SAMPLE FORMS, LETTERS, NOTICES AND BROCHURES

FORMS (for forms HUD has translated into other languages, go to http://www.hud.gov/offices/fheo/promotingfh/lep.cfm#Indian)

Adjusted Income Worksheet
AgencyPlan Checklist
Agenda for Board Meeting - Example
Allowance Checklist
Annual Income Checklist
Annual Income Worksheet
Applicant/Tenant Certification Eng
Applicant/Tenant Certification Span
Application for HCV (THA)
Application for Public Housing (THA)
Application for Public Housing 2
Application for Public Housing 3
Application Renewal Form

Assets

Asset Divestiture Data-gathering Worksheet
Asset Divestiture Verification
Asset Income Worksheet
Asset Income Verification
Asset Income Verification 2
Asset Questionnaire
Asset Questionnaire Spanish

Athletic Scholarship
Attendant Care Verification
Auxiliary Apparatus - Employer's Certification of need for Auxiliary Apparatus for Disabled
Auxiliary Apparatus - Verification of Cost of Auxiliary Apparatus for Disabled
Bank Draft for Rent 1
Bank Draft for Rent 2
Bid Documents

HUD-5369 Instructions to Bidders
HUD-5369-a Represent., Certs, and Other Statements of Bidders
HUD-5369-b Instr. to Offerors - Non-Construction
HUD-5369-c Certs and Reps of Offerors - Non-Construction
HUD-5370 Gen. Conditions for Construction Contracts
HUD-5370-c1 Gen. Conditions for Non-Constr. Contracts
HUD-5370-c2 Gen. Cond, for Non-Constr. Contracts w/Maintenance
HUD-5370EZ - Gen. Cond. for Small Constr./Dev. Contracts

Budget Approval Resolution
Childcare Costs Verification - Babysitter
Childcare Costs Verification - Day Care Center
Citizen Input Form (Board Meetings)
Citizenship - Documentation of Status
Community Service Compliance Certification
Community Service Exemption Form
Community Service Tracking Form
Complaint Form - Resident
Contact Person or Organization (optional form for applicants)
Contact for Emergencies
Criminal Check Release
Criminal History Request Record
Debts Owed PHAs (HUD Form)
Deceased Release (in case of death of resident)
Declaration of Section 214 (Citizenship) Status
Depository Agreement (HUD Form)
Detox Center - Authorization to Release Information
Direct Deposit Form
Disability -Certification for Reimbursement
Disability - Checklist for Expenses Verification
Disability - Verification of
Disability - Verification of 2
Disability Assistance Need Verification
Disability Assistance Need Verification 2
Domestic Violence Certification
Domestic Violence
Certification (HUD)
Earned Income Disallowance/Disregard Worksheets (THA/HUDFW)

100% Disallowance Worksheet
50% Disallowance Worksheet
Income History Log
EID Calendar
EID Qualifying Form - PH
EID Qualifying Form - HCV

Earned Income Tax Credit Notice to Employees
Eligibility
Criteria - Public Housing Sample
Eligibility Criteria/Tenant Selection - Multifamily Sample
Employee Correction Counseling
Employee Evaluation Form - Executive Director
Employee Evaluation Form 1
Employee Evaluation
Form 2
Employee Evaluation
Guidance
Employment Application
Employment- Auth for Criminal/Credit Check
Employment Verification
Environmental Forms

Certificate of Exemption
Compliance Documentation
Checklist
Certificate of Categorical Exclusion, not subject to 58.5
Certificate of Categorical Exclusion
, subject to 58.5
Statutory Checklist
Notice of Intent to Request Release of Funds
Request Release of Funds
Authorization to Use Grant
Funds
Environmental Assessment
Checklist
Combined Notice

Extermination Policy Acknowledgement
Forcible Entry and Detainer form (evictions)
Fostercare
Verification
Fulltime Student Verification
Gas, Authorization for New Service
Hardship Request
Home Visit Checklist
Housing Choice Voucher forms

Housing Assistance Payments Contract (HAP) Eng
Housing Assistance Payments Contract (HAP) Span
Voucher Eng
Voucher Span
Request for Tenancy Approval Eng
Request for Tenancy Approval Span
Tenancy Addendum Eng
Tenancy Addendum Span

Housing Assistance Verification
HQS Inspection Form
Identity Theft Documentation
Income from Contributions Worksheet
Income Targeting Worksheet
Indemnification Agreement
Informal Hearing Summary
Inspection Form (FWHUD)
Inspection Form 2
Inspection Form 3
Interagency Tenant Cross Check
Interview Questionnaire Public Housing English
Interview Questionnaire Public Housing Spanish
Interview Questionnaire HCV
Labor Reporting Form
Landlord Verification Form
Lawncare Agreerment
Lead Paint Brochure Certification
Lead Paint Certification
Lead Disclosure Form Eng
Lead Disclosure Form Span
Lease - Ability to Comply
Lease - Certification for Assistance to An Applicant Complying with Lease Terms
Lease - THA
Maintenance Checklist
Medical Costs Verification
Military Income Verification
Minimum Rent Waiver
Minimum Rent Waiver Request
No Additional Adults Certification
Noncitizen - Certification of Noneligible Immigrant Status
Oath of Office Form / Certificate of Appointment - Commissioners
Parent Responsibility Form
Pensions/Annuities Verification
Personnel Action Form
Pest Control - Emergency Waiver
Pet Policy Certification
PHA Certification for Tenant File
Physical Needs Assessment (Short Form used with old CGP)
Physical Needs Assessment (Long Form for CFP/OFP)
PILOT Computation Form
Police Record Verification - City
Police Record Verification - Sheriff
Police Report
Portability (Section 8, HUD-52665)
Portability Log Forms
Power of Attorney
Pre-Application for Public Housing
Prescription Verification
Privacy Notice (HUD)
Race and Ethnic Reporting Form (HUD-27061)
Reasonable Accommodation (Section 504) (Accessibility) Checklist
Reasonable Accommodation Notice
Records Required for Tenant File
Re-examination Form
Re-examination Update Form
Release of Information (Privacy Act) Form
Rent Calculation - Pro-Rated Public Housing- for Mixed Families

Determining Maximum Public Housing Rent

Rent Calculation - Pro-Rated Housing Choice Voucher - for Mixed Families
Rent Calculation - Public Housing Worksheet
Rent Calculation - Housing Choice Voucher Worksheet
Rent Choice Certification
Rent Reasonableness Certification
Rent Reasonableness Survey
Rental--No History
Renters' Rights
Repayment Agreement
Repayment Agreement 2
Resolutions - Generic format
School Information Release Form
Screening Forms
Self Employment Verification
Self Certification Form - Applicant/Resident
Sick Leave Transfer - Request for
Smoke Detector Certification
Social Security Number - Application for Card
Social Security Number - Certification for No SSN, under 18
Special Unit Requirement Verification
Student Eligibility - Section 8

Student Questionnaire for Eligibility            
Student Certification of Dependent Status
            
Student Financial Aid Verification
            
Parent Certification - Income 

Student Status Verification
TANF Verification
Tax Exemption Forms

Gas Tax Refund Request, Compt Letter
Hotel
Documentation, Comptroller Letter
Hotel Tax - Louisiana
Rental Car
Sales Tax
Vehicle Tax Reimbursement

Tax Return Request Form (IRS)
Telephone
Interview Form
Tenant File Checklist - Public Housing
Tenant File Checklist - HCV
Threat Assessment
Transfer Approval
Under $200 Income Worksheet
Unemployment Benefits Verification
Unemployment Insurance Verification - Texas Workforce Commission
Utilities - Verification of
Utility Allowances - Sec 8 Consumption Estimate Worksheet
Utility Allowances - Sec 8 Consumption Data
Utility Consumption Release
Utility Reimbursement Paid to Utility Co. - Authorization Form
Utilization Worksheet - Housing Choice Voucher Program
VA Benefits Verification
Vacancy Tracking Form
Vacated Unit Report
Vehicle Registration (Eng, Sp)
Verification Update - Third Party
Visitor Registration
Wait List Acknowledgment
Water, Authorization for New Service
Worker's Comp Verification
Work Order Tracking Form
Zero Income Checklist


LETTERS/NOTICES

Abandoned Unit Notice
Criminal
Trespass Letter 1
Criminal Trespass Letter 2
Denial Letter - Add-On to Lease
Denial Letter - Admission
Denial Letter - Transfer
Drug Abuse Warning
Eligibility Letter - Short Waiting List
Eligibility Letter - Long Waiting List

Evictions/Violations

Agreement to Vacate
Eviction Checklist
Eviction Hold Off Agreement
Forcible Entry and Detainer
Vacate Demand Notice
Not Accepting Rent
Notice of Delinquent Rent
Notice of Intent to Vacate
Notice of Intent to Vacate 2
Notice
of Lease Infractions
Notice of Lease Infractions 2
Notice of Lease Termination
Notice to Vacate for Nonpayment of Rent
Notice to Vacate for Nonpayment of Rent 2
Notice to Vacate for Nonpayment of Rent 3
Notice to Vacate - Non Rent/Grievance
Notice to Vacate - Non Rent /No Grievance
Notice to Vacate - Non Rent/ Spanish
Violation - Community Service
Violation - Pets
Violation - Housekeeping
Violation - Info Needed


Hardship Notification Letter
Inspection Notice Public Housing
Inspection - Re-Inspection Notice Public Housing
Maintenance - Emergency
Maintenance - Response Procedures
Meeting Notice,
Certificate of Posting
New Lease Sign Notice
Notice to Applicants on Reasonable Accommodation
No More Checks letter
Pilot Submission
Pilot Waiver
Police Department, Letter to
Public Meeting Notice
(Agency Plan)
Returned Check
Sheriff's Department,
Letter to
Re-Exam Letter
-First
Re-Exam Letter
- Follow Up
Rent Adjustment Notice
Satellite Dish - sample letter to resident
Terminations HCV

Violation of HAP Contract
Violation of HAP Contract 2
Voucher Assistance Termination
OverIncome

Unreported Income Public Housing
Unreported Income Section 8
Waiting List - Notice of Closing

BROCHURES

A Good Place to Live
Disaster Supply Kit
Ethics Guide (HUD)
Fair Housing Brochure (English)
Fair Housing Brochure (Spanish)
Fraud Prevention Bulletin
How Your Rent is Determined in PH and HCV
How Your Rent is Determined in PH and HCV Spanish
Lead Paint Brochure
New Resident Welcome Packet
Resident Handbook, Temple HA
Things You Should Know
Things You Should Know (Spanish)
Section 3 Booklet - English
Section 3 Booklet - Spanish