Form Hud-9834 - Management Review For Multifamily Housing Projects Page 31
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46ADDENDUM A
OMB Approval No. 2502-0178
Exp. 11/30/2011
rd
All reported income and deductions verified
3
Party Verification?
Amount Reported
Did income information on the 50059 agree with
and calculated correctly?
on 50059
verified file information? If no, comment on
discrepancies identified
4. Wages
Yes
No
$
5. Social Security Benefits
Yes
No
$
6. Welfare/Public Assistance/TANF
$
Yes
No
7. Other income
Yes
No
$
8. Actual Income from Assets
Yes
No
$
9. Imputed income when assets are greater than
$
Yes
No
$5,000
10. Dependent Allowance
Yes
No
$
11. Medical Expenses
Yes
No
$
12. Disability Expenses
$
Yes
No
13. Childcare Expenses
Yes
No
$
14. Elderly/disabled household allowance
Yes
No
$
15. Are all expenses/allowances claimed
Comments:
Yes
No
eligible under the HUD Handbook 4350.3 REV-
1?
16. Was the correct unit rent used for rent
Yes
No
Comments:
determination?
Amount Reported on the
Did income information on the 50059 agree with verified file
Enter the reviewer verified amounts for the
50059
information? If no, comment on Discrepancies Identified.
following:
$
Comments:
17. Total Tenant Payment
$
$
Comments:
18. Tenant Rent
$
$
Comments:
19. Utility Reimbursement
$
Comments:
$
20. Assistance Payment
$
21. Is the tenant paying minimum rent?
Comments:
Yes
No
N/A
22. Has a hardship exception been granted for
Yes
No
N/A
Comments:
paying minimum rent?
23. Was a 30-day rent increase notice provided
Comments:
Yes
No
N/A
to tenant?
24. If applicable, has tenant entered into a
Yes
No
N/A
Comments:
written payment plan for monies due to the
project?
form HUD-9834 (6/2009)
Ref. HUD Handbook 4350.1, REV-1
and HUD Handbook 4566.2
Page 3 of 4
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