18
Hifumi En Rental Application Cover Letter August 2020 Page | 1 APPLICATION COVER LETTER HUD SECTION 8 PROPERTIES Property Name: Hifumi En Apartments Property Address: 926 E. 8 th Avenue, Spokane, WA 99202 Phone Number: (509) 534-2339 Fax: (509) 534-8593 TDD 711 E-mail: [email protected] Office Hours: Mon, Tues, Thurs, Fri 8:00 AM – 4:00 PM Dear Future Tenant, Thank you for applying to live at the Hifumi En Apartments. Please take a few minutes to read over our requirements for filling out and returning our application package. We hope that you will soon be calling the Hifumi En Apartments your new home. Should you have any questions or concerns please give us a call at (509)534-2339. All interested individuals have the right to complete and submit an application. Filling out the application: The application package may include one or more rental applications, income/asset questionnaires, citizenship/non-citizenship forms (for each household member), emergency contact forms and possibly other forms as required by the property. Each adult must complete a separate application package. The Supplement to Application for Federally Assisted Housing emergency contact form(s) is required by HUD. It is optional for you to provide additional contact information, but very useful for application/tenant contact for housing providers. Included in this cover letter is information regarding the policies of our apartment community regarding eligibility and our procedures for selecting tenants. More information is contained in out Tenant Selection Policy Plan, which is available from management upon request. When completing the application package, please sit down and allow yourself a few minutes to read it over first, and then fill it out in its entirety. This should take you about 20-30 minutes. You will need to fill it out to the best of your knowledge. The attached income/asset questionnaire will assist you in determining what is considered to be income, assets and any adjustments or allowances to income. Please do not leave any blank spaces or if you make a mistake please cross out rather than using white out. If a questions does not apply to you please write out the worlds “Not Applicable”. Be sure to sign and date the application and the other forms. If you need assistance in completing the application package, we will be happy to help you. We provide reasonable accommodations to persons with disabilities in completing our application documents or returning our application to us for processing. We support the federal protections in the Violence against Women Act (VAWA) during application and tenancy. Please let us know if you would like more information. Once you have completed and signed our rental application package, you will need to either bring it back to our office or mail it to the rental office. Please let us know if you need an accommodation. We will look over the completed application packets. As a result of our review, we will either offer you an available unit, place you on the waiting list or find you ineligible based on information provided. Regardless of the disposition of your application, we will advise you in writing on our application status notification within 10 days of receiving your completed application(s). Who is eligible to live at our property? This property is a HUD Project-Base Section 8 for individuals and families. The occupancy and income limits for this property are posted at the property or you can call for information. Our priority is to take the extremely low income households (below 30% AMI- area median income) first in our fiscal year for up to 40% of our expected vacancies, then offer units to the application on our list that are either FOR OFFICE USE ONLY Date application given ____________________________ Applicants Name _____________________________ Applicants Phone # ____________________________ Alternate Phone # ____________________________ Special requests/needs ____________________________

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Page 1: Date application given APPLICATION COVER LETTER HUD

Hifumi En Rental Application Cover Letter August 2020 Page | 1

APPLICATION COVER LETTER HUD SECTION 8 PROPERTIES

Property Name: Hifumi En Apartments

Property Address: 926 E. 8th Avenue, Spokane, WA 99202

Phone Number: (509) 534-2339 Fax: (509) 534-8593 TDD 711

E-mail: [email protected]

Office Hours: Mon, Tues, Thurs, Fri 8:00 AM – 4:00 PM

Dear Future Tenant,

Thank you for applying to live at the Hifumi En Apartments.

Please take a few minutes to read over our requirements for filling out and returning our application package. We hope that you will soon be calling the Hifumi En Apartments your new home. Should you have any questions or concerns please give us a call at (509)534-2339. All interested individuals have the right to complete and submit an application.

Filling out the application:

The application package may include one or more rental applications, income/asset questionnaires, citizenship/non-citizenship forms (for each household member), emergency contact forms and possibly other forms as required by the property. Each adult must complete a separate application package. The Supplement to Application for Federally Assisted Housing emergency contact form(s) is required by HUD. It is optional for you to provide additional contact information, but very useful for application/tenant contact for housing providers. Included in this cover letter is information regarding the policies of our apartment community regarding eligibility and our procedures for selecting tenants. More information is contained in out Tenant Selection Policy Plan, which is available from management upon request.

When completing the application package, please sit down and allow yourself a few minutes to read it over first, and then fill it out in its entirety. This should take you about 20-30 minutes. You will need to fill it out to the best of your knowledge. The attached income/asset questionnaire will assist you in determining what is considered to be income, assets and any adjustments or allowances to income. Please do not leave any blank spaces or if you make a mistake please cross out rather than using white out. If a questions does not apply to you please write out the worlds “Not Applicable”. Be sure to sign and date the application and the other forms. If you need assistance in completing the application package, we will be happy to help you. We provide reasonable accommodations to persons with disabilities in completing our application documents or returning our application to us for processing. We support the federal protections in the Violence against Women Act (VAWA) during application and tenancy. Please let us know if you would like more information.

Once you have completed and signed our rental application package, you will need to either bring it back to our office or mail it to the rental office. Please let us know if you need an accommodation. We will look over the completed application packets. As a result of our review, we will either offer you an available unit, place you on the waiting list or find you ineligible based on information provided. Regardless of the disposition of your application, we will advise you in writing on our application status notification within 10 days of receiving your completed application(s).

Who is eligible to live at our property?

This property is a HUD Project-Base Section 8 for individuals and families. The occupancy and income limits for this property are posted at the property or you can call for information. Our priority is to take the extremely low income households (below 30% AMI- area median income) first in our fiscal year for up to 40% of our expected vacancies, then offer units to the application on our list that are either

FOR OFFICE USE ONLY

Date application given

____________________________

Applicants Name

_____________________________

Applicants Phone #

____________________________

Alternate Phone #

____________________________

Special requests/needs

____________________________

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Hifumi En Rental Application Cover Letter August 2020 Page | 2

extremely very low or very low income (below 50% area median income) chronologically thereafter until our income limit goals are met for the year.

Rents at this property are all HUD subsidized and are equal to 30% of your monthly-adjusted income. Water, Sewer, Garbage and Electric are included in your rent. There is a HUD Section 8 required minimum total tenant payment of $25 per month, unless a verifiable hardship exists. Please contact the manager for details about the rent structure at this property.

A background screening will be performed on all applicants (adult and juveniles approaching 18 years of age) as they get closer to the top of the waiting list. The property (not the applicant) will pay the cost of the screening. We preform screening to determine things such as acceptable prior rental and criminal history, public records and credit history (poor credit history is not a major factor in application review). There are certain restrictions for non-citizens and students in HUD subsidized housing. If any of your household members are ineligible non-citizens or students, management will explain how this may affect your qualification and/or HUD subsidy at this property. If you are denied based on our screening criteria you will be notified in writing and given the option to appeal the decision.

The Waiting List

We will choose applicants off of our waiting list in chronological order from the date and time they submit their application within the income targeting and/or other criteria associated with this property and HUD. You are also welcome to request any reasonable accommodations or modifications to the units, site property policies or procedures to accommodate a disability. Please indicate on your application if you believe you qualify for an accommodation.

If you are placed on our waiting list, it will be important that you update us with any changes in your household. Changes such as change of address, phone number, household size, members or income are very important to tell us immediately. You will also need to contact us at least every 6 months to let us know that you are still interested in remaining on our waiting list. If you do not contact us we mat send you a letter (at tour last known address) asking for your continued interest in reaming on our waiting list. If we do not hear back from you, we may have to remove you name from our waiting list, so please keep us informed of changes.

When an Apartment becomes available:

You will be contact in chronological order from the waiting list when a unit becomes available or will be available soon. It is a requirement to contact all applicants at the tip of the list every time a unit becomes available. Please be available by phone so we may contact you when your name comes to the tip of the waiting list. If we have trouble getting a hold of you, we may have to skip over or remove your application based on our policies in the Tenant Selection Plan.

Once being contacted by the Property Supervisor you will be required to come into the rental office to finalize your application process within 10 days. This is when we will perform the background screening and start the verification process to verify all of your income/assets and expenses for your rent calculation. All persons expected to reside in the unit will be required to complete citizenship review and other forms at that time, if not already provided. All adult household members must come for the same final interview, including children that are expected to reside with you. )

Please bring picture ID and original Social Security cards for all potential household members. Birth certificates and/or custody papers may also be required for verification of eligibility of age or family composition. Verification of Social Security numbers is required for all household members prior to move-in, with only a few exceptions. There are alternatives to the actual Social Security cards if you do not have the original. For example: driver’s license with SSN, identification card issued by a federal state, or local agency, a medical insurance provider, employer or trade union, earning statement on payroll stubs, bank statements with SSN, form 1099, benefit award letter or retirement benefit letter, life insurance policy, or court records with SSN. There are also alternatives to birth certificates such as passports, naturalization certificates and other options. Please ask the Property Supervisor if you have any questions. We may ask you to bring additional documents with you to speed up the application process.

Please also bring proof of income, assets and/or expenses of ALL potential household members. See the attached income/asset statement for definition of what HUD considers income, assets and/or allowable expenses. Please use this as a guide to provide current information. A final decision regarding your

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Hifumi En Rental Application Cover Letter August 2020 Page | 3

eligibility cannot be made until all of the above information has been verified, received and reviewed. Once you have passed our final screening requirements, and an apartment is available that meets your needs and requirements you will be notified to start the move-in process.

The move-in:

When we have accepted you as a new tenant, a date for moving into your new apartment will be set. The Property Supervisor will calculate your rent based on verification received back from third party sources and information provided by you. Payment of a full or partial Security Deposit and Pet Deposit (with payment plan if applicable) will be requested at that time. If your move-in date is other than the 1st of the month, your rent will be pro-rated for that month only.

You will be required to sign a lease, house rules, rent calculation certification and other property policies and addendums. We will conduct a walk-through move-in inspection of your new apartment with you and keys will be given to you at that time. You will need to accompany the manager during the move-in inspection and sign a walk-through form if you accept the condition of the unit. If you have any questions regarding completing the application, about the disposition of your application or about the property or regulations, or would like a copy of our Tenant Selection Plan, please do not hesitate to call us.

Site Supervisor Signature:________________________________________________________

Property Name: Hifumi En Apartments 504 Coordinator Name:

Randy Rollins

Hifumi En Apartments does not discriminate on the basis of disability status in the admission or access to its federally assisted programs and activities. The person name below has been designated to coordinate compliance with nondiscrimination

requirements contained in the Departments of Housing and Urban Development’s regulations implementing Section 504 (24

CFR, part 8 dated June 2, 1988) We do business in accordance with the Federal Fair Housing Act and provide persons with disabilities reasonable accommodation upon request. TTY # (for hearing impaired) 711. Persons with language barriers may

request or arrange interpretation alternatives or services based on the property’s LEP Policy

ADDRESS: Spokane Housing Authority, 25 W. Nora Ave., Spokane, WA 99205 Telephone # (509) 328-2953

Eric J. Lundin

Page 4: Date application given APPLICATION COVER LETTER HUD

Hifumi En Rental Application January 2021 Page | 1

ALL QUESTIONS MUST BE ANSWERED ON THIS APPLICATION AND ANY ATTACHMENTS. ALL YES/NO

OPTIONS MUST BE CIRCLED. IF A QUESTIONS DOES NOT APPLY PUT N/A IN THE BLANK SPACE. PLEASE COMPLETE ONE RENTAL APPLICATION PER ADULT HOUSEHOLD MEMBER

• Please contact the property management office if you need help understanding this document. • Contacte por favor la oficina de gestión si usted necesita ayuda a comprender este documento. (Spanish) • Por favor contate o escritório de gerência se deve ajudar entendimento este documento. (Portugese) • Si vous avez besoin d'aide à la compréhension de ce document, veuillez communiquer avec le Bureau de gestion. (French) • Souple kontakte Biwo jesyon a si w bezwen èd pou konprann dokiman sa a. (Haitian Creole) • Xin liên lạc với văn phòng điều hành nếu bạn cần giúp đỡ sự hiểu biết tài liệu này. (Vietnamese) • Пожалуйста свяжитесь с офисом управления, если Вам нужна помощь в понимании этого документа. (Russian) • Bitte kontaktieren Sie das Leitungsbüro, wenn Sie helfen müssen, dieses Dokument zu verstehen. (German) • 請聯絡管理辦公室,如果你需要幫助理解這份文件。(Chinese)

• もしこの文書を理解しているための助けを必要としていれば、経営オフィスと連絡を取ってください。(Japanese)

LIST ALL PERSONS WHO ARE EXPECTED TO RESIDE IN YOUR UNIT:

LIST ALL PERSONS WHO ARE EXPECTED TO RESIDE IN YOUR UNIT: LEGAL NAME (Last, First, Middle initial)

Pre-Rental Application Section 8 HUD Properties Please note: You will be required to complete a full rental application if chosen for final eligibility and screening

PROPERTY NAME/ADDRESS: Hifumi En Apartments- 926 E. 8th Avenue, Spokane, WA 99202 Phone: (509)534-2339

Email: [email protected] OFFICE HOURS: Mon, Tues, Thurs, Fri 8:00 AM – 4:00 PM

HEAD OF HOUSEHOLD LEGAL NAME(Last, First, Mid. Initial) PHONE NUMBER ALT. PHONE NUMBER E-MAIL ADDRESS

PREVIOUS NAMES, ALIASES OR NICNAMES USED

STREET ADDRESS CITY STATE ZIP

RENT

OWN

RENT PER MONTH OR MORTGAGE BALANCE DATE OF RESIDENCY REASON FOR MOVING

HOH FULL NAME (Last, First, Mid. Initial) RELATION SOCIAL SECURITY NUMBER IS MEMBER A STUDENT? YES NO

GENDER (0PTIONAL)

BIRTHDATE

CO-HEAD FULL NAME (Last, First, Mid. Initial) RELATION SOCIAL SECURITY NUMBER IS MEMBER A STUDENT? YES NO

GENDER

(0PTIONAL)) BIRTHDATE

NAME (Last, First, Mid. Initial) RELATION SOCIAL SECURITY NUMBER IS MEMBER A STUDENT? YES NO

GENDER (0PTIONAL)

BIRTHDATE

NAME (Last, First, Mid. Initial) RELATION SOCIAL SECURITY NUMBER IS MEMBER A STUDENT? YES NO

GENDER (0PTIONAL)

BIRTHDATE

CURRENT LANDLORD NAME

DOES ANYONE IN HOUSEHOLD REQUEST A WHEELCHAIR ACCESSIBLE UNIT, ACCESSIBLE FEATURES OR UPSTAIRS/DOWNSTAIRS UNIT? YES NO

IF YES, PLEASE EXPLAIN YOUR REQUEST:

LIST ALL STATES AND COUNTRIES THAT ALL APPLICANT HOUSEHOLD MEMBERS WERE A RESIDENT (INCLUDING CHILDREN):

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Hifumi En Rental Application January 2021 Page | 2

SOURCES OF INCOME AND ASSETS- USE ADDITIONAL PAGES IF NECESSARY

FAMILY MEMBER NAME EMPLOYER, AGENCY, ETC. WHO ARE SOURCES OF INCOME TO YOU (List name & addresses) ANNUAL GROSS INCOME $

FAMILY MEMBER NAME EMPLOYER, AGENCY, ETC. WHO ARE SOURCES OF INCOME TO YOU (List name & addresses) ANNUAL GROSS INCOME $

FAMILY MEMBER NAME EMPLOYER, AGENCY, ETC. WHO ARE SOURCES OF INCOME TO YOU (List name & addresses) ANNUAL GROSS INCOME $

FAMILY MEMBER NAME EMPLOYER, AGENCY, ETC. WHO ARE SOURCES OF INCOME TO YOU (List name & addresses) ANNUAL GROSS INCOME $

HAS ANYONE LISTED ON THIS APPLICATION EVER BEEN CITED FOR NON-PAYMENT OF RENT, LEASE VIOLATIONS OR HAVE EVER BEEN EVICTED? YES NO

IF YES, WHO? WHERE? WHEN?

EXPLAIN:

HAS ANYONE LISTED ON THIS APPLICATION EVER BEEN EVICTED WITHIN THE LAST THREE YEARS FROM FEDERALLY ASSISTED HOUSING FOR DRUG RELATED CRIMINAL

ACTIVITY? YES NO IF YES, WHO? WHEN? WHERE?

EXPLAIN:

HAS ANYONE LISTED ON THIS APPLICATION EVER BEEN ARRESTED, CONVICTED, PLED GUILTY OR NO-CONTEST TO ANY CRIME? YES NO

IF YES, WHO? WHEN? WHERE?

EXPLAIN:

IS ANYONE LISTED ON THIS APPLICATION A REGISTERED OR NON-REGISTERERD SEX OFFENDER IN ANY STATE? YES NO IF YES, WHO?

ARE THEY SUBJECT TO A STATE LIFETIME SEX OFFENDER REGISTERY? YES NO

DOES ANYONE LISTED ON THIS APPLICATION CURRENTLY USE ILLEGAL DRUGS OR ABUSE ALCOHOL? YES NO

IF YES, WHO? EXPLAIN:

DOES ANYONE LISTED ON THIS APPLICATION HAVE A HISTORY OF USING ILLEGAL DRUGS OR ABUSING ALOCHOL? YES NO

IF YES, WHO? EXPLAIN:

WILL EVERYONE LISTED ON THIS APPLICATION BE ABLE TO PROVIDE PROOF OF THESE HUD REQUIREMENTS PRIOR TO MOVE-IN? YES NO

A. VALID SOCIAL SECURITY NUMBERS FOR ALL FAMILY MEMEBERS AT LEAST 90 DAYS PRIOR TO MOVE-IN

(EXCEPTIONS: MEMBERS 62 OR OLDER AS OF 1/31/2010 WHOSE INITIAL DETERMINATION OF ELIGIBILITY BEGAN BEFORE 1/31/2010 AND MEMBERS THAT DO

NOT CONTEND ELIGIBLE IMMIGRATION STATUS)

B. PROOF OF ELIGIBILITY AND ALLOWANCES FOR ALL FAMILY MEMBERS (AGE, HOUSEHOLD MEMBERSHIP, CUSTODY, DISABILITY STATUS ETC., IF APPLICABLE)

C. LEGAL NON-CITIZENSHIP/IMMIGRATION STATUS (IF APPLICABLE, FOR NON-CITIZENS UNDER 62 YEARS OF AGE)

IF NOT, WHY?

DOES ANYONE LISTED ON THIS APPLICATION REQUEST PROTECTIONS, ASSISTANCE AND SUPPORT UNDER THE VIOLENCE AGAINST WOMEN ACT (VAWA), PROTECTING

VICTIMS OF DOMESTIC VIOLENCE, DATING VIOLENCE, STALKING OR SEXUAL ASSAULT? YES NO

THIS LAW REQUIRES OWNERS TO PROVIDE SPECIAL CONSIDERATION AND CONFIDENTIALITY DURING THE RENTAL APPLICATION PROCESS AND PREVENTS DENIAL OF

TENANCY TO THE VICTIM AND THE VICTIMS FAMILY, SOLELY BASED ON HISTORY OR CURRENT CIRCUMSTANCES RELATED TO DOMESTIC VIOLENCE, STALKING, SEXUAL

ASSAULT AND DATING VIOLENCE. IF REQUESTED, MORE DOCUMENTATION MAY BE REQUIRED.

DO YOU HAVE ANY PETS OR ANIMALS? YES NO IF YES, PLEASE SPECIFY TYPE AND NUMBER

List all INCOME SOURCES for all members (including minors). Includes, but is not limited to, full and/or part-time employment, income

from public agencies, (DSHS, etc.), Social Security, Pensions, SSI, Disability, L & I, Unemployment, Child Care, Alimony, Child Support,

Financial Aid, Income from sale of property, Interest on assets, Dividends, Annuities, and regular contributions from people not residing

with you or payments of expenses on your behalf.

Page 6: Date application given APPLICATION COVER LETTER HUD

Hifumi En Rental Application January 2021 Page | 3

ASSET INFORMATION: List all assets of all members (including minors) Circle one account type per

account

BANK SOURCE NAME STOCKS/BONDS SAVINGS CHECKING TRUST IRA CD MONEY MARKET DEBIT OR PREAPAID CARD DIRECT EXPRESS QWEST/EBT DCS PREPAID

CURRENT BALANCE $

BANK SOURCE NAME STOCKS/BONDS SAVINGS CHECKING TRUST IRA CD MONEY MARKET DEBIT OR PREAPAID CARD DIRECT EXPRESS QWEST/EBT DCS PREPAID

CURRENT BALANCE $

BANK SOURCE NAME STOCKS/BONDS SAVINGS CHECKING TRUST IRA CD MONEY MARKET DEBIT OR PREAPAID CARD DIRECT EXPRESS QWEST/EBT DCS PREPAID

CURRENT BALANCE $

LIFE INSURANCE POLICIES: WHOLE LIFE INSURANCE UNIVERSIAL LIFE INSURANCE TERM INSURANCE NO LIFE INSURANCE

CASH VALUE $

REAL PROPERTY: DO YOU OWN ANY PROPERTY OR BUILDING IN ANY STATE OR COUNTRY? YES NO IF YES, TYPE OF PROPERTY? LOCATION:

CASH VALUE $

HAVE YOU SOLD/DISPOSED/GIVEN AWAY ANY PROPERTY OR ASSETS IN THE LAST 2 YEARS? YES NO IF YES, TYPE OF PROPERTY/ASSETS LOCATION:

CASH VALUE $

DO YOU HAVE ANY OTHER ASSETS NOT LISTED ABOVE (EXCLUDING HOUSEHOLD GOODS)? YES NO IF YES, WHAT?

CASH VALUE $

RACE AND ETHNICITY OF HEAD OF HOUSEHOLD: This information is solicited on this application in order to assure the Federal Government acting through HUD that the

Federal laws prohibiting discrimination against tenant applications on the basis of race, color, national origin, religion, sex, familial status, age, and disability are complied

with. You are not required to furnish this information.

ETHNICITY: PLEASE CIRCLE Hispanic or Latino Not Hispanic or Latino

RACE: PLEASE CIRCLE American Indian/Alaskan Native Asian Black/African American Native Hawaiian or Other Pacific Islander

White Other:

PLEASE READ: In compliance with the Fair Credit Reporting Act, we are informing you that information as to your household member’s rental history, character references

(if applicable), public records, criminal history, credit history is being verified. I/We understand that any misrepresentation will be sufficient cause for dismissal or voiding of

the application. I/We understand that, upon acceptance of this application for tenancy, I/We must provide releases and or verification of ALL income and assets and

household composition (including custody or guardianship of minor children) and consent to release for wage and/or income matching by HUD, including Enterprise Income

Verification (EIV) or the owner/agent. I/We also agree to signify all terms of occupancy by signing the Lease Agreement, Rules and Regulations of the property and a Tenant

Certification for Calculation of Rent from HUD-50059. The Department of Housing and Urban Development (HUD) is authorized to collect this information by the U.S.

Housing Act of 1937 (42 U.S.C. 1437 et. seq.), by Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d), and by the Fair Housing Act (42 U.S.C. 3601-19). The Housing and

Community Development Act of 1987 (42 U.S.C. 3543) requires applicants and participants to submit proof of valid Social Security Number of each household member (if

applicable). Your income and other information are being collected by HUD to determine your eligibility, the appropriate bedroom size, and the amount your family will pay

towards rent and utilities. Other uses: HUD uses your family income and other information to assist in managing and monitoring HUD-assisted housing programs, to protect

the Government’s financial interest, and to verify the accuracy of the information you provide. This information may be released to appropriate federal, state and local

agencies, when relevant, and to civil, criminal, or regulatory investigators, prosecutors. However, the information will not be otherwise disclosed or released outside of

HUD, except as permitted or required by law.

HOW DID YOU HEAR ABOUT OUR PROPERTY?

Page 7: Date application given APPLICATION COVER LETTER HUD

Hifumi En Rental Application January 2021 Page | 4

PLEASE ACKNOWLEDGE ALL (CHECK BOXES):

I ACKNOWLEDGE THAT I MUST INFORM MANAGEMENT OF CHANGES TO OUR APPLICATION INFORMATION AND OF MY/OUR

CONTINUTED INTEREST AT LEAST EVERY 6 MONTHS IN ORDER TO REMAIN ON THE WAITING LIST. FAILURE TO UPDATE WILL

RESULT IN REMOVAL FROM THE WAITING LIST.

I CERTIFY THAT THIS APARTMENT WILL BE MY PERMENANT RESIDENCE AND THAT I WILL NOT MAINTAIN A SEPARATE SUBSIDIZED

RENTAL UNIT IN A DIFFERNET LOCATION.

SECTION 1001 OF TITLE 18 OF THE U.S. CODE MAKES IT A CRIMINAL OFFENSE TO MAKE WILLFUL FALSE STATEMENTS OR

MISREPRESENTATIONS TO ANY DEPARTMENT OR AGENCY OF THE UNITED STATES AS TO ANY MATTER WITHIN ITS JURISDICTION.

FAILURE TO COMPLETE AND SIGN THE APPLICATION WITH REQUIRED ATTACHMENTS, PROVIDINIG FALSE STATEMENTS OR

FAILURE TO PROVIDE COMPLETE AND THRUTHFUL INFORMATION RELATED TO YOUR APPLICATION MAY RESULT IN DELAY OF

YOUR ELIGIBILITY APPROVAL, REJECTION OF YOUR APPLICATION OR EVICTION AFTER TENANCY.

IF YOU ARE REJECTED YOU HAVE THE RIGHT TO APPEAL THE DECISION WITHIN (14) FOURTEEN DAYS OF THE RECEIPT OF THE

REJECTION NOTICE BY CONTACTING THE MANAGEMENT OF THIS PROPERTY IN WRITING OR REQUESTING A MEETING. A COPY OF

THE GRIEVANCE AND APPEAL PROCEDURE IS POSTED IN THE SITE OFFICE. YOU MAY REQUEST A COPY OF THIS APPEAL

PROCEDURE BY CONTACTING THE RENTAL OFFICE. PERSONS WITH DISABILITIES HAVE THE RIGHT TO REQUEST REASONABLE

ACCOMMODATIONS TO PARTICIPATE IN THE INFORMAL HEARING PROCESS

SIGNATURES REQUIRED:

_______________________________________________ ___________________

APPLICANT (Head of Household) SIGNATURE DATE

_______________________________________________ ___________________

CO-HEAD/SPOUSE/OTHER ADULT SIGNATURE DATE

ATTACHMENTS: PLEASE RETURN ALL FORMS WITH YOUR COMPLETED PRE-RENTAL APPLICATION.

APPLICATION COVER LETTER- EXPLAINS ELIGIBILITY, APPLICATION PROCESS, WAIT LIST PROCESSES AND

SELECTING APPLICANTS

HUD-92006 SUPPLEMENT TO APPLICATION FOR FEDERALLY ASSISTED HOUSING- ONE FOR EACH ADULT

OF THE HOUSEHOLD. OPTIONAL TO PROVIDE ADDITIONAL CONTACT. IF YOU CHOOSE NOT TO PROVIDE

ADDITONAL CONTACT PLEASE STILL COMPLETE THE TOP PORTION OF THE FORM WITH YOUR NAME,

CHECK THE BOX INDICATING THAT YOU CHOOSE TO NOT PROVIDE ADDITONAL CONTACT

INFORMATION, SIGN AND DATE FORM AND RETURN WITH APPLICATION.

RESIDENT SELECTION POLICY- EXPLAINS ELIGIBILITY REQUIREMENTS

OFFICE Use Only: ACKNOWLEDGEMENT OF RECEIPT OF RENTAL APPLICATION

Property Name: Hifumi En Apartments 504 Coordinator Name:

Randy Rollins

Hifumi En Apartments does not discriminate on the basis of disability status in the admission or access to its federally assisted

programs and activities. The person name below has been designated to coordinate compliance with nondiscrimination

requirements contained in the Departments of Housing and Urban Development’s regulations implementing Section 504 (24

CFR, part 8 dated June 2, 1988) We do business in accordance with the Federal Fair Housing Act and provide persons with disabilities reasonable accommodation upon request. TTY # (for hearing impaired) 711. Persons with language barriers may

request or arrange interpretation alternatives or services based on the property’s LEP Policy

DATE RECEIVED TIME RECEIVED PERSON THAT RECEIVED APPLICATION AND REVIEWED FOR COMPLETENESS: SIGNATURE

EACH ADULT SHOULD

SIGN/DATE EACH OTHERS

APPLICATION AS HEAD,

CO-HEAD, SPOUSE OR

OTHER ADULT

HOUSEHOLD MEMBER

ADDRESS: Spokane Housing Authority, 25 W. Nora Ave., Spokane, WA 99205 Telephone # (509) 328-2953

Page 8: Date application given APPLICATION COVER LETTER HUD

OMB Control # 2502-0581 Exp. (02/28/2019)

Supplemental and Optional Contact Information for HUD-Assisted Housing Applicants

SUPPLEMENT TO APPLICATION FOR FEDERALLY ASSISTED HOUSING This form is to be provided to each applicant for federally assisted housing

Instructions: Optional Contact Person or Organization: You have the right by law to include as part of your application for housing, the name, address, telephone number, and other relevant information of a family member, friend, or social, health, advocacy, or other organization. This contact information is for the purpose of identifying a person or organization that may be able to help in resolving any issues that may arise during your tenancy or to assist in providing any special care or services you may require. You may update, remove, or change the information you provide on this form at any time. You are not required to provide this contact information, but if you choose to do so, please include the relevant information on this form.

Applicant Name:

Mailing Address: Telephone No: Cell Phone No:

Name of Additional Contact Person or Organization: Address: Telephone No: Cell Phone No: E-Mail Address (if applicable): Relationship to Applicant: Reason for Contact: (Check all that apply)

Emergency Unable to contact you Termination of rental assistance Eviction from unit Late payment of rent

Assist with Recertification Process Change in lease terms Change in house rules Other: ______________________________

Commitment of Housing Authority or Owner: If you are approved for housing, this information will be kept as part of your tenant file. If issues arise during your tenancy or if you require any services or special care, we may contact the person or organization you listed to assist in resolving the issues or in providing any services or special care to you.

Confidentiality Statement: The information provided on this form is confidential and will not be disclosed to anyone except as permitted by the applicant or applicable law.

Legal Notification: Section 644 of the Housing and Community Development Act of 1992 (Public Law 102-550, approved October 28, 1992) requires each applicant for federally assisted housing to be offered the option of providing information regarding an additional contact person or organization. By accepting the applicant’s application, the housing provider agrees to comply with the non-discrimination and equal opportunity requirements of 24 CFR section 5.105, including the prohibitions on discrimination in admission to or participation in federally assisted housing programs on the basis of race, color, religion, national origin, sex, disability, and familial status under the Fair Housing Act, and the prohibition on age discrimination under the Age Discrimination Act of 1975.

Check this box if you choose not to provide the contact information.

Signature of Applicant Date

The information collection requirements contained in this form were submitted to the Office of Management and Budget (OMB) under the Paperwork Reduction Act of 1995 (44 U.S.C. 3501-3520). The public reporting burden is estimated at 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Section 644 of the Housing and Community Development Act of 1992 (42 U.S.C. 13604) imposed on HUD the obligation to require housing providers participating in HUD’s assisted housing programs to provide any individual or family applying for occupancy in HUD-assisted housing with the option to include in the application for occupancy the name, address, telephone number, and other relevant information of a family member, friend, or person associated with a social, health, advocacy, or similar organization. The objective of providing such information is to facilitate contact by the housing provider with the person or organization identified by the tenant to assist in providing any delivery of services or special care to the tenant and assist with resolving any tenancy issues arising during the tenancy of such tenant. This supplemental application information is to be maintained by the housing provider and maintained as confidential information. Providing the information is basic to the operations of the HUD Assisted-Housing Program and is voluntary. It supports statutory requirements and program and management controls that prevent fraud, waste and mismanagement. In accordance with the Paperwork Reduction Act, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information, unless the collection displays a currently valid OMB control number. Privacy Statement: Public Law 102-550, authorizes the Department of Housing and Urban Development (HUD) to collect all the information (except the Social Security Number (SSN)) which will be used by HUD to protect disbursement data from fraudulent actions.

Form HUD- 92006 (05/09)

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HIFUMI EN TENANT SELECTION PLAN & POLICY

We accept valid comprehensive reusable tenant screening reports. All applications will be

screened for residence/rental history, credit history and public records. Requirements for approval are:

No negative rental history with in the past seven (3) years No balance owed to landlord. Or provide proof of payment plan. Credit history, excluding medical. No bankruptcy within past 2 years

The following are reasons for denying residency to an applicant:

Poor rental history. Owning balance to a landlord without a payment plan in place. Poor credit history (lack of credit is assumed to be positive credit) Evictions in the past 3 years from federally assisted housing for drug-related criminal activity Conviction of a drug related crime within the last 3 years. The 3 year period must be unsupervised time

and crime free.

Any household member who is subject to a state sex offender life-time registration requirement, any state.

Reasonable cause to believe that behavior from current abuse, or pattern of abuse, caused from alcohol, may interfere with the health, safety and peaceful enjoyment of others.

A household in which any member is currently engaged in illegal use of drugs or for which the owner has reasonable cause to believe that a member’s illegal use or pattern of illegal use of a drug may interfere with the health, safety and right to peaceful enjoyment of the property by other residents.

Conviction of a crime against person or property, within the last 3 years. The three year period must be unsupervised time and crime free.

Any household member who constitutes a direct threat to the health, safety, or right to peaceful enjoyment of the premises by other residents; or criminal activity that would threaten the health and safety of SHA, contractors, or agent of SHA.

Providing false, incomplete or misleading information on the application. Being over or under established income limits or not meeting applicable program eligibility

requirements. Households whose members include a student enrolled in an Institute of Higher Education. (except

under certain conditions) Possible Remedies for failure to meet criminal conviction criteria

In matters relating to criminal conviction history, circumstances and mitigating facts that may be considered include: Nature and severity of past conduct; age of individual at time of conduct; evidence of good tenant

history before or after conviction or conduct; evidence of rehabilitation and treatment efforts; restitution of damages if any; nature of severity of offense(s); number of similar past offense(s) or lack thereof; and impact of housing decision on other offending household members.

If you are rejected you have the right to appeal the decision within (14) days of the receipt of the rejection notice by contracting the management of this property in writing or requesting a meeting.

If you feel this adverse action is due to domestic violence, dating violence, sexual assault or stalking, please contact the Hifumi En office to discuss immediately. Spokane Housing Authority (SHA) and Hifumi En Apartments is concerned about the safety of its tenants, and such concern extends to tenants or applicants who are victims of domestic violence, dating violence, sexual assault, or stalking. In accordance with the Violence against Women Act (VAWA)

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VAWA support and/or assist victims of domestic violence, dating violence, sexual assault and stalking. It protects victims, as well as members of their family, from being denied housing or from losing their HUD assisted housing if an incident of violence [that] is reported and confirmed. The VAWA also provides that an incident of actual or threatened domestic violence, dating violence, sexual assault, or stalking does not qualify as a serious or repeated violation of the lease nor does it constitute good cause for terminating the assistance, tenancy, or occupancy rights of the victim. Furthermore, criminal activity directly relating to domestic violence, dating violence, sexual assault or stalking is not grounds for terminating the victim's tenancy. The Owner/Agent (O/A) may bifurcate (divide a lease as a matter of law) in order to evict, remove, or terminate the assistance of the offender while allowing the victim, who is a tenant or lawful occupant, to remain in the unit.

Persons with disabilities have the right to request reasonable accommodations may request to participate in the informal hearing ________________________________ ______________ Applicant Signature Date ________________________________ _______________ Co-Applicant Signature Date

Dear Applicant, Section 214 of the Housing and Community Development Act of 1980, as amended, prohibits the Secretary of HUD from making financial assistance available to persons other than U.S. citizens or nationals, or certain categories of eligible non-citizens, in the following HUD programs: Section 8 Housing Assistance Payments programs; Section 236 of the National Housing Act Including Rental Assistance Payment (RAP); and Section 101/Rent Supplement Program.

You have applied or are applying for, assistance under one of these programs, therefore, you are required to declare U.S. Citizenship or submit evidence of eligible immigration status for each of your family members for whom you are seeking housing assistance. You must do the following prior to final residency approval: a. Complete a Family Summary Sheet to list all family members who will reside in the assisted unit. b. Each family member (including you) listed on the Family Summary Sheet must complete a Declaration. If

there are 8 people listed on the Family Summary Sheet, you should have 8 completed copies of the Declaration. The Declaration has easy-to-follow instructions and explains what, if any other forms and/or evidence must be submitted with each declaration.

c. Submit the Family Summary Sheet, the Declaration, and any other forms and/or evidence to the Community Supervisor of the property you are certifying with, or to the address below:

HIFUMI EN APARTMENTS 926 E. 8th Avenue

Spokane, WA. 99202

HIFUMI EN RESIDENT SELECTION CRITERIA

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Hifumi En Resident Selection Criteria Revised September 16,2019 Page 3 of 8

Spokane Housing Authority (SHA) follows Equal Opportunity Housing practices as stated in Section 504 of the Rehabilitation Act of 1973, the Fair Housing Act Amendments of 1988 and 6c, Title VI of the Civil Rights Act of 1964 and Washington State Law. We provide equal access to Housing in HUD Programs. It is intended to ensure that housing across HUD/SHA programs is open to all eligible individuals and families regardless of actual or perceived sexual orientation, gender identity or marital status. We do not discriminate on the basis of race, color, religion, creed, national origin, sex, sexual orientation or gender identity, familial status, marital status, disability, or other protected class status. Potential applicants receive an application form, the Resident Selection Criteria, and form HUD-1140-OIG “Things You Should Know”. When an application is received it is reviewed for completeness to determine if the applicant appears to qualify. If the applicant does not have enough basic information, it is returned to the applicant noting information that needs to be supplied. Applicant’s assistance in subsidized housing is restricted to (1) U.S. citizens or nationals; and (2) Non-citizens who have eligible immigration status. All family members must declare their citizenship or immigration status, at the time the application is submitted. Assistance to applicants and tenants excluding tenants age 62 and over as of January 31,2010, whose initial determination of eligibility was begun prior to January 31, 2010 and those individuals who do not contend eligible immigration status, to disclose and provide documentation of complete and accurate SSN assigned to them. This information will be verified according to HUD guidelines prior to final residency approval through the SAVE system (Systematic Alien Verification for entitlements). Once completed, the application is reviewed for qualification according to income, age, family composition, and need for mobility impaired access unit. If an applicant does not appear to qualify under any of the categories, a letter of explanation is sent to the applicant who is told that he/she can meet with us if they wish to have any questions answered. If the applicant appears to qualify the application is placed on the waiting list file and logged according to date and time received. All adults in each applicant family must sign a “Consent for the release of information” prior to receiving assistance and annually thereafter. The unit for which the family is applying must be the family’s only residence. An applicant must agree to pay the rent required by the program under which the applicant will receive assistance. All information reported by the family is subject to verification. Applicants for Hifumi En must be either elderly family or a person of disability status, per HUD eligibility guidelines. (Elderly family means a family whose head, or spouse, or sole member is a person who is at least 62 years of age.) Hifumi En will use EIV Existing Tenant Search (request brochure for more details) to verify whether applicants are currently receiving assistance for another location prior to admitting the applicant for residency. By engaging in the screening process, you hereby accept to such search. All applicant and tenant household members must disclose and provide verification of the complete and accurate SSN assigned to them except for those individuals who do not contend eligible immigration status or tenants who were age 62 or older as of January 31, 2010, and whose initial determination of eligibility was begun before January 31, 2010. This paragraph explains the requirements and responsibilities of applicants or tenants to supply owners with this information, the responsibility of owners to obtain this information, and the consequences for failure to provide the information.*

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A. Key Requirements 1. Applicants and tenants must disclose and provide verification of the complete and accurate SSN assigned to each household member. Failure to disclose and provide documentation and verification of SSNs will result in an applicant not being admitted or a tenant household’s tenancy being terminated. Exceptions to disclosure of SSN: a. Individuals who do not contend eligible immigration status. (1) Mixed Families: For projects where the restriction on assistance to noncitizens applies and where individuals are required to declare their citizenship status, proration of assistance or screening for mixed families must continue to be followed. In these instances, the owner will have the tenant’s Citizenship Declaration on file whereby the individual did not contend eligible immigration status to support the individual not being subject to the requirements to disclose and provide verification of a SSN. Please ask the site manager if you have any questions.

An applicant may not become a participant in the program unless the applicant submits the required SSN documentation for all non-exempt household members to the owner. The applicant must provide SSN documentation for all non-exempt household members to the owner within 10 days from the date they are first offered an available unit to disclose and/or verify the SSN. If the owner has determined that the applicant is otherwise eligible for admission into the property, and the only outstanding verification is that of the SSN, the applicant may, at its discretion, retain his or her place on the waiting list. After 90 days, if the applicant has been unable to disclose and/or verify the SSN’s of all non-exempt household members, the applicant should be determined ineligible and removed from the waiting list. Tenants who do not meet the SSN disclosure, documentation and verifications for all non-exempt household members within the stated timeframe will be considered in non-compliance with their lease and Hifumi En Apartments must terminate the tenancy of that household.

We accept applicant households that include an applicant family member who is under the age of 6, who does

not yet have a Social Security Number (SSN) assigned to him/her, and was added to the household 6 months

or less from the move-in date. As a result of this change, the owner or owner agent (O/A) will not deny

occupancy to such applicant households. O/A will give the household 90 days from the effective date of their

move-in certification to provide documentation of the SSN for the child. An additional 90-day period will be

granted by the O/A if the failure to provide documentation of a SSN is due to circumstances that are outside

the control of the household.

The applicant household’s annual income must not exceed the very-low income limits (50% of area median income). In accordance with HUD requirements, the owner must not lease less than 40% of the dwelling units that become available for occupancy in the fiscal year to extremely low-income families. To implement this method, SHA will select the first extremely low-income applicant on the waiting list (which may mean skipping over some applicants with higher incomes) for the available unit, and then select the next eligible applicant currently at the top of the waiting list (regardless of income) for the next available unit. As subsequent units become available, tenant selection continues to alternate between the next extremely low-income applicant and the eligible applicant at the top of the list until the 40% target is reached. Current income limits are available at the rental office.

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Hifumi En is comprised of 41 one bedroom units and household size is limited to 3 members per unit. When a unit transfer is at the request of the resident, the resident may be required to provide third party verification of the need of the transfer. The cost of the transfer generally will be borne by the resident. Depending upon the circumstances of the transfer, a tenant may be obligated to pay all costs associated with the move. However, if a tenant is transferred as a reasonable accommodation to a household member’s disability, then the owner must pay the costs associated with the transfer, unless doing so would be an undue financial and administrative burden. The resident may request a transfer due to a medical reason or disability, by submitting a Reasonable Accommodation or Letter to SHA. Once a request for transfer has been received the date and time of the request will be documented to establish priority when more than one request for the same unit size and/or location is being considered. Unit transfers are only allowable as a Reasonable Accommodation for a medical reason or a disability or falls under VAWA. Approved transfer requests will be placed at the top of the waiting list. Current residents will have priority over residents waiting to move-in. Spokane Housing Authority (SHA) is concerned about the safety of its tenants, and such concern extends to tenants or applicants who are victims of domestic violence, dating violence, sexual assault, or stalking. In accordance with the Violence against Women Act (VAWA) SHA allows under VAWA support and or assistance to tenants who are victims of domestic violence, dating violence, sexual assault, or stalking to request an emergency transfer from the tenant’s current unit to another unit. The ability to request a transfer is available regardless of sex, gender identity, or sexual orientation. The ability of SHA to honor such request for tenants currently receiving assistance, however, may depend upon a preliminary determination that the tenant is or has been a victim of domestic violence, dating violence, sexual assault, or stalking, and on whether SHA has another dwelling unit that is available and is safe to offer the tenant for temporary or more permanent occupancy. Mobility impaired accessible units are offered to in-place residents who are in need of that type of unit. If there are not any persons in need of the accessible unit in the building, the unit will be offered to persons on the Mobility Impaired Accessible waiting list according to date and time of application. If there are not any persons on the waiting list then the unit will be offered to persons on the waiting list for regular units with the understanding that they may have to move to a non-accessible unit when one becomes available, at the residents expense. When screening applicants we require a credit and criminal history with no negative rental/residence history. Denials will be issued for instances including but not limited to the following reasons:

Evictions in the past 3 years, from federally assisted housing for drug-related criminal activity Any household member who is subject to a state lifetime sex offender registration requirement. A household in which any member is currently engaged in illegal use of drugs or for which the owner

has reasonable cause to believe that a member’s illegal use or pattern of illegal use of a drugs may interfere with the health, safety and right to peaceful enjoyment of the property by other residents.

Criminal conviction history for serious crimes against person or property. All prospective residents will have an interview with a SHA representative. In determining suitability for residency the most appropriate criteria are those that demonstrate that a person can meet the obligations of tenancy such as paying rent on time, maintaining the dwelling as required by the lease/rental agreement, and avoiding disruptive or destructive behavior. Applicants that do not meet the screening criteria will be notified in writing why they will not be accepted as a resident. Applicants will be given 14 days to appeal the denial. They will be given an opportunity to meet with

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a representative of Spokane Housing Authority to discuss any questions they may have regarding the screening criteria. The Landlord may not consider incidents of domestic violence, dating violence, sexual assault or stalking as serious or repeated violations of the lease or other “good cause” for termination of assistance, tenancy or occupancy rights of the victim of abuse. The Landlord may not consider criminal activity directly relating to abuse, engaged in by a member of a tenant’s household or any guest or other person under the tenant’s control, cause for termination of assistance, tenancy, or occupancy rights if the tenant or an immediate member of the tenant’s family is the victim or threatened victim of that abuse. If the applicant feels their application for tenancy was denied due to being a victim of domestic violence, dating violence, sexual assault or stalking, they should contact the Hifumi En office to discuss immediately. They will be required to complete certification and/or provide alternate documentation to verify their claim. Required information shall be completed and submitted within 14 business days, or an agreed upon extension date, to receive protection under the VAWA. All information provided to an owner or management agent related to the incident(s) of domestic violence, dating violence, sexual assault and stalking, including the fact that an individual is a victim of domestic violence, dating violence sexual assault or stalking shall be retained in confidence by the owner or management agent and shall neither be entered into any shared database nor provided to any related entity, except to the extent that such disclosure is: (1) Requested or consented to by the victim in writing; (2) Required for use in an eviction proceeding or termination of assistance; or (3) Otherwise required by applicable law. Applicants who do not respond to updates or who do not keep in contact with Spokane Housing Authority every six months will be dropped from the current waiting list file and filed in a non-responsive/contact file. Acceptable applicants are processed according to HUD certification rules and rents are figured accordingly. All residents must sign a rental agreement, house rules, disposition of assets form, release of information form, all applicable verification forms, HUD-50059 form, HUD 9887 and 9887A forms, and move-in/move-out inspection form. Owners must use, and the student must meet the following criteria to be eligible for Section 8 assistance as an independent student: Student Eligibility Requirements:

Is enrolled part time or full time as a student at an institution of higher education (as defined under section 102 of the Higher Education Act of 1965 (20 U.S.C. 1002); to obtain a degree, certificate, or other program leading to a recognized educational credential.

Must be 24 years of age or older by December 31 of the award year;

Is an orphan in foster care, or award of the court or was an orphan, in foster care or a ward of the court at any time when the individual was 13 years of age or older;

Is or was immediately prior to attaining the age of majority, an emancipated minor or in legal guardianship as determined by a court of competent jurisdiction in the individuals state of legal residence;

Is a veteran of the Armed Forces of the United States or is currently service on active duty in the Armed Forces for other than training purposes;

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Is a graduate or professional student;

Is a married individual;

has legal dependents other than a spouse;

Has been verified during the school year in which the application is submitted as either an unaccompanied youth who is a homeless child or youth or as unaccompanied, at risk of homelessness and self-supporting;

Is a student for whom a financial aid administrator makes a documented determination of

independence by reason of other unusual circumstances

Is not a person with disabilities (defined in 3 (b) (3) (E) of the U.S. Housing Act of 1937 (42 U.S.C 1437 a (b) (3) (E) and was not receiving Section 8 assistance as of November 30, 2005.

Is not individually eligible to receive Section 8 assistance or has parents (individually or jointly) who are not income eligible to receive Section 8 assistance.

Owners must verify the student’s independence from his or her parents. To determine that the students’ parents’ income is not relevant in determining the student’s eligibility for assistance by doing all the following:

Review and verify previous address information to determine evidence of a separate household verifying the student meets the U.S. Department of Education’s definition of independent student;

Review a student’s prior year income tax returns to verify the student is independent or verifying the student meets the U.S. Department of Education’s definition of independent student;

Verify income provided by parents by requiring written certification from an individual providing the support. Financial assistance that is provided by persons not living in the unit is part of the annual income.

Certification is also required if the parent is providing No support to the student. The rule does not apply to students residing with their parents in a section 8 assisted unit or who reside with parents who are applying to receive section 8 assistance.

2. For purposes of determining the eligibility of a person to receive assistance under section 8 of the United States Housing Act of 1937 (42 U.S.C. 1437f), any financial assistance a student receives (1) under the Higher Education Act of 1965, (2) from private sources, or (3) from an institution of higher education (as defined under the Higher Education Act of 1965 ,that is in excess of the amounts received for tuition ins included in annual income , except if the student is over the age of 23 with dependent children or if the student is living with his or her parents who are receiving Section 8 Assistance.

Closing waiting lists: The waiting list may be closed for one or more unit sizes when the average wait exceeds one year. The owner will advise potential applicants that the wait list is closed and will refuse to accept additional applications. The owner will publish notice in a publication likely to be read by potential applicants such as the Spokesman Review or Inlander.

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Opening wait list: When the owner agrees to accept applications again, notice of this action will be announced in a publication most likely to be read by potential applicants, in the same manner as the notification that the wait list was closed. In accordance with State and Federal laws you are hereby notified that an investigation may be made by MRI

Resident Check., The Information Source of the information you provide on this application, together with the

information as to your character, general reputation, personal characteristics and mode of living. You have the

right to dispute the accuracy of information provided by MRI Resident Check., The Information Source or by

the entities you have disclosed above, and upon written request, the right to a complete and accurate disclosure

of the nature and scope of the investigation and/or a written summary of your rights under the WA Fair Credit

Reporting Act. Direct all inquiries to: MRI resident check. LLC 5005 LBJ Freeway, Suite 225, Dallas. TX

75244 1-(800) 491-2580, Fax 1(800) 495-4842. I/We certify that to the best of my/our knowledge all

statements made herein are true and correct. I/We authorize MRI Resident Check LLC, The Information Source

to obtain such credit reports, character reports, verification of rental and employment history it deems is

necessary to verify all information set forth in the above Application, and provide an investigative report to the

undersigned Landlord. I/We further understand that false, fraudulent or misleading information disclosed

above may be grounds for denial of tenancy or subsequent eviction.

Prospective tenants have the right to obtain a free copy of the consumer report in the event of denial or other adverse action and to dispute the accuracy of information appearing in the consumer report.

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Appendix F Reasonable Accommodation Policy

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SPOKANE HOUSING AUTHORITY NOTICE OF RIGHT TO REASONABLE ACCOMMODATION

Any family that includes a person with a disability assisted under the Housing Choice Voucher program or other federally assisted housing program may request a reasonable accommodation in rules, policies, practices, or services when such accommodation may be necessary to afford a person with a disability the equal opportunity to use and enjoy a program or dwelling under the program. Federal regulations stipulate that requests for accommodations will be considered reasonable if they do not create an “undue financial and administrative burden” for the PHA, or result in a “fundamental alteration” in the nature of the program or service offered.

Such request for reasonable accommodations may include but are not limited to the following:

❑ Permitting applications and re-examinations to be completed by mail ❑ Conducting home visits

❑ Using higher payment standards if the PHA determines this is necessary to enable a person with disabilities to obtain a suitable housing unit

❑ Providing time extensions for locating a unit when necessary because of lack of availability of accessible units or special challenges of the family in seeking a unit

❑ Permitting an authorized designee or advocate to participate in the application or certification process and any other meetings with SHA staff

❑ Assistance in locating satisfactory housing or an accessible unit ❑ A change in the way SHA communicates or provides information

❑ A change in the rules or policies to give you an equal opportunity to use the facilities or take part in the Housing Choice Voucher program or other federal assisted housing programs

❑ For persons with vision impairments, large print or audio versions of key program documents

❑ For public meetings or presentations, request for one-on-one assistance ❑ Request for a sign language interpretation

❑ Request to property owner to modify the unit to make it accessible (Please note that the federal regulation regarding making modifications to a unit states that owners must permit a person with a disability to make reasonable modifications to the unit; however, the owner is not required to pay for the modification and may require that the unit be restored to its original state at the family’s expense when the family moves)

How to Request a Reasonable Accommodation?

To request a reasonable accommodation, please inform your housing eligibility specialist or property manager, or complete the Request for Reasonable Accommodation form. The Housing Authority encourages the family to make its request in writing using a reasonable accommodation request form. However, SHA will consider the accommodation any time the family indicates that an accommodation is needed whether or not a formal written request is submitted. The family must explain the relationship between the requested accommodation and the disability. There must be an identifiable relationship, or nexus, between the requested accommodation and the individual’s disability.

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Appendix D Reasonable Accommodation Policy

Page 2/2

Verification of Disability - Disability status will need to be verified by a licensed physician or health care provider or professional representing a social service agency, disability agency, or clinic.

A response to grant or deny the request for a reasonable accommodation will be made in writing within 10 business days of the request.