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PART V.- DETERMINATION OF INCOME ELIGIBILITY I I <br />.TOTALA*7t IT., HOUSEHOLD <br />INCOAMMOM ALL SOLT.CE& <br />Fro -it— P —page <br />curpentIncome Itimniipe 11 rvaxailyS12i� <br />Income Level of unit ANaf <br />Puemety Low, gent Up'v, Loii, <br />Nkdarapa) <br />Householdincomeexczeds <br />0 -Yes, D.No, <br />Household S- timGv=� <br />- I I FA la_ <br />, <br />TART T.M. PRO G&AM TYPE <br />Idenfifv the prGgrm(s) for which this household's unit will be counted toward the property's occupmey requirements. <br />Select one of the followkg� Select all that appl3n. <br />b 910 Allo cmtedFederal Homing Tax Credit 13 HOME. (including TC AP <br />114% AlloratedYederalHoming Tax Credit o CDBG <br />11 Tax -Exempt Bond Only (No tax credits) (3 Other HUD. including 202- 911, and 236 <br />Eicitylucimionalyunits 0 National Housing Trust Fund <br />C1 Other 0 USDA Rural Housing Service, inchuiing 514,5115, and 538 <br />13 Other Ltate.arlocal housingprogram <br />SIGNATURE OF 011 NIERMEPRESENTA1117E <br />BisedmrharepresmtationshELieinandup6ntheproofsad docmnentiliGnrequired robi'subcaitted,93L-in&-Lidmi(s)sensed inPaVH,Dfthis Ta�tt <br />Incom CertificRtion is,'Pm &6VIe under the provisions of Secdon-42 of the luternal Revenue Code. w. mnea&d, and the Lan dUse Resmiction <br />Apeeiuear(if 2pplicable). to livein aunt in this Project. <br />SIGNATURE OF 4k[ VE DATE <br />2 Tenant Income Certfficatbm (Apria 202I <br />REV: 05-21-25 LF <br />ATTY/Ar-'P 9n95 1 nnlHP:APT-.q\/ 1A17.qt;;mhqi inh.qf 1 (Pqnp. A9 of R51 <br />PART AM: RENT <br />=Tenant Paid Monddy-Renr., <br />3 <br />Monzh1ytTtWtyAno%mce', <br />S <br />,Mherlfanthly Nm-puanal charges- <br />S <br />GROSS MONTHLY RENT FOR UNUT- <br />xr-ant paid rent ylus lltiliry Allowance <br />ctiient ]E R t for this unit, <br />STUDENUSTATUIS <br />ME AM OCCvp'U'M FL -II. MfE StUDEMM? if yes, gnter =&1xt'8.9b1Mtioc& <br />1 <br />AFDC I TAN F.Aasisdwe <br />(also attach docunLentation) <br />-2, <br />JA Training Pxag= <br />0 tt-. O'No <br />3 <br />SiiWe P arnti'Depindent ChiM <br />Eater <br />4 <br />XamedJuoiniRstun <br />�' <br />1-5 <br />5 <br />Fortner Fasmr Cam <br />TART T.M. PRO G&AM TYPE <br />Idenfifv the prGgrm(s) for which this household's unit will be counted toward the property's occupmey requirements. <br />Select one of the followkg� Select all that appl3n. <br />b 910 Allo cmtedFederal Homing Tax Credit 13 HOME. (including TC AP <br />114% AlloratedYederalHoming Tax Credit o CDBG <br />11 Tax -Exempt Bond Only (No tax credits) (3 Other HUD. including 202- 911, and 236 <br />Eicitylucimionalyunits 0 National Housing Trust Fund <br />C1 Other 0 USDA Rural Housing Service, inchuiing 514,5115, and 538 <br />13 Other Ltate.arlocal housingprogram <br />SIGNATURE OF 011 NIERMEPRESENTA1117E <br />BisedmrharepresmtationshELieinandup6ntheproofsad docmnentiliGnrequired robi'subcaitted,93L-in&-Lidmi(s)sensed inPaVH,Dfthis Ta�tt <br />Incom CertificRtion is,'Pm &6VIe under the provisions of Secdon-42 of the luternal Revenue Code. w. mnea&d, and the Lan dUse Resmiction <br />Apeeiuear(if 2pplicable). to livein aunt in this Project. <br />SIGNATURE OF 4k[ VE DATE <br />2 Tenant Income Certfficatbm (Apria 202I <br />REV: 05-21-25 LF <br />ATTY/Ar-'P 9n95 1 nnlHP:APT-.q\/ 1A17.qt;;mhqi inh.qf 1 (Pqnp. A9 of R51 <br />