PARTICIPANT CERTIFICATION
Giving True and Complete Information - I certify that all the information provided on Household composition, income, family assets and items for allowances and deductions, is accurate and complete to the best of my knowledge. I have reviewed the application form and certify that the information is true and correct.
Reporting Changes in Household Composition - I know I am required to report immediately in writing any change in household composition. I further understand that if I am unemployed and become gainfully employed and/or start receiving a benefit I must report to the Housing Authority immediately. Promptly notify housing authority of any the birth, adoption or court-awarded custody of a child or the placement of a foster child in the home. Additionally, clients must notify the Housing Authority of the addition of a live-in aide to reside in the unit. Clients must request the landlord to approve any additional family member as an occupant of the unit. Additional members must meet the same eligibility requirements.
Income reporting cutoff – The housing authority requires clients to present all income changes by the 20th of the month to be effective for the following month.
No Duplicate Residence of Assistance - I certify that the house or apartment will be my principal residence and that I will not obtain duplicate Federal housing assistance while I am in this current program. I will not live anywhere else without notifying the Housing Authority immediately in writing. I will not sublease my assisted residence.
Criminal Activity – Any criminal activity could jeopardize your housing assistance and violate the terms of your lease. Be sure to review the housing authority’s criminal background policy. Even criminal activity non-committed by the household members may jeopardize housing assistance.
Livability of the housing – The housing authority may terminate housing assistance upon repeated claims of disruption of livability of a project. Additionally, the client must keep the unit in a clean and safe condition, dispose of waste properly, and avoid damage to the unit.
Move policy – The Housing Authority requires tenants to stay in their residence for a period of one year prior to moving to another residence. The Housing Authority may grant exceptions to this policy if there is an inspection violation, health issue, domestic violence, increased cost, or an unsafe environment.
Moving Out of the Unit - I agree to give the Housing Authority a 30-day written notice before moving out of the unit or terminating the lease.
Eviction/End of Lease -- Promptly give the Housing Authority a copy of any owner eviction or end of lease notices. The housing authority may terminate assistance if an eviction or end of lease is caused due to a lease or program violation.
Cooperation - I know I am required to cooperate in supplying all information needed to determine my eligibility, level of benefits, or verify my true circumstances. Cooperation includes attending pre-scheduled meetings and completing and signing needed forms. I Understand failure to do so may result in delays, termination of assistance, or eviction.
Ownership - I have no ownership interest in the rental property I am leasing.
Visitors – Visitors cannot stay in a Housing Authority supported residence for more than 10 days. If the household wishes to add the person to the program, they must schedule a meeting with Housing Authority within those 10 days. Households may be terminated if the landlord or Housing Authority determines their guest has stayed longer than 10 days.
Debts Owed - Income not reported to the housing authority may be discovered in a HUD data base. Upon discovery, the housing authority will determine if a repayment is due to the PHA. Failure to pay on a repayment agreement may result in termination of assistance for up to ten years. The U.S. Department of Housing and Urban Development maintains a national repository of debts owed to Public Housing Agencies (PHAs) or Section 8 landlords and adverse information of former participants who have voluntarily or involuntarily terminated participation.
Protections under VAWA - If you otherwise qualify for assistance under Section 8 Voucher, you cannot be denied admission or denied assistance because you are or have been a victim of domestic violence, dating violence, sexual assault, or stalking. If you are receiving assistance under Section 8 Voucher, you may not be denied assistance, terminated from participation, or be evicted from your rental housing because you are or have been a victim of domestic violence, dating violence, sexual assault, or stalking. Also, if you or an affiliated individual of yours is or has been the victim of domestic violence, dating violence, sexual assault, or stalking by a member of your household or any guest, you may not be denied rental assistance or occupancy rights under Section 8 Voucher solely on the basis of criminal activity directly relating to that domestic violence, dating violence, sexual assault, or stalking.
Participant responsibility – I understand that it is the participant’s responsibility to report all income, asset, deduction, and household composition changes to the housing authority. Delaying, falsifying, or not reporting changes may result in program termination, assistance repayment, collections reporting, and/or criminal charges.
Criminal and Administrative Actions for False Information - I understand that knowingly supplying false, incomplete or inaccurate information is punishable under Federal or State criminal law. I understand that knowingly supplying false, incomplete, or inaccurate information is grounds for termination of housing assistance or termination of tenancy.
Penalties For False Statements
If the applicant deliberately submits false information or withholds information regarding income, family composition, or other data on which the applicant’s eligibility is determined, the Housing Authority may deny or terminate rental assistance of the applicant. In addition, HUD may also pursue other penalties available under Federal Law. These penalties include fines up to $5,000 and/ or imprisonment for up to two years.
I agree to give the Housing Authority the authority to investigate any reference or income sources necessary to determine eligibility. I have read and understand the above information. The information listed above is true and correct to the best of my knowledge.
Privacy Act Notice Authority:
The Department of Housing and Urban Development (HUD) is authorized to collect this information by the U.S. Housing Act of 1937 (42 U.S.C. 1437 et. Seq.), Title VI of the Civil Rights Act of 1964 (42 U.S.C. 200d), and by the Fair Housing Act (42 U.S.C. 3601-19). The Housing and Community Development Act of 1987 (42 U.S.C. 3543) requires applicants and participants to submit the Social Security Number of each household member who is six years old or older. Purpose: HUD to determine your eligibility, the appropriate bedroom size, and the amount your family will pay toward rent and utilities is collecting your income and other information. Other Uses: HUD uses your family income and other information to assist in managing and monitoring HUD-assisted housing programs, to protect the Government’s financial interest, and to verify the accuracy of the information you provide. This information may be released to appropriate Federal, State, and local agencies, when relevant, ant to civil, criminal, or regulatory investigators and prosecutors. However, the information will not be otherwise disclosed or released outside of HUD, except as permitted or required by law. Penalty: You must provide all of the information requested by the HA, including all Social Security Numbers you, and all other household members age six years and older, have and use. Giving the Social Security Numbers of all household members six years of age and older is mandatory, and not providing the Social Security Numbers will affect your eligibility. Failure to provide any of the requested information may result in a delay or rejection of your eligibility approval. Penalties for Misusing this Consent HUD, the HA and any owner (or any employee of HUD, the HA or the owner) may be subject to penalties for unauthorized disclosures or improper uses of information collected based on the consent form.
Use of the information collected based on the Release of Information is restricted to the purposes cited on the form. Any person who knowingly or willfully requests, obtains or discloses any information under false pretenses concerning an applicant or participant may be subject to a misdemeanor and fined not more the $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, the HA or the owner responsible for the unauthorized disclosure or improper use. Original is retained by the requesting organization.
THE OPTION OF PORTABILITY NOTICE
WHAT IS PORTABILITY?
Portability is an option for a family to move from one housing authority’s jurisdiction to another housing authority with continued rental assistance. A family, which has a legal residence or employment in the jurisdiction of the Housing Authority at the time the family first submits its application, may lease a unit anywhere in the jurisdiction of the Housing Authority. In addition, the family may move to a different housing authority that operates the Housing Choice Voucher (HCV) program. The housing authority may allow a client portability early in certain instances for a special family need or emergency transfer because of domestic violence.
If the head or spouse of the assisted household does not have a legal residence or employment in the jurisdiction of the Housing Authority at the time of its application, the family will have to lease and reside in the jurisdiction for a period of one year. A participant family may move with portability upon the
completion of the initial term of the lease, or subsequent term of the lease. The landlord releasing a client from the lease, prior to the completion of the initial term, does not constitute completion of the lease for portability purposes.
TO USE YOUR PORTABILITY OPTION:
- If client is a current resident or working in the jurisdiction: Client must request portability in writing that includes when and where, and must be signed by the head of household; or
- If the client is not a current resident or working in the jurisdiction: Client must live in the jurisdiction for a minimum period of 12-months or one (1) year; or
- An out-of-jurisdiction client provides proof that services in the region cannot assist them because of special circumstances; the housing authority can review and determine if portability is possible; Or
- A client provides documentation that they are victims of domestic violence and require a move for protection. A client can exercise the option of
portability by submitting in writing their intent to move and to what jurisdiction.
The housing authority will review records for eligibility, arrange a
meeting, issue a voucher, and contact the new housing authority in a timely manner.