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30 Day Notice to Landlord Sample

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30 Day Notice to Landlord Sample document sample

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									  Welcome to the Housing Choice
   Voucher Program Briefing
Section 8 Rental Assistance and the Housing Choice Voucher Program are the same.

Sign required releases and forms
Review program rules and regulations
Review Affordability and Rent
Be issued a voucher and provided with the
 Request for Tenancy Approval
Locate the HUD
Authorization for
Release of Information.
This is a two sided
document. The head of
household signs, dates
and put their Social
Security number on this
form, other members over
18 sign and date. - This
allows our agency to
verify Income and Assets
Only and allows use of
computer matching
system with the IRS and
Social Security.
Head Of Household
Signs, Dates and put
their Social Security
Number under their

Other household
members 18 and over
sign and date.
Please Locate the
Authorization for
Release of
Read and Sign this
This allows the HA to
verify income, assets,
child care expense,
medical expense, etc
and to talk to your
landlord when the
papers are sent in.
• Please locate the
• This is a release for
  our agency to
  investigate criminal
  background for all
  household members
  who are 18 or older.
• Please locate the
• Please list all arrests
  for all the people in
  your household.
Locate the Tenant
Form - This Form
will be read to you
before you sign it.
Program Participant Certification

I certify that all the information provided on household
composition, income, family assets and items for allowances and
deductions, is accurate and complete to the best of my knowledge.
I have reviewed the application form and the interview worksheet,
and I certify that the information shown is true, correct and

  What Happens if I provide false information? -- You will
  lose your rental assistance, you will need to repay the
  funds you are not entitled to and you may be prosecuted
  for Fraud.
Program Participant Certification
  I know that I am required to report immediately in writing
  any change in income amounts or sources. I know I am
  required to report immediately in writing any change in the
  household size, and when a person moves in or out of the
  unit. I understand that if someone stays with me fifty percent
  (50%) of the time or four (4) nights a week, and/or if
  someone stays with me for 30 days in a calendar year, I must
  report their presence and income to the Housing Authority.
You must Report ANY new source of income, even if it is a part
time job for $5.00 per week - on or off the books.
You must also report anytime a current income source, one that
you have today, changes.
You must report when someone moves in or out of your unit.

It is your responsibility to remember this.
All Reporting Must Be Done In WRITING With
Back Up 3rd Party DOCUMENTATION.
What Counts as Income?
Wages - even if they are off the books.
SSI / SSD for you or anyone in your household.
Child Support - whether through Child Support Collection, court
order, or just agreement --- EVEN if paid in cash!
All the other sources you were questioned about.
  Program Participant Certification

I certify that I have disclosed where I received any previous Federal housing
assistance and whether or not any money is owed. I certify that for this previous
assistance I did not commit any fraud, knowingly misrepresent any information, or
vacate the unit in violation of the lease.

I certify that the house or apartment will be my principle residence and that I will
not obtain duplicate Federal housing assistance while I am in this current
program. I will not live anywhere else without notifying the Housing Authority
immediately in writing. I will not sublease my assisted residence.

    You may only have your rent subsidized by one agency. You may not live
    in two places. You must remain in the unit you lease for at least 12
  Program Participant Certification

I know I am required to cooperate in supplying all information needed to
determine my eligibility, level of benefits, or verify my true
circumstances. Cooperation includes attending pre-scheduled meetings
and completing and signing needed forms. I understand failure or refusal
to do so will result in delays, or the termination of assistance. I
understand that if I miss two (2) appointments to recertify for
Section 8, it may result in the termination of assistance.

   Once you are on the program you will be sent a letter notifying you of an
   annual recertification appointment. You must call immediately if you can not
   keep the appointment. You must show for your appointment. If you do not
   show or you cancel that counts as a missed appointment. If you do that again
   for that annual recertification - YOU WILL BE TERMINATED FROM THE
   PROGRAM. - Showing Up Is Important!
Program Participant Certification

I understand that if suspected, or convicted of, the unlawful
manufacture, distribution, dispersion, possession or use of a
“controlled substance” while receiving Rental Assistance is
grounds for immediate termination of rental assistance.

 The One Strike Policy - 24 CFR Parts 5 et al. Screening and
 Eviction for Drug Abuse and Other Criminal Activity; Final
 Rule, Dated May 24, 2001. The voucher you are issued today will be
 withdrawn if it is discovered that you are currently engaging in this type of
 activity. What does that mean? With respect to behavior such as illegal use of a
 drug, other drug-related criminal activity, or other criminal activity, currently
 engaging in means that the individual has engaged in the behavior recently
 enough to justify a reasonable belief that the individual’s behavior is current.
Program Participant Certification

I understand that knowingly supplying false, incomplete or
inaccurate information is a felony and is punishable under
Federal and State criminal law. I understand that knowingly
supplying false, incomplete, or inaccurate information is grounds
for termination of housing assistance and prosecution.

  What Happens if I provide false information? -- You will
  lose your rental assistance, you will need to repay the
  funds you are not entitled to and you will be prosecuted
  for Fraud. The fine is up to $10,000 and 5 years in jail.
Title 18 US Code Section 1001 states that a person
is guilty of a felony for knowingly and willingly
making a false or fraudulent statement to any
department or agency of the United States. If this
form contains false or incomplete information, you
may be required to repay all overpaid rental
assistance you received: Fined up to $10,000,
imprisoned for up to 5 years; and/or prohibited
from receiving future assistance.
Program Participant Certification

I hereby certify that I have reviewed and understand the above
responsibilities of being a program participant in the Section 8
Rental Assistance Program.


  Are There Any Questions?
Locate the Reasons
for Termination of
 Assistance. This
will be read to you
before you sign it.
Reasons For Termination of Assistance

In accordance with federal law, this office may terminate
rental assistance to a tenant family for the following reasons:

 The family is guilty of program abuse or fraud. Fraud is a criminal

 The family violates their obligations under the program as listed on the

 The family refuses to supply any certification, release of information, or
  documentation which the Housing Agency (HA) or HUD determines to
  be necessary for the administration of the program;

 The family vacates the dwelling unit without proper notice to the HA
  (Moves without 30 day notice to landlord/HA)
Reasons For Termination of Assistance
In accordance with federal law, this office may terminate
rental assistance to a tenant family for the following reasons:

 The family does not use the dwelling as its principal residence;

 The family does not pay their share of their rent (violation of the
  lease) ; or refuses to pay the HA amounts due under a repayment
  agreement or an agreement for damages/unpaid rent, paid to the
  owner by the HA, on the family’s behalf;

 If the family does not pay for utilities they are responsible for
  paying (HQS failure);
 Reasons For Termination of Assistance

In accordance with federal law, this office may terminate
rental assistance to a tenant family for the following reasons:

 The family commits any serious or repeated violations of the

 The family engages in drug-related activity or violent criminal
  activity, including criminal activity by any family member;

 The family engages in or threatens abusive or violent behavior
  toward the Section 8/HCV Program personnel.
Reasons For Termination of Assistance

If your assistance is terminated for one of the above reasons, both
you and the owner will be provided with a 30 day written notice of
termination. Your notice will state:
   The reason(s) for the termination;
   The effective date of the termination;
   The family’s right to request an informal hearing;
   The family’s responsibility to pay the full contract rent to the
   owner if they remain in occupancy.
Anyone over the age of 18 must sign below. By signing you certify
that you have read the above and understand what I have read.

Are There Any Questions?
You will sign a form stating
that you have received this
booklet. This booklet is in
        your folder.
Locate the Notification
- Watch Out for Lead-
Based Paint Poisoning.
You need to read this
form and then check the
box on the bottom
stating: I have received
a copy of the Pamphlet
entitled “Protect Your
Family From Lead in
Your Home.”
Head of Household
needs to: Date, Print
And Sign!
   This is the
  Declaration of      e

Please put the date
 on the top of the
Each applicant who will benefit under the Housing Choice Voucher Program (Section 8) must
either be a citizen or national of the United States, or be a noncitizen who has eligible
immigration status that qualifies them for rental assistance as determined by the U.S. Department
of Housing and Urban Development and the U.S. Immigration and Naturalization Service.

 One box on this form must be checked for each member of the applicant family
 indicating status as a citizen or a national of the United States or a noncitizen with eligible
 immigration status. Applicants residing in the unit to be assisted that do not claim to be a
 citizen or national of the United States, or do not claim to be a noncitizen with eligible
 immigration status should not check any box.

All adults must sign where indicated. For each child who is not 18 years of age, the form must
be signed by an adult member of the family residing in the dwelling unit who is responsible for
the child. Use blank lines to add family members who are not listed.
                                           I am a citizen           I am a
                                           or national of        non-citizien
  First Name     Last   Name         Age      the U.S.           with eligible Signature of Adult Listed to the Left, or
                                                                 immigration Signature of Guardian for Minors.

  _____________ _________________ _____                    or                x_______________________

  _____________ _________________ _____                    or                x_______________________
Head of household
needs to sign on the
back to certify that
the information on the
front is correct and
that all household
members are listed.
NOTE: Applicants who have
checked a box indicating that
they are a non-citizen with
eligible immigration status must
complete Part 2 of this form.
Portability Information
Sheet - Tenant Briefing

Please sign and date this
  form at the bottom.
 Portability means that
you may take the rental
assistance Voucher and
move anywhere that has
  the HCV Program.
You are subsidized, not
       the unit.
         Portability Information Sheet - Tenant Briefing

If you do not use your option to port now as an INITIAL Port
and you lease up in Livingston County, you must stay in the unit
you are in for one year before you are eligible to port again.

Anytime after that one year mark of being leased, you may
request to Port. As a HCV Program participant in good standing,
a housing agency must accept you into their program. You do not
need to meet initial eligibility requirements.

The Housing Choice Voucher Program is a national program.

                Are There Any Questions?
What is a Good Place To Live?     (You have a booklet with more details)

  For minimum Housing Quality Standards, It Must Have:
  A working smoke detector.
  Two sources of electricity in the bedrooms and living room - this
  may be an overhead and an outlet or two outlets.
  A kitchen must have a permanently installed light fixture.
  A bathroom must have a fan or window for ventilation.
  Bedrooms must have a window and if the window is meant to open,
  it must open.
  Outlet or switch plate covers must be in place. If the unit has been
  painted, make sure they put these back in place.
  Paint must be in good condition, no cracking, chipping, peeling or
  chalking paint please.
This form explains the term
of your voucher. Your
voucher was issued today,

7/13/2010 it is valid
for 60 days. If you are not
able to locate a unit by that
date and would like to keep
your voucher active, you
will need to submit a
written request and a search
record you may be granted
up to four additional 30 day
periods. The maximum amount
of time you will have to lease up
in is 180 days.
If your request for extension is
not granted you must reapply.
If you need an extension
on the term of your
voucher, you will need
to submit a written
request, including a
Search Record.

You may use our form
or write the information
on your own paper.

Your request for an
extension must be in
our office on or prior to
the expiration date on
your voucher.
You MUST submit your request for an extension on or
before the date your voucher expires.

You have written your deadlines on the Voucher Term
Form. Please mark your calendars at home or find a way
to remind yourself so you don’ t lose this opportunity any
sooner than you have to.

If you do not submit the written request with a record of
what you have been doing - you will TIME OUT and
need to reapply. Your voucher will expire when you fail
to submit your request or when 60 has passed.
                        Request for Tenancy Approval                                                        U.S. Department of Housing and                                      OMB Approval No. 2577-0169

                        Housing Choice Voucher Program                                                      Urban Development
                                                                                                            Office of Public and Indian Housing

                        Public reporting burden for this collection of information is estimated to average 5 minutes per response, including the time for reviewing instructions, searching existing data sources,

Find the Request for    gathering and maintaining the data needed, and completing and reviewing the collection of information. This agency may not conduct or sponsor, a nd a person is not required to respond
                        to, a collection of information unless that collection displays a valid OMB control number.

                        Eligible families submit this information to the Public Housing Authority (PHA) when applying for housing assistance under Section 8 of the U.S. Housing Act of 1937 (42U.S.C. 1437f).

Tenancy Approval.       The PHA uses the information to determine if the family is eligible, if the unit is eligible, and if the lease complies with program and statutory requirements. Responses are required to
                        obtain a benefit from the Federal Government. The information requested does not lend itself to confidentiality.

                        1. Name of Public Housing Agency (PHA)                                            2. Address of Unit (Street Address, Apartment Number, City, State & Zip)
                        Livingston County Office of Housing
                           6 Court St Room 305 Geneseo, NY

Please write:                Phone: (585) 243-7555 Fax: 243-7566
                        3. Requested Beginning Date of Lease
                        ( (mo/ day / yr)
                                                                    4. No. of Bedrooms      5. Year Constructed 6.Proposed Rent                 7. Security Deposit Amount      8. Date unit available for inspection

Please return to:       9. Type of House/Apartment
                         Single Family Detached                   Semi-Detached/Row House  Manufactured Home  Garden/Walkup  Elevator/High-Rise
                        10. If this unit is subsidized, indicate type of subsidy:
                         Section 202              Section 221(d)(3)(BMIR)                 Section 236 (Insured or noninsured)                    Section 515 Rural Development

Our agency attention:   11. Utilities and Appliances
                        The owner shall provide or pay for the utilities and appliances indicated below by an “O”. The tenant shall provide or pay for the utilities and appliances indicated
                        below by a “T”. Unless otherwise specified below, the owner shall pay for all utilities and appliances provided by the owner.
                        Item                           Specify Fuel Type                                                                                                      Provided By               Paid By

     Ruth Swift         Heating

                                                        Natural Gas

                                                        Natural Gas
                                                                                  Bottle Gas

                                                                                  Bottle Gas
                                                                                                         Oil

                                                                                                         Oil
                                                                                                                         Electric

                                                                                                                         Electric
                                                                                                                                            Coal or Other

                                                                                                                                            Coal or Other

                        Water Heating                   Natural Gas              Bottle Gas            Oil            Electric          Coal or Other

          or            Other Electric



    Christina Cox       Trash Collection

                        Air Conditioning



                        Other (Specify)

                        Previous editions are obsolete                                                 Page 1 of 2 Pages                                                            form HUD-52517 (7/2000)
                                                                                                                                                                                       Ref. Handbook 7420.8
Turn the page. On the second page you need to
print your name in the box on the lower right hand
side that says Participant Family. Sign your name,
write your address and phone number
Print or type name of Owner or Other Party Authorized to Execute the Lease   Print or type name of Family

Signature                                                                    Signature(s)

Business Address                                                             Present Address of Family (Street Address, Apartment No., City, State & Zip)

Telephone Number                              Date                           Telephone Number                              Date

                        NOT THIS
                    LANDLORD                                                                       Tenant
The Next Page is The
Owner’s Responsibility
Page. You need to sign
on the line that says:

These are the landlord’s
responsibility. You are
entitled to know about
them. You will be
taking this package

with you.
The next page is the
landlord certification
regarding his/her
knowledge of and
records of Lead
Based paint in your
unit. Please sign
where it says: Lessee.

The next two pages
are for the landlord
only. The landlord
MUST supply a W-9
to our agency.
    What can I look for?
                                            Questions you may
    How much can I spend?                        have.
    What are my limits?

You were given a form entitled: How to Find An Affordable
Unit. Locate that now.

Since all apartments do not include all utilities and it would be
impossible to assist families if that were required, HUD had to
find a way to make it easy to see if unit A with all utilities, unit B
that included Heat/Hot water, unit C that had electric heat paid by
tenant and unit D with oil heat… or any other combination - could
be comparable in order to subsidize the units. You will find a
utility chart in your folder.
You have a Utility Chart
in your folder. This
shows a row house on
the left upper side, a
single family on the
upper right side, and a
duplex on the left lower
side and an apartment
house on the right lower
side. We also have one
for mobile homes.

You need to use the
correct chart for the size
unit you are renting and
the correct utilities.
If Heat is included, there is
no allowance added.

If the stove is electric and
the tenant pays electric, for
a one bedroom you would
have $6 Plus $15 for a $21
utility allowance.
This explains Affordability.
If you rent a unit at or below
the payment standard, you
pay 30% of your adjusted
income as a Total Tenant

You can rent a unit that
costs more than the payment
standard, however, you pay
the difference. And, you are
never allowed to pay more
than 40% of your adjusted
gross income for an initial
lease up.
What is “Gross Rent”?

Contract rent:                $_______          this is what the landlord says
                                                he/she wants – the rent for the

Plus Utility Allowance: + $_______              this is utilities NOT included in
                                                the rent, using utility chart.

Equals Gross Rent           =$_______           Payment Standards are Based
                                                on Gross Rent
   If you locate a rental unit that is less than or equal to the Payment Standard you
   will pay 30% of your adjusted gross income as a total tenant payment. You are
   allowed to rent a unit above that standard, but never more than your Maximum
   ALLOWABLE Gross Rent for an initial lease up. $1.00 over that and the
   landlord needs to lower the rent!
          How Is Your Share of Your Rent Determined?
   Total Tenant          Plus + any amount the
    Payment              gross rent is above the
                           payment standard                       Minus
This is 30% of your                                            any utility
     Adjusted          (take the gross rent and subtract       allowances
  Gross Income            the payment standard if the      (Use the utility chart)
                          gross rent is more than the
                              payment standard)

                                        Tenant Share of the Rent
                        =               This may be less than the Total
                                              Tenant Payment
Program Highlights.
This is the Gross Rent
calculation. []a
This is the formula for
how your share of your
rent is calculated. []a

Remember that you will
pay more if the unit you
rent has a gross rent
above the payment
This is the back side of
Program Highlights

This shows you how we
calculate your adjusted
gross income.

Your total Tenant
Payment range is
between 1 and 2 of the
Affordable unit Sheet.
SSI of 450 x 12 =    $ 5,400
SSD of 202 x 12 =    $ 2,424
  Gross Income =     $ 7,824

Ckg at Fleet = $500 = $0.00

Disabled Allowance = $400.00
No Medical
No Children

Adjusted Gross Income : $7,824 - $400.00 = $7,424.00
AGI $7,424.00 x 30% / 12 = $186.00 Total Tenant Payment
AGI $7,424.00 x 40% / 12 = $247.00 Max Total Tenant Payment
        How To Find An Affordable Unit Calculation

Payment Standard:     $658.00 One Bedroom
TTP at 30%            -186.00 Using 652/m, 1 person hh
Maximum Subsidy       $472.00

Maximum Subsidy       $472.00
TTP at 40% Max        +247.00
Maximum Gross Rent $719.00 Maximum Gross

Total Tenant Payment Range $186.00 - $247.00
Gross Rent Range     $ 658.00 or less up to $ 719.00
                   Payment Standards
               Bedrooms Payment Standard
                      1                      $ 630
                      2                      $ 770
                      3                      $ 835
                      4                      $ 885
                      5                      $ 926

You are entitled to a certain number of bedrooms based on Household Size. If
you rent a unit of that size, you get that payment standard. If you rent a smaller
unit, that smaller payment standard is used. If you rent a larger unit, you will
only be allowed the payment standard you are entitled to. Utility allowances are
based on actual unit size rented.
• The head of household
  and all members 18
  years and older should
  now sign this form.
     Other Items
       In Your
      Folder 
You will be taking these items with you. Please review them.
If you have any questions after reviewing them, please call
our office and speak to your case worker.
Section 8 Guidelines for

This booklet explains
the material reviewed
with you today. It has
the Family Obligations
and Grounds for
Denial or Termination
of Assistance. This is
your program guide.
This is a white booklet.
When you are looking for a
place to live, if you think
the landlord is not renting
to you because of race,
color, national origin,
religion, sex, family status,
handicap or disability you
can file a complaint. If you
need assistance we will help
A Good Place To
  Live Booklet
This document explains
when you are entitled to
 informal hearings and
This packet explains
the program to your

If a landlord has any
questions you may
give him/her this

We will send this to
your landlord once
you lease up.
  This is a sample
  voucher. You will
sign a real voucher
 for our files at the
end of the briefing.
This is the back of the
sample voucher. This
shows the Obligations
of the Family. It is
your responsibility to
read this and abide by
the regulations.
• The US Privacy Act of
  1974 protects your
  right to privacy. The
  head of household and
  all members 18 years
  and older should now
  sign this form.
Other Parts of the
 Housing Choice
Voucher Program
 Please read this
  brochure—it is
important for you
 to know that we
expect units to be
    in sanitary
Livingston County Office of Housing Assistance is one of the
housing agencies that offers the new Section 8 To
Homeownership Program.
 You are not eligible for this program until after you have
    leased up under the Section 8 Program for at least one year.
 The program requires that you have a minimum income of
    $17,000 per year.
 The head or co-head must be employed full time and have
    been employed for two years.
 You would still need to qualify for a mortgage.
 This program would allow you to use your Section 8 housing
    assistance payment to help pay for a mortgage!
These requirements may be waived for disabled households.
Notes:If you are responsible for paying heat in your unit -
you may be eligible for HEAP and we do not count HEAP
We do not count food stamps, however, Food Stamps
wants to know your share of your rent with Rental
Assistance. You are sent a letter telling you your share -
We do not do the Landlord Verification for Public
All Reporting of Changes MUST BE DONE IN
We do not provide security deposits. DSS may provide a
security agreement. Many of our clients work with the
landlord to arrange payment of security in installments.
One of the most important documents you received today
is the Request For Tenancy Approval. Once you find a
place, have the landlord fill out the Request For Tenancy
Approval. Either you or the landlord can mail or bring it
in. Once it is in our office we will make
arrangements to inspect the unit.
Make sure you request your extensions
on time!
  Are There Any Questions?
             UNIT SEARCH
• Please start searching
  for a unit immediately.

• Or if you wish to stay
  in the unit you are in
  have your current
  landlord fill out the
  Request for Tenancy
  Approval form.
This Form States That
 I Have Provided You
With The Information
You Were Given Today.
                The Family Self-Sufficiency Program

If You Are:

  Currently receiving housing assistance through the Housing
   Choice Voucher Program.

  Willing to work toward full time employment and be free of public
   assistance for one year prior to completion of the contract. PA
   does not include food stamps or medicaid.

  Committed to achieving a better way of life for you and your
   family and willing to work with a counselor to identify what you
   and your family need to make life better
Tenancy Addendum -
You will sign three
copies of this now and
keep one unsigned copy
for your records.

They have a red box that
says “Agreed to By:”
and a line for you to sign
on. This addendum is
an add on to your lease
that incorporates the
Housing Choice Voucher
Program Requirements
with your lease.
The Family Self-Sufficiency Program (FSS) allows you to earn
money when your share of your rent increases due to increases in
earned income!! The “match” will be deposited into an Escrow or
savings account for you every month. When you reach your goals
or make enough to be over the income level to qualify for this
program and are off of Public Assistance for one year, you will
recieve the money in your account!
If you are interested in this program, you will need to fill out an
There is currently a waiting list for this program. You will not
actually be able to sign up until you are leasing up a unit.
We have given away checks for up to $14,000.00!!
Sample Lease - HUD
prefers the landlord to
use their own lease, but
if they do not have one,
we will provide one.
 This is a handy
booklet. This tells
you your rights in
  New York as a
   tenant and a
landlord’s rights.

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