless original |legalization under the Immigration Reform|
| | | |Identification card issued by a |Social Security card is provided. |and Control Act of 1986 will be able to |
| | | |federal, State, or local agency, a| |disclose their social security numbers |
| | | |medical insurance provider, or an | |but unable to supply cards for |
| | | |employer or trade union. | |documentation. Social security numbers |
| | | |Earnings statements on payroll | |are assigned to these persons when they |
| | | |stubs | |apply for amnesty. The cards go to DHS |
| | | |Bank statement | |until the persons are granted temporary |
| | | |Form 1099 | |lawful resident status. Until that time,|
| | | |Benefit award letter | |their acceptable documentation is a |
| | | |Retirement benefit letter | |letter from the DHS indicating that |
| | | |Life insurance policy | |social security numbers have been |
| | | |Court records | |assigned. |
|Unborn children. |None required. |None required. |None required. | Applicant/tenant self-certifies to | Owner may not verify further than |
| | | | |pregnancy. |self-certification. |
| Unemployment compensation. | Verification form completed by| Telephone or in-person contact | Copies of checks or records from | | Frequency of payments and expected |
| |source. |with agency documented in a file |agency provided by applicant | |length of benefit term must be verified. |
| | |by an owner. |stating payment amounts and dates.| |Income not expected to last full 12 |
| | | |Benefit notification letter signed| |months must be calculated based on 12 |
| | | |by authorizing agency. | |months and interim recertification |
| | | | | |completed when benefits stop. |
| Welfare payments (as-paid states | Verification form completed by| Telephone or in-person contact | Maximum shelter allowance | Not appropriate. | Actual welfare benefit amount not |
|only). |welfare department indicating |with income source, documented in|schedule with ratable reduction | |sufficient as proof of income in |
| |maximum amount family may |file by the owner. |schedule provided by applicant. | |“as-paid” states or localities since |
| |receive. | | | |income is defined as maximum shelter |
| |Maximum shelter schedule by | | | |amount. |
| |household size with ratable | | | | |
| |reduction schedule. | | | | |
|Zero Income. |Not applicable. |Not applicable. |Not applicable. | Applicant/Tenant self-certifies to | Owners may require applicant/tenant to |
| | | | |zero income. |sign verification release of information |
| | | | | |forms for state, local, and federal |
| | | | | |benefits programs, as well as the HUD |
| | | | | |9887 and HUD 9887-A. |
| | | | | |Owners may require the tenant to reverify|
| | | | | |zero income status at least every 90 |
| | | | | |days. |
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4350.3 REV-1
Appendix 3
4350.3 REV-1
Appendix 3
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