Form 8877 - Request For Waiver Of Annual Income Recertification Requirement For The Low-Income Housing Credit Page 3

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Form 8877 (Rev. 1-2006)
Page
Part II
Consent of Disclosure to Monitoring Agency
Name of building or project
Name of building owner
Street address of building or project
Street address of owner
City, state, and ZIP code
City, state, and ZIP code
Building identification number (BIN)
Taxpayer identification number
I am a building owner applying for the annual income recertification waiver provided for in section 42(g)(8)(B) for the building(s) with the
building identification number(s) set forth in this consent. The waiver takes effect on the date that the waiver is approved by the IRS. If
the IRS grants the waiver and then the waiver is revoked, I consent to the IRS disclosing the revocation to the compliance monitoring
agency responsible for monitoring the building(s) (compliance monitoring agency). This consent is effective from the date the waiver takes
effect to the date that the compliance period of the building(s) ends, unless the waiver is revoked, in which case the consent is terminated
immediately following the disclosure by the IRS of the revocation to the compliance monitoring agency.
Signature of building owner
Title
Date
Type or print name
Telephone number
Additional BINs (continue in same format on an attached statement if necessary)
8877
Form
(1-2006)

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