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Sample Move-In/Move-Out Inspection Form

1. Relevant information to verify with third party:

HUD Handbook 4350.3 REV-1 — Occupancy Requirements of Subsidized Multifamily Housing Programs · 2026 edition · updated 2026-07-29 · United States

a. Name of original annuitant;

HUD Occupancy Handbook Appendix 6-C: Guidance About Types of Information to Request When Verifying Eligibility and Income

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Appendix 6-C

4350.3 REV-1

  • b. Pension claim number or social security number of person receiving the pension claim;

  • c.

    • Current monthly gross amount of pension or annuity;
  • d. Deductions from gross amount for medical insurance premiums;

  • e.

    - Date benefits began; 
    
    • f. Effective date of current amount;

    • g. For annuities, ask: Did the individual invest in an annuity? If yes, what is the amount invested? What is the amount received to date from the annuity? Does the individual receive regular payments? When are they received (monthly, annually)?

    • h. For pensions and annuities, ask: Is the individual reimbursed for medical costs?

    1. Acceptable forms of verification:
    • a. Benefit verification form completed by the company/agency providing the benefits;

    • b. Award or benefit notification letters prepared and signed by the authorizing company/agency. (Checks or bank deposit slips show only net amounts remaining after deductions.)

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Contents — HUD Handbook 4350.3 REV-1 — Occupancy Requirements of Subsidized Multifamily Housing Programs
HUD Handbook 4350.3 REV-1 — Occupancy Requirements of Subsidized Multifamily Housing Programs
  1. HUD Handbook 4350.3: Occupancy Requirements of Subsidized Mult…
  2. Exhibit 3-12: Section 8, RAP, and Rent Supplement Programs – S…
  3. Exhibit 3-13: Section 236 Without Additional Assistance – Spec…
  4. Exhibit 3-14: Section 236 With Benefit of Additional Assistanc…
  5. Document Package for Applicant's/Tenant's Consent to the Relea…
  6. Exhibit 7-2: Sample Annual Recertification First Reminder Notice
  7. Exhibit 7-4: Sample Annual Recertification Third Reminder Noti…
  8. SAMPLE TENANT CONSENT TO DISCLOSE EIV INCOME INFORMATION
  9. Applying the Model Lease for Subsidized Programs to Individual…
  10. Applying the Model Leases for Section 202 PRAC and Section 811…
  11. Sample Move-In/Move-Out Inspection Form
  12. Memorandum February 5, 2002: Fact Sheets for Project-Based Ass…

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