SAMPLE FORMS, LETTERS, NOTICES AND BROCHURES

FORMS (for forms HUD has translated into other languages, go to )


Agency Plan Checklist
Application/Re-exam Forms

Pre-App Sample - Public Housing
Pre-App Sample - HCV
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
Citizenship - Documentation of Status
Contact Person or Organization (optional form for applicants)
Contact for Emergencies
Criminal Check Release
Criminal History Request Record
Eligibility Criteria - Public Housing Sample
Eligibility Criteria/Tenant Selection - Multifamily Sample
Interview Questionnaire Public Housing English
Interview Questionnaire Public Housing Spanish
Interview Questionnaire HCV
Noncitizen - Certification of Noneligible Immigrant Status
Noncitizen  - Info Release
Release of Information (Privacy Act) Form
Release of Information - Spanish
Re-examination Form
Re-examination Update Form
Update Form
Wait List Acknowledgment

Bank-Related Forms

Bank Draft for Rent 1
Bank Draft for Rent 2
Depository Agreement (HUD Form)
Direct Deposit Form
Direct Deposit Authorization sample 1
Direct Deposit Authorization sample 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-5370 EZ - Gen. Cond. for Small Constr./Dev. Contracts

Board Meeting Related Forms

Agenda for Board Meeting - Example
Citizen Input Form (Board Meetings)
Report to Board - Sample Format 1
Report to Board - Sample Format 2
Report to Board - Sample Format 3
Report to Board - Sample Format 4
Report to Board - Sample Format 5
Report to Board - Sample Format 6
Report to Board - Misc Sample Formats

Budget Approval Resolution
Certificate of Apointment (Commissioners)
Complaint Form - Resident
Contract Template
Debts Owed PHAs (HUD Form)
Employment Forms

Confidentiality Agreement
Earned Income
Tax Credit Notice to Employees
Employee Correction Counseling
Employee Drug Testing Agreement
Employee Evaluation Form - Executive Director
Employee Evaluation Form 1
Employee Evaluation
Form 2
Employee Evaluation
Guidance
Employment Application
Employment Applicant Rating 1
Employment Applicant Rating 2
Employment
- Auth for Criminal/Credit Check
Personnel Action Form
Sick Leave Transfer - Request for

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

Files - Tenant

Tenant File Checklist - Public Housing
Tenant File Checklist - HCV

Housing Choice Voucher forms

Housing Assistance Payments Contract (HAP) Eng
Housing Assistance Payments Contract (HAP) Span
Portability (Section 8, HUD-52665)
Portability Log Forms
Rent Reasonableness Certification
Rent Reasonableness Survey
Request for Tenancy Approval Eng
Request for Tenancy Approval Span
Tenancy Addendum Eng
Tenancy Addendum Span
Utilization Worksheet
Voucher Eng
Voucher Span

Identity Theft Documentation
Income Checklists/ Worksheets

Adjusted Income Worksheet
Adjusted Income Worksheet (2)
Allowance Checklist
Annual Income Checklist
Annual Income Worksheet
Asset Divestiture Data-gathering Worksheet
Asset Income Worksheet
Asset Questionnaire
Asset Questionnaire Spanish
Income from Contributions Worksheet
Income/Rent Forms Package
Income Worksheet - Under $200
Income Worksheet - Zero Income 1
Income Worksheet - Zero Income 2
Income Worksheet - Zero Income 3

Income Targeting Worksheet
Informal Hearing Summary
Inspection Forms

HQS Inspection Form - Short
HQS Inspection Form - Long
Public Housing Inspection Form (FWHUD)
Public Housing Inspection Form 2
Public Housing Inspection Form 3

Labor Reporting Form
Lease Documents

Lease - THA
Community Service Compliance Certification
Community Service Exemption Form
Community Service Tracking Form
Deceased Release (in case of death of resident)
Drug Abuse Warning
EIV Notice
Extermination Policy Acknowledgement
Indemnification Agreement
Lawncare Agreement
Lead Paint Brochure Certification
Lead Paint Certification
Lead Disclosure Form Eng
Lead Disclosure Form Span
No Additional Adults Certification
Parent Responsibility Form
Pet Policy Certification
PHA Certification for Tenant File
School Information Release Form
Smoke Detector Certification

Lead Paint - EPA Application to become certified to do LBP/RRP Activities
Maintenance Checklist
MENAR Tracker Worksheet
Oath of Office (Commissioner)
Pest Control - Emergency Waiver
Physical Needs Assessment (Short Form used with old CGP)
Physical Needs Assessment (Long Form for CFP/OFP)
PILOT Computation Form
Power of Attorney
Race and Ethnic Reporting Form (HUD-27061)
Rent Calculation/Certification Forms

Earned Income Disallowance/Disregard Worksheets 1 (THA/HUDFW)

100% Disallowance Worksheet
50% Disallowance Worksheet
Income History Log
EID Calendar

EID Qualifying Form - PH
EID Qualifying Form - HCV

Earned Income Disallowance Worksheets 2

Hardship Request
Maximum Rent Determination - Public Housing
Minimum Rent Waiver
Minimum Rent Waiver Request
Rent Calculation
- Pro-Rated Public Housing- for Mixed Families
Rent Calculation - Pro-Rated Housing Choice Voucher - for Mixed Families
Rent Calculation - Public Housing Worksheet
Rent Calculation - Housing Choice Voucher Worksheet
Rent Choice Certification
Repayment Agreement
Repayment Agreement 2
Repayment - Forms Package
Utility Reimbursement Paid to Utility Co. - Authorization Form


Resolutions - Generic format
Social Security Number - Application for Card
Tax Exemption Forms

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

Threat Assessment
Transfer Approval

Utilities

Authorization for New Service - Gas
Authorization for New Service - Water
Request
to Utility Co. for Consumption Data - sample letter
Utility Allowance Questionnaire for Residents
Resident Release of Consumption Data 1

Utility Release of Consumption Data 2
Utility Allowances - Sec 8 Consumption Estimate Worksheet
Utility Allowances - Sec 8 Consumption Data


Vacancy Tracking Form
Vacated Unit Report
Vehicle Registration (Eng, Sp)
Verification Forms

Asset Divestiture Verification
Asset Income Verification
Asset Income Verification 2
Athletic Scholarship verification
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
Childcare Costs Verification - Babysitter
Childcare Costs Verification - Day Care Center
Detox Center - Authorization to Release Information
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)
Employment Verification
Employment - Self Verification of
Fostercare Verification
Fulltime Student Verification
Home Visit Checklist
Housing Assistance Verification
Interagency Tenant Cross Check
Landlord Verification Form
Lease - Ability to Comply
Lease - Certification for Assistance to An Applicant Complying with Lease Terms
Medical Costs Verification
Military Income Verification
Pensions/Annuities Verification
Police Record Verification - City
Police Record Verification - Sheriff
Police Report
Prescription Verification
Reasonable Accommodation (Section 504) (Accessibility) Checklist
Reasonable Accommodation Certification
Reasonable Accommodation Miscellaneous Forms
Reasonable Accommodation Notice
Reasonable Accommodation Request
Rental--No History
Screening Forms
Self Employment Verification
Self Certification Form - Applicant/Resident
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 Return Request Form (IRS)
Telephone Interview Form
Unemployment Benefits Verification
Unemployment Insurance Verification - Texas Workforce Commission
Utilities - Verification of
VA Benefits Verification
Verification Update
- Third Party
Worker's Comp Verification

Visitor Registration
Work Order Tracking Form
 


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 - Housekeeping
Violation - Community Service
Violation - Pets
Violation - Info Needed

HAP Abatement Letter
Hardship Notification Letter
Inspection Notice Public Housing
Inspection - Re-Inspection Notice Public Housing
Maintenance - Emergency
Maintenance - Response Procedures
Meeting Notice,
Certificate of Posting
Meeting Notice, Certificate of Posting (2)
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
Utility Company - Notice to PHA when Tenant has delinquency
Waiting List - Notice of Closing
Waiting List  - sample notices of opening
 

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