HUD Handbook 4350.3 § 5-15

A.        Consent and Verification Forms

                   Adult members of assisted families must authorize owners to request
                   independent verification of data required for program participation. To provide
                   owners with this authorization, adult family members must sign two HUD-
                   required consent forms plus the owner’s specialized verification forms. Owners
                   must create their own verification forms to request information from employers,
                   child care providers, and others. Families sign these and the two HUD consent
                   forms at the time of move-in certification and annual recertification. All adults in
                   each assisted family must sign the required consent forms or the family must be
                   denied assistance. Owners must give the family a copy of each form the family
                   signed.

         B.        HUD-Required Consent and Release Forms

                   Applicants and tenants must sign two HUD-required consent forms.

                   1.      Form HUD-9887, Notice and Consent to the Release of Information to
                           HUD and to a PHA. Each adult member must sign the form regardless of
                           whether he or she has income. Each family member who is at least 18
                           years of age and the head, spouse or co-head, regardless of age, must
                           sign this form at move-in, initial and at each annual recertification. The
                           form must also be signed when a new adult member joins the household.
                           The form is valid for 15 months from the date of signature. The consent
                           allows HUD or a public housing agency to verify information with the
                           Internal Revenue Service *(IRS), the Social Security Administration
                           (SSA), the Department of Health and Human Services (HHS’) National
                           Directory of New Hires (NDNH), and with state agencies that maintain
                           wage and unemployment claim information (SWICAs).* Owners must

keep the original signed form in the tenant’s file and provide a copy to the
                         family. Exhibit 5-5 contains a copy of form HUD-9887.

                2.       Form HUD-9887-A, Applicant’s/Tenant’s Consent to the Release of
                         Information – Verification by Owners of Information Supplied by
                         Individuals Who Apply for Housing Assistance. Owners and the head of
                         household, spouse, co-head, *regardless of age,* and each family
                         member who is at least 18 years of age must sign a HUD-9887-A form at
                         move-in and at each annual recertification. Each adult member must sign
                         a form regardless of whether he or she has income. The consent allows
                         owners to request and receive information from third-party sources about
                         the applicant or tenant. Owners keep the original form in the tenant’s file
                         and provide a copy to the family. Exhibit 5-6 contains a copy of form
                         HUD-9887-A.

         C.     Information to Tenants

                Owners must provide applicants and tenants with the HUD Fact Sheet, a copy of
                the Resident Rights and Responsibilities brochure, *and a copy of the EIV & You
                brochure.*

                1.       HUD-9887 Fact Sheet. When applicants and tenants sign form HUD-
                         9887 and form *HUD-9887-A*, owners must provide each family with a
                         copy of the *HUD-9887/A* Fact Sheet. This Fact Sheet describes the
                         verification requirements for applicants and tenants and the tenant
                         protections that are part of the verification process. Exhibit 5-7 contains a
                         copy of the *HUD-9887/A* Fact Sheet.

                2.       Resident Rights and Responsibilities Brochure. Owners must provide
                         applicants and tenants with a copy of the Resident Rights and
                         Responsibilities brochure at move-in and annually at recertification. *See
                         Chapter 1, paragraph 1-7.B for information on obtaining copies of the
                         brochure.*

                3.       *EIV & You Brochure. Owners must provide applicants and tenants with
                         a copy of the EIV & You brochure at move-in and annually at
                         recertification. See Chapter 1, paragraph 1-7.B for information on
                         obtaining copies of the brochure.*

         D.     Owner-Created Verification Forms

                1.       Owners must create verification forms for specific verification needs and
                         must include the language required by HUD as shown in Figure 5-5.
                         Appendix 6 contains instructions, a sample verification consent, and
                         guidance about the types of information to request when verifying income
                         and eligibility.

                2.       It is important that the applicant or tenant know whom owners will ask to
                         provide information and to whom the completed form will be returned.
                         Therefore, verification forms must clearly state in a prominent location
                         that the applicant or tenant may not sign the consent if the form does not

clearly indicate who will provide the requested information and who will
                         receive the information. When sending a request for verification to a third
                         party, owners send the verification form with the applicant’s or tenant’s
                         original signature to the third-party source. Owners must retain a copy of
                         the verification form and provide a copy to the applicant or tenant upon
                         request.

                     Figure 5-5: Language Required on all Consent Forms

The following statement must appear on all consent forms developed by
               owners:

               “Title 18, Section 1001 of the U.S. Code states that a person is guilty of a
               felony for knowingly and willingly making false or fraudulent statements to
               any department of the United States Government. HUD and any owner (or
               any employee of HUD or the owner) may be subject to penalties for
               unauthorized disclosures or improper use of information collected based on
               the consent form. Use of the information collected based on this
               verification form is restricted to the purposes cited above. Any person who
               knowingly or willingly requests, obtains or discloses any information under
               false pretenses concerning an applicant or participant may be subject to a
               misdemeanor and fined not more than $5,000. Any applicant or participant
               affected by negligent disclosure of information may bring civil action for
               damages, and seek other relief, as may be appropriate, against the officer
               or employee of HUD or the owner responsible for the unauthorized
               disclosure or improper use. Penalty provisions for misusing the social
               security number are contained in the Social Security Act at 208 (a) (6), (7)
               and (8). Violation of these provisions are cited as violations of 42 U.S.C.
               408 (a) (6), (7) and (8)