Form Hud-9834 - Management Review For Multifamily Housing Projects Page 29
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46ADDENDUM A
OMB Approval No. 2502-0178
Exp. 11/30/2011
Tenant File Review Worksheet
Instructions: Review the appropriate number of tenant files and complete this worksheet for each file reviewed. Indicate the initial move-in date
in the appropriate box. Indicate by marking the appropriate box (Yes, No, or N/A) for each document available in the tenant file. For move-out
and applicant rejections files, reviewer should only complete the pertinent sections.
Name of Reviewer:
Type of Review:
Applicant Rejection
Tenant Move-In
Tenant Move-Out
Certification/Recertification
Effective date of certification(s) reviewed:
If Certification/Recertification, indicate certification type:
Certification Type:
Initial
Annual
Interim
Other
Family Name:
Unit Number:
Move-in Date:
Bedroom Size:
0 Bedroom
1 Bedroom
2 Bedroom
3 Bedroom
4 Bedroom
5 or more Bedrooms
A. HOUSEHOLD INFORMATION
1. Is the application complete, including the date and time
Comments:
Yes
No
received by the owner/agent?
2. Are the household members identified correctly?
Yes
No
Comments:
(head, spouse, dependent, co-head, other adult(s), live-in
aide)
3. Is the unit size appropriate for household?
Comments:
Yes
No
4. Was household income eligible at move-in?
Yes
No
Comments:
(This question applies only to a tenant file move-in
review.)
Over income?
Low income?
Very low income?
Extremely low income?
5. If household was not income eligible at move-in, was
Yes
No
Comments:
an exception granted?
Yes
No
N/A
Comments:
6. Is the lead-based paint acknowledgement in the file?
7. Does the file contain the ethnicity and racial Data
Yes
No
Comments:
Certification as provided to the owner/agent?
8. Have the HUD-9887/9887-A Consent Forms been
Yes
No
Comments:
signed by head, spouse, co-head regardless of age and
family members at least 18 years of age?
9. Was the HUD-9887 Fact Sheet provided to the tenant?
Yes
No
Comments:
Yes
No
Comments:
10. Does the file contain the Resident Rights and
Responsibilities acknowledgement?
form HUD-9834 (6/2009)
Ref. HUD Handbook 4350.1, REV-1
and HUD Handbook 4566.2
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