Laserfiche WebLink
PARTY.; DETEM"fTi ATIOIN OF ENXO 1IE ELIGIBiL= <br />RECEATTFICATION, ONLY: <br />TOTAL _4N�Rir4L HOUSEHOLD <br />Y'r{COME FROOMALL SOUMCE; <br />From itrsii (L) ongage I S <br />Camrotlocomelinii9 per Family Size <br />Income Levelo€ ait(06 A -ally" <br />Extremely I ow, ilervLow, Low <br />'�ia%erasey <br />Hohnsehold Income exceeds" <br />limit <br />❑Yes 13 No, <br />Household Size at MOIM-in: <br />SIGN— ATURE OF O1i NERt(REPRE SEs' T:3<MM <br />Eased on therepresentations berein and upon the proof and documentation required to ba'submined, the indiridtektl(sj maned in Part Iio€this Tenant <br />Income Certification isi ate eligihle under the Provisions of Section 42 of the Internal Revenue Code, as amended, and die LaadDse Restriction <br />Agreement "(if applicable)," to line in a unit is this Project <br />SIGN-kTLTME OF Oti0,M1;LREPRESENTA=E- DATE <br />2 Tenant Income Certification (April 20 y1) <br />REV: 05-20-25 LF <br />ATTY/AGR.2025.100.3/HEART-SV (417 Stambauah - Reoulatory Aareement) (Pane 34 of 35) <br />°-I'.1RT'VTII. PROG&MTYPE <br />R RT'171 RENT <br />,Select one of the following. <br />Select all that apply.": <br />Tenant Paid Mot tiny Henn.: <br />S <br />❑ 4% Allocated Federal Housing Tax Credit <br />0 CDBG <br />❑ Tax -Exempt Bond Only (Nil tax credits) <br />onthly Utility AlIawance: <br />S <br />❑ Nation Housing Tout Fund <br />❑ Other <br />❑ USDA Rural Housing Service, including 5i4, 515, and 538 <br />.. - <br />other I1lonAly Non -optional charges_;. <br />S <br />CROSS MONTHLY RENT FOR Uh3T_ <br />(i'enant paid rent plus Utility Allowance <br />'odlir nonroptional cheFees) <br />S <br />CurreaAffzr&blt Rent forthisUnt. <br />PART -VILTLDEItiTST TUI <br />+Student£xplanaHon. <br />ARE AILOCCUPANTS FULL MME STUDENI57 <br />ifyes, Entersw&zit expiaaatioe <br />I " <br />:#FDC 174hT isistance <br />(also attach docti,a,�atation): <br />2 <br />_ <br />'Jab Training Program <br />6 Yes D No <br />3 <br />Single PareutDepeudew Odd <br />Enter <br />4' <br />-11,arAedrlointRiMm <br />I-5 <br />5 <br />.;Fortner Foster Care <br />SIGN— ATURE OF O1i NERt(REPRE SEs' T:3<MM <br />Eased on therepresentations berein and upon the proof and documentation required to ba'submined, the indiridtektl(sj maned in Part Iio€this Tenant <br />Income Certification isi ate eligihle under the Provisions of Section 42 of the Internal Revenue Code, as amended, and die LaadDse Restriction <br />Agreement "(if applicable)," to line in a unit is this Project <br />SIGN-kTLTME OF Oti0,M1;LREPRESENTA=E- DATE <br />2 Tenant Income Certification (April 20 y1) <br />REV: 05-20-25 LF <br />ATTY/AGR.2025.100.3/HEART-SV (417 Stambauah - Reoulatory Aareement) (Pane 34 of 35) <br />°-I'.1RT'VTII. PROG&MTYPE <br />Identify the program(s) for which this household's unit will be counted toted the: property's occupancy requirements, <br />,Select one of the following. <br />Select all that apply.": <br />Q 9% Allocated Federal Housing Tax Credit <br />-13 HOME {including TCAP} <br />❑ 4% Allocated Federal Housing Tax Credit <br />0 CDBG <br />❑ Tax -Exempt Bond Only (Nil tax credits) <br />0 tither HTTUD- inchtdinE 70'x, $31; and 236 <br />❑ City IndusionaiyUnits <br />❑ Nation Housing Tout Fund <br />❑ Other <br />❑ USDA Rural Housing Service, including 5i4, 515, and 538 <br />.. - <br />❑ Other ztate or local housing programs <br />SIGN— ATURE OF O1i NERt(REPRE SEs' T:3<MM <br />Eased on therepresentations berein and upon the proof and documentation required to ba'submined, the indiridtektl(sj maned in Part Iio€this Tenant <br />Income Certification isi ate eligihle under the Provisions of Section 42 of the Internal Revenue Code, as amended, and die LaadDse Restriction <br />Agreement "(if applicable)," to line in a unit is this Project <br />SIGN-kTLTME OF Oti0,M1;LREPRESENTA=E- DATE <br />2 Tenant Income Certification (April 20 y1) <br />REV: 05-20-25 LF <br />ATTY/AGR.2025.100.3/HEART-SV (417 Stambauah - Reoulatory Aareement) (Pane 34 of 35) <br />