Sample Move-In/Move-Out Inspection Form
S. Family Type and Membership in Family
HUD Handbook 4350.3 REV-1 — Occupancy Requirements of Subsidized Multifamily Housing Programs · 2026 edition · updated 2026-07-29 · United States
For elderly household where the head, co-head, or spouse is 62 years of age or older verification of age may be provided by:
a. Copy of a birth certificate, baptismal certificate, census record, official record of birth or other authoritative document; or
b. Receipt of supplemental security income old age benefits or social security retirement benefits.
For disability (because the individual's eligibility for admission is dependent on his/her being a person with a disability [handicap] or because the individual claims eligibility for income deductions that are given to persons with disabilities [handicaps]) verification of disability (handicap) may be provided by:
a. Receipt of supplemental social security disability or social security disability benefits, which would provide verification that an individual met the definition of "person with disabilities" as shown in Definition E of Figure 3-6 in Chapter 3 of this handbook; or
b. Verification by a reliable source that the individual meets the relevant definition of a "person with a disability (handicap)" for the particular project. See Chapter 2 regarding individuals' requests for reasonable accommodations.
IMPORTANT : See Appendix 6-B for the limitations on information that may be verified. Appendix 6-B also requires the owner to provide an explanation to the applicant/tenant describing these limitations. In particular, the consent should request the third party to identify any of the relevant definitions that apply to the individual. Any other request for information about the individual is not relevant and may not be asked (e.g., diagnosis, treatment plan).
- For family members younger than age 18, verification of age may be provided by birth certificate, adoption papers, and/or custody agreements.
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- HUD Handbook 4350.3: Occupancy Requirements of Subsidized Mult…
- Exhibit 3-12: Section 8, RAP, and Rent Supplement Programs – S…
- Exhibit 3-13: Section 236 Without Additional Assistance – Spec…
- Exhibit 3-14: Section 236 With Benefit of Additional Assistanc…
- Document Package for Applicant's/Tenant's Consent to the Relea…
- Exhibit 7-2: Sample Annual Recertification First Reminder Notice
- Exhibit 7-4: Sample Annual Recertification Third Reminder Noti…
- SAMPLE TENANT CONSENT TO DISCLOSE EIV INCOME INFORMATION
- Applying the Model Lease for Subsidized Programs to Individual…
- Applying the Model Leases for Section 202 PRAC and Section 811…
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▸ Sample Move-In/Move-Out Inspection Form
Overview- Appendix 5: Sample Move-In/Move-Out Inspection Form
- APPENDIX 6: VERIFICATION AND CONSENT – GUIDANCE AND SAMPLE FOR…
- Appendix 6-A: Guidance for Development of Individual Consent F…
- EXAMPLE – Information That Is Not Necessary to Determine Eligi…
- 2. SAMPLE VERIFICATION CONSENT FORMAT
- SAMPLE VERIFICATION CONSENT
- INFORMATION BEING REQUESTED
- PENALTIES FOR MISUSING THIS CONSENT:
- Appendix 6-B: Verification of Disability – Instructions to Own…
- 1. EXPLANATION TO THE APPLICANT
- 2. SAMPLE FORMATS
- FOR USE WITH SECTION 202/8 , SECTION 202 PAC , Section 202 PRA…
- Appendix 6-C: Guidance About Types of Information to Request W…
- 1. Relevant information to verify with third party:
- 2. Acceptable forms of verification:
- B. Date Employment Terminated
- C. Social Security and Supplementary Security Income (SSI)
- 2) Acceptable forms of verification:
- D. Pensions and Disability Income Other Than from the Social S…
- 1. Relevant information to verify with third party:
- E. Unemployment Compensation
- 2. Acceptable forms of verification:
- G. Alimony or Child Support Payments
- H. Net Income from a Business
- Recurring Gifts
- K. Assets Disposed of for Less than Fair Market Value During T…
- L. Income from Sale of Real Property Pursuant to a Purchase Mo…
- M. Rental Income from Property Owned by Applicant/Tenant
- Full-Time Student Status
- O. Child Care Expenses
- S. Family Type and Membership in Family
- T. Statutory and HUD Regulatory Preferences – Displacement by …
- 1. Relevant information to verify with third party:
- Memorandum February 5, 2002: Fact Sheets for Project-Based Ass…