Form Hud-9887 - Document Package For Applicant'S/tenant'S Consent To The Release Of Information Page 5
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6Applicant's/Tenant's Consent to the
U.S. Department of Housing
and Urban Development
Release of Information
Office of Housing
Federal Housing Commissioner
Verification by Owners of Information
Supplied by Individuals Who Apply for Housing Assistance
Instructions to Owners
Purpose of Requiring Consent to the Release of Information
1. Give the documents listed below to the applicants/tenants to sign.
In signing this consent form, you are authorizing the Owner of the
Staple or clip them together in one package in the order listed.
housing project to which you are applying for assistance to request
information from a third party about you. HUD requires the housing
a. The HUD-9887/A Fact Sheet.
owner to verify all of the information you provide that affects your
b. Form HUD-9887.
eligibility and level of benefits to ensure that you are eligible for
c. Form HUD-9887-A.
assisted housing benefits and that these benefits are set at the
d . Relevant verifications (HUD Handbook 4350.3 Rev. 1).
correct levels. Upon the request of the HUD office or the PHA (as
Contract Administrator), the housing Owner may provide HUD or the
2. Verbally inform applicants and tenants that
PHA with the information you have submitted and the information
a. They may take these forms home with them to read or to
the Owner receives under this consent.
discuss with a third party of their choice and to return to sign
them on a date they have worked out with you, and
Uses of Information to be Obtained
The individual listed on the verification form may request and
b. If they have a disability that prevents them from reading and/
receive the information requested by the verification, subject to the
or signing any consent, that you, the Owner, are required to
limitations of this form. HUD is required to protect the income
provide reasonable accommodations.
information it obtains in accordance with the Privacy Act of 1974, 5
3. Owners are required to give each household a copy of the
U.S.C. 552a. The Owner and the PHA are also required to protect
HUD9887/A Fact Sheet, form HUD-9887, and form HUD-9887-A
the income information they obtain in accordance with any
after obtaining the required applicants/tenants signature(s). Also,
applicable state privacy law. Should the Owner receive information
owners must give the applicants/tenants a copy of the signed
from a third party that is inconsistent with the information you have
individual verification forms upon their request.
provided, the Owner is required to notify you in writing identifying the
Instructions to Applicants and Tenants
information believed to be incorrect. If this should occur, you will
have the opportunity to meet with the Owner to discuss any
This Form HUD-9887-A contains customer information and
discrepancies.
protections concerning the HUD-required verifications that Owners
must perform.
Who Must Sign the Consent Form
1. Read this material which explains:
Each member of your household who is at least 18 years of age, and
• HUD’s requirements concerning the release of information,
each family head, spouse or co-head, regardless of age must sign the
and
relevant consent forms at the initial certification, at each
• Other customer protections.
recertification and at each interim certification, if applicable. In
2. Sign on the last page that:
addition, when new adult members join the household and when
• you have read this form, or
members of the household become 18 years of age they must also
• the Owner or a third party of your choice has explained it to you,
sign the relevant consent forms.
and
• you consent to the release of information for the purposes and
Persons who apply for or receive assistance under the following
uses described.
programs must sign the relevant consent forms:
Authority for Requiring Applicant's/Tenant's Consent to the
Rental Assistance Program (RAP)
Release of Information
Rent Supplement
Section 904 of the Stewart B. McKinney Homeless Assistance
Section 8 Housing Assistance Payments Programs (administered by
Amendments Act of 1988, as amended by section 903 of the Housing
and Community Development Act of 1992. This law is found at 42 U.S.C.
the Office of Housing)
3544.
Section 202
In part, this law requires you to sign a consent form authorizing the Owner to
Sections 202 and 811 PRAC
request current or previous employers to verify salary and wage
Section 202/162 PAC
information
pertinent
to
your
eligibility
or
level
of
benefits.
Section 221(d)(3) Below Market Interest Rate
In addition, HUD regulations (24 CFR 5.659, Family Information and
Section 236
Verification) require as a condition of receiving housing assistance that
you must sign a HUD-approved release and consent authorizing any
HOPE 2 Home Ownership of Multifamily Units
depository or private source of income to furnish such information that is
necessary in determining your eligibility or level of benefits. This includes
information that you have provided which will affect the amount of rent you
pay. The information includes income and assets, such as salary, welfare
benefits, and interest earned on savings accounts. They also include certain
adjustments to your income, such as the allowances for dependents and for
households whose heads or spouses are elderly handicapped, or disabled;
and allowances for child care expenses, medical expenses, and handicap
assistance expenses.
ref. Handbooks 4350.3 Rev-1, 4571.1, 4571.2 & 4571.3
form HUD-9887-A (02/2007)
Original is retained on file at the project site
and HOPE II Notice of Program Guidelines
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