Unicef Application Unicef Application Form For Rental Subsidy Page 2
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2This page to be completed by the Senior Certifying Official at the Duty Station.
One box below must be checked or application will be returned.
□
13.a I certify that the dwelling occupied by the staff member is appropriate to the circumstances and family status
of the staff member and that the rent is reasonable given the local market conditions. To the best of my
knowledge all the information recorded is up to date.
The necessary supporting documentation has been submitted and verified and kept at the duty
station.
□
13. b In view of the staff member's family status and/or the conditions prevailing in the local housing market, the
rent shown in 10. is inappropriately high. It is therefore recommended that a rental amount of
be used for the calculation of the rental subsidy.
□
13.c I certify that the dwelling provided to the staff member is of substandard quality and that the calculated
deduction (if any) should be reduced to one half.
14. Lease Agreement
I certify that I have reviewed the lease agreement and have verified that the information provided by the staff member is
in accordance with the lease agreement.
Title Certifying Official
Signature Certifying Official
Date (dd.mm.yyyy)
If this application is incomplete or illegible it will be considered invalid and returned to originating field
office.
Plese scan/fax or pouch application to the attention of DHR/HRSS – Payroll Unit – New York HQs Office #TA 26B.
Fax 212.824.6328.
Application for Rental Subsidy (and Rental Deduction) for Field Stations Form
UNICEF 403 (09/09)
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