The amounts set forth below are an estimate of the actual expenses that will be paid by me to provide housing for the year 2022. I understand that no expenses should be included on my tax return that are not actually incurred. It is my responsibility to verify any expenses which I may claim on my tax return as housing expenditures in the event of an IRS audit. The amount of actual housing claimed on the tax return cannot exceed the lesser of the approved estimate, the actual expenditures or the fair rental value of the home, plus utilities and furnishings.

IMPORTANT: Please use figures for the whole year. Not a monthly estimate. 

I understand the amount I am claiming on this form will be set aside as a housing allowance designation from income received during the year, provided my estimate receives approval from the GSI Housing Committee and Board as being reasonable. GSI will provide me with an official Housing Allowance statement as a separate document from my 1099 for my 2022 taxes.