Form Hud-9887 And 9887-A - Document Pachagefor Applicant'S/tenant'S Concent To The Release Of Information - U.s. Department Of Housing And Urban Development Page 2
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6BC!DEFFG60)H+#()I9&&())
Verification of Information Provided by
OMB Approval #2502-0204
0pplicants and Tenants of Assisted Housin-)))))))))))))))))))))))))))))))))))))))))))))))))))))
))))))))))
BC!)."/%)EFFGDEFFG0);TU)&V1AN06/30/2012O
)
If an adult member of your household, due to extenuating circumstances, is
What Verification Involves
unable to sign the form HUD-9887 or the individual verification forms on time,
To receive housing assistance, applicants and tenants who are at least 18
the O/A may document the file as to the reason for the delay and the specific
years of age and each family head, spouse, or co-head regardless of age
plans to obtain the proper signature as soon as possible.
must provide the owner or management agent (O/A) or public housing agency
The O/A must tell you, or a third party which you choose, of the
(PHA) with certain information specified by the U.S. Department of Housing
findings made as a result of the O/A verifications authorized by your
and Urban Development (HUD).
consent. The O/A must give you the opportunity to contest such
findings in accordance with HUD Handbook 4350.3 Rev. 1. However, for
To make sure that the assistance is used properly, Federal laws require
information received under the form HUD-9887 or form HUD-9887-A, HUD, the
that the information you provide be verified. This information is verified in two
O/A, or the PHA, may inform you of these findings.
ways:
O/As must keep tenant files in a location that ensures confidentiality.
Any employee
of the O/A
who fails to keep tenant
information
1. HUD, O/As, and PHAs may verify the information you provide by
confidential is subject to the enforcement provisions of the State Privacy Act
checking with the records kept by certain public agencies (e.g.,
and is subject to enforcement actions by HUD. Also, any applicant or tenant
Social Security Administration (SSA), State agency that keeps wage
affected by negligent disclosure or improper use of information may bring civil
and unemployment compensation claim information, and the
action for damages, and seek other relief, as may be appropriate, against the
Department of Health and Human Services’ (HHS) National Directory
employee.
of New Hires (NDNH) database that stores wage, new hires, and
unemployment compensation). HUD (only) may verify information
HUD-9887/A requires the O/A to give each household a copy of the Fact
covered in your tax returns from the U.S. Internal Revenue Service
Sheet, and forms HUD-9887, HUD-9887-A along with appropriate individual
(IRS). You give your consent to the release of this information by
consent
forms.
The
package
you
will
receive
will
include
the
signing form HUD-9887. Only HUD, O/As, and PHAs can receive
following documents:
information authorized by this form.
1.BC!DEFFG60)H+#()
I9&&(: Describes the requirement to verify
information provided by individuals who apply for housing assistance. This
2.
The O/A must verify the information that is used to determine your
fact sheet also describes consumer protections under the verification
eligibility and the amount of rent you pay. You give your consent to the
process.
release of this information by signing the form HUD-9887, the form
2.H"/%)BC!DE FFG?
Allows
the
release
of
information
between
HUD-9887-A, and the individual verification and consent forms that
government agencies.
apply to you. Federal laws limit the kinds of information the O/A can
3.H"/%)BC!DE FFGD0?
Describes
the
requirement
of
third
party
receive about you. The amount of income you receive helps to
verification along with consumer protections.
determine the amount of rent you will pay. The O/A will verify all of the
4.<'>3L3>$+2)L &/3.3#+(3"') #"'5&'(5? Used to verify the relevant
sources of income that you report. There are certain allowances that
information provided by applicants/tenants to determine their eligibility and
reduce the income used in determining tenant rents.
level of benefits.
EV+%12&?) Mrs. Anderson is 62 years old. Her age qualifies her for a
medical allowance. Her annual income will be adjusted because of
8"'5&W$&'#&5)."/)X"()I3-'3'-)(9&)8"'5&'()H"/%5)
this allowance. Because Mrs. Anderson’s medical expenses will
help determine the amount of rent she pays, the O/A is required to
If you fail to sign the form HUD-9887, the form HUD-9887-A, or the
verify any medical expenses that she reports.
individual verification forms, this may result in your assistance being
denied (for applicants) or your assistance being terminated (for tenants). See
EV+%12&?) Mr. Harris does not qualify for the medical allowance
further explanation on the forms HUD-9887 and 9887-A.
because he is not at least 62 years of age and he is not
handicapped or disabled. Because he is not eligible for the medical
If you are an applicant and are denied assistance for this reason, the O/A
allowance, the amount of his medical expenses does not change
must notify you of the reason for your rejection and give you an
the amount of rent he pays. Therefore, the O/A cannot ask Mr.
Harris anything about his medical expenses and cannot verify with
opportunity to appeal the decision.
a third party about any medical expenses he has.
If you are a tenant and your assistance is terminated for this reason,
8$5("%&/)*/"(&#(3"'5)
the O/A must follow the procedures set out in the Lease. This includes
the opportunity for you to meet with the O/A.
Information received by HUD is protected by the Federal Privacy Act.
Information received by the O/A or the PHA is subject to State privacy
*/"-/+%5)8"L&/&>)JK)(935)H+#()I9&&()
laws. Employees of HUD, the O/A, and the PHA are subject to
Rental Assistance Program
(RAP)
penalties for using these consent forms improperly. You do not have to
sign the form HUD-9887, the form HUD-9887-A, or the individual
Rent Supplement
verification consent forms when they are given to you at your
Section 8 Housing Assistance Payments Programs (administered by the
certification or recertification interview. You may take them home with
Office of Housing)
you to read or to discuss with a third party of your choice. The O/A will
Section 202
give you another date when you can return to sign these forms.
Sections 202 and 811 PRAC
If you cannot read and/or sign a consent form due to a disability, the
Section 202/162 PAC
O/A shall make a reasonable accommodation in accordance with
Section 221(d)(3) Below Market Interest Rate
Section 504 of the Rehabilitation Act of 1973. Such accommodations
may include: home visits when the applicant's or tenant's disability
Section 236
prevents him/her from coming to the office to complete the forms; the
HOPE 2 Home Ownership of Multifamily Units
applicant or tenant authorizing another person to sign on his/her
behalf; and for persons with visual impairments, accommodations may
include providing the forms in large script or braille or providing
readers.
O/As must give a copy of this HUD Fact Sheet to each household. See the Instructions on form HUD-9887-A.
Attachment to forms BC!DEFFG)S)EFFGD0)(02/2007)
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