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HomeMy WebLinkAbout6B2("'6co Department of Community Investment 1200 County -City Building, 227 West Jefferson, South Bend, Indiana 46601 -1830 Phone 574/235 -9371 Fox 574/235 -9021 To: Redevelopment Corn . sion From: Bill Schalliol Subject: Contract for se ousing Authority of South Bend for 701 E South Street, Apt A Date: November 21, 2012 Attached to this memorandum is a contract for services between the Housing Authority of South Bend and the City of South Bend Redevelopment Commission. The property at 701 E South Street was formerly owned by the Housing Development Corporation (HDC) of South Bend and was recently transferred to the Commission as part of the disposition of several properties located near the intersection of South and Lincoln Way East. The tenant presently living in 701 E South Street Apartment A has been living in the property for a number of years and would likely remain a tenant in the property after the unit is sold. The Housing Authority previously had a similar contract with the HDC and a new contract needs to be executed with the Commission to provide Section 8 Housing Services. Staff requests approval of the contract. What We Do Today Makes A Difference! PLEASE READ CAREFULLY HAP CONTRACT CHECKLIST (HOUSING ASSISTANCE PAYMENT) "PLEASE DO NOT TAKE THIS CONTRACT APART" THIS CONTRACT 15 TERMINATED IF NOT RETURNED WITHIN 60 DAYS Please check to make sure you have completed the following: ➢ _Owner sign Payment Contract ➢ _Owner /Tenant Sign Lead Base Form ➢ —Owner/Tenant sign Lease Attachment Form ➢ _Owner sign Landlord Certificate Form > _Owner complete and sign W -9 Form ➢ _Change of ownership Lease Procedure Form ➢ _Copy of signed lease between Owner and Tenant ➢ _Owner attach Proof of Rental Property ➢ (Title and/ or Insurance Policy) ➢ _Owner attach copy of Picture Identification ➢ _Owner attach copy of Social Security Card NOTE: YOU ARE RESPONSIBLE FOR HAVING YOUR TENANT SIGN THE NECESSARY DOCUMENTATION If you are a company please include the following: ➢ _Company Rental Property Ownership ➢ _Company Federal Identification Number Documentation ➢ _Management Agreement (if applicable) ➢ _Agent attach Letter of Authorization ➢ _Agent attach Picture Identification ALL THE ABOVE INFORMATION (INCLUDING THIS SHEET) MUST BE RETURNED BEFORE PAYMENT WILL BEGIN TO HELP EXPEDITE THE EXECUTION OF YOUR HOUSING ASSISTANCE PAYMENT CONTRACT: ➢ PLEASE BE SURE THAT THE HAP CONTRACT AND ALL ENCLOSED DOCUMENTS ARE SIGNED AND DATED BY YOU AND YOUR TENANT ➢ PLEASE DO NOTTAKE THE HOUSING ASSISTANCE PAYMENT (HAP) CONTRACT APART. AFTER ALL IS SIGNED BY THE SECTION 8 MANAGER OR SECTION 8 ASSISTANT MANAGER A COPY WILL BE MAILED TO YOU ➢ PLEASE RETURN ALL INFORMATION TO THE FOLLOWING HOUSING REPRESENTATIVE Step -hante McMoPGis THANKS FOR YOUR COOPERATION Corporate Office: 501 Alonzo Watson Dr. South Bend. IN 46601 (574)235.9346 (574) 283 -1902 fax (574) 235 -9590 T.D.D. Commissioners: Earl L. Hairston Rafael Morton Gladys Muhammad Dale Devon Andy Kcsfielney Randall Byrd Angela Watson - Washington o r�"`vers' rrrrr' SING ,4UTHORITYofsomm November 2, 2012 Viola Tucker 701 South St. Apt. A South Bend, IN 46601 Dear Housing Choice Participant: This form serves as notice of the amount of rent you pay directly to your landlord and the amount the Housing Authority pays of your rent. If you have any questions, please contact your Housing Specialist. CONTRACT NUMBER: V44012 TENANTS NAME: Viola Tucker RENTAL PROPERTY ADDRESS: 701 South St- Apt. A TENANT PAYMENT: $125.00 HOUSING AUTHORITY PAYMENT: $275.00 EFFECTIVE DATE: November 1, 2012 — October 31, 2013 Craig Stevens Section 8 Housing Specialist cc: City of South Bend Redevelopment Commission 1200 County City Building 227 W. Jefferson South Bend, IN 46601 "Building Solid Foundations Together" 11/02/2012 Date Sectc "o [ Tenn of Based aoce m9 N IT) Housl As5ls aocc pay eof co tact p acl <c �? c D Housing Assistance Payments Contracts (HAP Contract) Section 8 Tenant -Based Assistance Housing Housing Choice Voucher Program Part A of the HAP Contract: Contract Information (To Prepare the contract, fill out all contract information in Pan A.) Contents of Contract This HAP contract has three parts: Part A: Contract Information Part B: Body of Contract Part C: Tenancy Addendum 2. Tenant Tucker, Viola 3. Contract Unit 701 South St. Apt. A South Bend, IN 46601 U.S. Department of Housing and Urban Development Office of Public and Indian 4. Household The following persons may reside in the unit. Other persons may not be added to the household without prior written approval of the owner and the PHA. Tucker, Viola (Head) Williams, Devon (Youth) 5. Initial Lease Term The initial lease term begins on (mm/ddlyyyy); November 1, 2012 The initial lease term ends on (mm /ddlyyyy): October 3 1 2013 6. Initial Rent to Owner The initial rent to owner is: $400.00 During the initial lease term, the owner may not raise the rent to owner. Initial Housing Assistance Payment The HAP contract term commences on the first day of the initial lease term. At the beginning of the HAP contract term, the amount of the housing assistance payment by the PHA to the owner is $275.00 per month. The amount of the monthly housing assistance payment by the PHA to the owner is subject to change during the HAP contract tern in accordance with HUD requirements. form HUD -52641 (0; Previous editions are obsolete Page 2 of 12 ref Handbook Other (specify) Signatures: Housing Authority of South Bend Pent or Type Name of PHA Jacelyn R. Phillips Section $ Manager Pent or Type Name and TNe of Signatory Date (mmlddlyyyy) Mail Payments to: City of South Bend Redevelopment Commisssion Print or Type Name or Owner Signature _ to cram Print or Type Name and Title of Signatory Date(mmlddlyyyy) Name Address (street, city, State, Zip) Previous editions are obsolete Page .3 of 12 torte HUD -52641 (08/2009) ref Handbook 7420.8 �© ®y a XXXXXXX �s e e ae •. .I • •: Other (specify) Signatures: Housing Authority of South Bend Pent or Type Name of PHA Jacelyn R. Phillips Section $ Manager Pent or Type Name and TNe of Signatory Date (mmlddlyyyy) Mail Payments to: City of South Bend Redevelopment Commisssion Print or Type Name or Owner Signature _ to cram Print or Type Name and Title of Signatory Date(mmlddlyyyy) Name Address (street, city, State, Zip) Previous editions are obsolete Page .3 of 12 torte HUD -52641 (08/2009) ref Handbook 7420.8 Housing Assistance Payments Contract U.S. Department of Housing HAP Contract and Urban Development Office of Public and Indian Housing Section 8 Tenant -Based Assistance Housing Choice Voucher Program Part B of HAP Contract- Body of Contract for such breach include recovery of overpayments, suspension of housing assistance payments, the Section 8 voucher program. .abatement or other reduction of housing assistance 1. Purpose payments, termination of housing assistance a. This is a HAP contract between the PHA and the payments, and termination of the HAP contract The owner. The HAP contract is entered to provide PHA may not exercise such remedies against the assistance for the family under the Section 8 owner because of an HQS breach for which the voucher program (see HUD program regulations at family is responsible, and that is not caused by the 24 Code of Federal Reguli tions Part 982). owner. b. The HAP contract only applies to the household and d. The PHA shall not make any housing assistance contract unit specified in Part A of the HAP payments if the contract unit does not meet the contract HQS, unless the owner corrects the defect within the C. During the HAP contract term, the PHA will pay period specified by the PHA and the PHA verifies housing assistance payments to the owner in the correction. If a defect is life threatening, the accordance with the HAP contract owner must correct the defect within no more than d. The family will reside in the contract unit with 24 horns. For other defects, the owner must correct assistance under the Section 8 voucher program. The the defect within the period specified by the PHA_ housing assistance payments by the PHA assist the C. The PHA may inspect the contract unit and premises tenant to lease the contract unit from the owner for at such times as the PHA determines necessary, to occupancy by the family. ensure that the nut is in accordance with the HQS. the locality by the owner and that is generally t The PHA most notify the owner of any HQS defects 2. Lease of Contract Unit shown by the inspection. a The owner has leased the contract unit to the tenant g• The owner must provide all housing services as d agreed to in the lease. WE occupancy by the famdy with assistance un a the Section 8 voucher program. 4. Term of HAP Contract b. The PHA has approved leasing of the unit in accordance with requirements of the Section 8 a Relation to lease term. The tam of the HAP voucher program. contract begins on the first day of the initial tam of o. The lease for the contract unit must include word- the lease, and terminates on the last day of the term for -word all provisions of the tenancy addendum of the lease (including the initial lease term and any required by HUD (Part C of the HAP contract). extensions). d. The owner certifies that b. When HAP contract terminates. (1) The owner and the tenant have entered into a (1) The HAP contract terminates automatically if lease of the contract unit that includes all the lease is terminated by the owner or the provisions of the tenancy addendum. tenant - (2) The ]ease is in a standard form that is used in (2) The PHA may terminate program assistance the locality by the owner and that is generally for the family for any grounds authorized in used for other unassisted tenants in the accordance with HUD requirements. If the premises. PHA terminates program assistance for the (3) The lease is consistent with State and local family, the HAP contract terminates law. antnmancelly. e. The owner is responsible for screening the family's (3) If the family moves from the contract unit, the behavior or suitability for tenancy. The PHA is not HAP contract terminates automatically. responsible for such screening. The PHA has no (4) The HAP contract terminates automatically 180 liability or responsibility to the owner or oilier calendar days after the last housing assistance persons for the family's behavior or the family's payment to the owner. conduct in tenancy. (5) The PHA may terminate the HAP contract if the PHA determines, in accordance with HUD 3. Maintenance, Utilities, and Other Services requirements, that available program finding is a The owner must maintain the contract unit and not sufficient to support continued assistance premises in accordance with the housing quality for famili es in the progam. standards (HQS). (6) The HAP contract terminates automatically upon the b. The owner must provide all utilities needed to death of a single member household, including single comply with the HQS. member households with alive -in aide. C. If the owner does not maintain the contract unit in accordance with the HQS, or fails to provide all utilities needed to comply with the HQS, the FHA may exercise any available remedies. PHA remedies form HUD -62641 (812009) Previous editions are obsolete Page 4 of 12 ref Handbook 7420.8 (7) The PRA may terminate the HAP contract if the governing penalties for late payment of rent by a PHA determines that the contract unit does not tenant; (it) It is the owner's practice to charge provide adequate space in accordance with the such penalties for assisted and unassisted tempts; HQS because of an increase in family size or a and (iii) The owner also charges such penalties change in flintily composition. against the tenant for late payment of family rent (8) If the family breaks up, the PHA may terminate to owner. However, the PHA shall not be the HAP contract, or may continue housing obligated to pay any late payment penalty if HUD assistance payments on behalf of family members determines that late payment by the PHA. is due who remain in the contract unit to factors beyond the PHA's controL Moreover, (9) The PHA. may te®inate the HAP contract if the the PHA shall not be obligated to pay any late payment penalty if housing assistance payments PHA determines that the unit does not meet all by the PHA are delayed or denied as a remedy for requirements of the HQS, or determines that the r owner breach the HAP contract including any owner has otherwise breached the HAP contract of the following PHA remedies: : recovery of 5. Provision and Payment for Utilities and Appliances overpayments, suspension of housing assistance a The lease must specify what utilities •are to be provided payments, abatement or reduction of housing or paid by the owner or the tenant assistance payments, termination of housing b. The lease must specify what appliances are to be pro- assistance payments and termination of the vided or paid by the owner or the tenant contract). C. Part A of the HAP contract specifies what utilities and (4) Housing assistance payments shall only be paid appliances are to be provided or paid by the owner or to the owner while the family is residing in the the tenant The lease shall be consistent with the HAP contract unit during the tam of the HAP contract contract The PRA shall not pay a housing assistance payment to the owner for any month after the 6. Rent to Owner. Reasonable Rent month when the family moves out a During the HAP contract term, the teat to owner may at b. Owner compliance with HAP contract. Unless the owner complied with provisions of the HAP no time exceed the reasonable rent for the contract unit contract, the owner does not have a right to receive as most recently determined or redetermined by the housing assistance payments under the HAP contact PHA in accordance with HUD requirements. c. Amount of PHA payment to owner b. The PHA must determine whether the rent to owner is (1) The amount of the monthly PHA housing reasonable in comparison to rent for other comparable assistance payment to the owner shall l be unassisted units. To make this determination, the PHA determined by the PHA in accordance with HUD must consider reg�+trt�+eats for a tenancy under the voucher (1) The location, quality, size, unit type, and age of the contract unit; and program. (2) The amount of the P HA housing assistance (2) Any amenities, housing services, maintenance payment is subject to change during the HAP and utilities provided and paid by the owner. connect term is accordance with HUD C. The PHA must redetermine the reasonable rent when requirements. The PHA must notify the family required in accordance with HUD requirements. The and the owner of any changes in the amount of PRA may redetermine the reasonable rent at any time. the housing assistance payment I During the HAP contract term, the rent to owner may (3) The housing assistance payment for the Ent not exceed rent charged by the owner for comparable month of the HAP contract term shall be pro- unassisted units in the premises. The owner must give rated fir a partial month. the PHA any information requested by the PHA on rents charged by the owner for other units in the d. Application of payment The monthly housing premises or elsewhere. assistance payment shall be credited against the monthly rent to owner for the contract unit 7. PHA Payment to Owner e. Limit ofPHA responsibility. (1) The PHA is only responsible for making housing a when paid assistance payments to the owner in accordance (1) During the term of the HAP contract, the PHA with the HAP contract and HUD requirements for must make monthly housing assistance payments a tenancy under the voucher program, to the owner on behalf of the family at the (2) The PHA shall not pay any portion pf the rent to beginning of each month owner in excess of the housing assistance (2) The PHA must pay housing assistance payments payment The PRA shall not pay any other claim promptly when due to fire owner. by the owner against the family. (3) If housing assistance payments are not paid f Overpayment to owner. If the PHA determines that promptly when due after the first two calendar the owner is not entitled to the housing assistance months of the HAP contract term, the PHA shall payment many part of it the PHA, in addition to other pay the owner penalties if all of the following remedies, may deduct the amount of the overpayment circumstances apply: (i) Such penalties are in from my mounts due the owner (including amounts accordance with generally accepted practices and due under any other Section 8 assistance contract). law, as applicable in the local housing market, 8. Owner Certification form HUD -62641 (a20%) Previous editions are obsolete Page 5 of 12 ref Handbook 7420.8 During the term of this contract, the owner certifies that: (5) If the owner has engaged in any drug- related L The owner is maintaining the contract unit and criminal activity or any violent criminal activity. premises in accordance with the HQS. b. If the PHA determines that a breach has occurred, the b. The contract unit is leased to the tenant The lease PHA may exercise any of its rights and remedies under includes the tenancy addendum (Part C of the HAP the HAP contract, or my other available rights and contract), and is in accordance with the HAP contract remedies for such breach. The PHA shall notify the and program requirements. The owner has provided the owner of such determination, including a brief lease to the PHA, including any revisions of the lease. statement of the reasons for the determination. The C. The rent to owner does not exceed rents charged by the notice by the PHA to the owner may require the owner . owner for rental of comparable unassisted units in the to take corrective action, as verified or determined by premises the PHA, by a deadline prescribed in the notice. d. Except for the rent to owner, the owner has not C. The PHA's rights and remedies for owner breach of the received and will not receive my payments or other HAP contract include recovery of overpayments, consideration (from the family, the PHA, HUD, or any suspension of housing assistance payments, abatement other public or private source) for rental of the wnb=t or other reduction of housing assistance payments, unit during the HAP contract teen termination of housing assistance payments, and M. The family does not own or have my interest in the termination of the HAP contract contract unit d. The PHA may seek and obtain additional relief by f To the best of the owner's knowledge, the members of judicial order or action, including specific performance, the family reside in the contract unit, and the unit is the other injunctive relief or order for damages. family's only residence e. Even if the family continues to live in the contract unit, g. The owner (including a principal or other interested the PHA may exercise any rights and remedies for party) is not time parent, child, grandpareent, grandchild. owner breach of the HAP contract slaw, m brother of any member of the family, unless ter f The PHA's exercise or non- exerci se of any right or the PHA has determined (and has notified the owner remedy for owner breach of time HAP contract is not a and the family of such determination) that approving waiver of the right to exercise that or say other right or rental of the remit, notwithstanding such relationship, remedy at my time. would provide reasonable soc=odation for a family member who is a person with disabilities. 11. PHA and HUD Access to Premises and Owner's Records a. The owner must provide any information pertinent to 9. Prohibition of Discrimination. In accordance with the HAP contract that the PHA or HUD may applicable equal opportunity statutes Executive Orders and Th and b Pe HAI, HUD the Comptroller General of the regulations: United States shall have fall and free access to the a. The owner must not discriminate inate against my Person contract unit and the premises, and to all accounts and because of race, color, religion, sax, national origin, other records of the owner that are relevant to the HAP age, familial status, or disability in =action with the contract, inct». ding the right to examine or audit the HAP contract records and to make copies. b. The owner must cooperate with the PHA and HUD in C. The owna must grant such access to computerized or conducting equal opportunity compliance reviews and other electronic records, and to any wmputas, equip - complaint investigations in connection with the HAP matt or fachb'ties containing such records, and must Contract provide any information or assistance needed to access the records. 10. Owner's Breach of HAP Contract a. Any of the following actions by the owner (including a 12. Exclusion of Third Party Rights principal or otha interested party) is a breach of the e. The family is not a party to or third patty beneficiary of HAP contract by the owner: Part B of the HAP contract The family may not (1) If the owner has violated any obligation under the enforce any provision of Part B, and may not exercise HAP contract, including- the owners obligation any right or remedy against the owner or PHA under to maintain the unit in accordance with the HQS. Part B. (2) If the owner has violated any obligation under b. The tenant or the PHA may enforce the tenancy my other housing assistance payments contract addendum (Part C of the HAP contract) against the owner, and may exercise any right or remedy against under Section S. The owner under the tenancy rm. (3) if the owner has committed fraud, bribery or any c. any responsibility The PHA does not assume any responsibility for injury other corrupt or criminal act in connection with to, or any liability to, any person injured a result of any Federal housing assistance program. n the owner's action or failure to act is connection with (4) For projects with mortgages insured by HUD or management of the contract unit or the premises or loans made by HUD, if the owner has failed to with implementation of the HAP contract, or as a result comply with the regulations for the applicable of say other action or failure to act by the owner. mortgage insurance or loan program, with the d The owner is not the agent of the PHA, and the HAP mortgage or mortgage note, or with the contract does not create or affect any relationship regulatory agreement; or if the owner has between the PHA and any lenda to the owner or my committed fraud, bribery or any other corrupt or suppliers, employees, contractors or subcontractors criminal act in connection with the mortgage or used by the owner in connection with management of loan form HUD -52641 (812009) Previous editions are obsolete Page 6 of 12 ref Handbook 7420.8 form HUD -52641 (6/2009) Previous editions are obsolete Page 7 of 12 ref Handbook 7420.8 the contract unit or the premises or with the Far Housing Act or other Federal equal implementation of the HAP contract. opportunity requirements. e. The HAP contract may not be assigned to a new owner 13. Conflict of Interest if the new owner (including a principal or other a. "Covered individual" nneins a person or entity who is a interested party) is the parent, child, grandparent, member of any of the following classes: grandchild, sister or bmther of any member of the (1) Any present or former member or officer of the family, unless the PHA has determined (and has PHA (except a PHA commissioner who is a notified the family of such determination) that participant in the program); approving the assignment, notwithstanding such (2) Any employee of the PHA, or any contractor, relationship, would provide reasonable accommodation sub- contractor or agent of the PHA, who for a family member who is a person with disabilities. formulates policy or who influences decisions £ The PHA may deny approval to assign the HAP with respect to the program; contract if the owner or proposed new owner (including (3) Any public official, member of a goveming body, (principal or other interested Party): ( i) Has violated obligations under a - housing or State or local legislator, who exercises assistance payments contrail under Section 8; assistance functions or responsibilities with respect to the program; or (2) Has committed fraud, bribery or any other (4) Any member of the Congress of the United corrupt or criminal act m connection with soy Federal housing program; b. States. A covered individual ,may not have any direct or (3) Has engaged m any drug related criminal activity or any violent criminal activity; indirect mterest in the HAP contract or in any benefits or payments under the contract (indudmg the interest (4) Has a history or practice of non - compliance with of an immediate family member of such covered the HQS for units leased under the Section 8 individual) while such person is a covered individual or tenam -based programs, or non - compliance with during one year thereafter. applicable housing standards for units leased with C. "Immediate family member" means the spouse, parent project-based Section 8 assistance or for units (including a stepparent), child (including a stepchild), leased under any other Federal housing program; gmdparent, grandchild, sister or brother (including a (5) Has a history or practice of Yarling to terminate stepsister or stepbrother) of any covered individual. tenancy of tenants assisted under any Federally d The owner certifies and is responsible for assuring that assisted housing program for activity eagaged in no person or entity has or will have a prohibited by the tenant, any member of the household, a interest, at execution of the HAP contract, or at any guest or another person under the control of any time during the HAP contract term member of the household that e. If a prohibited interest occurs, the owner shall promptly (a) 'threatens the right to peaceful enjoyment of and fully disclose such interest to the PHA and HUD. the premises by other residents; f. The conflict of interest prohibition under this section (b) Threatens the health or safety of other may be waived by the HUD field office for good cause. residents, of employees the PHA, of g. No member of or delegate to the Congress of the owner employees or other persons engaged m other g ge United States or resident commissioner shall be management of the housing admitted to any share or part of the HAP contract or to any benefits which may arise from it (c) Threatens the health or safety of; or the right to peaceful enjoyment of their residents by, 14. Assignment of the HAP Contract persons residing in the immediate vicinity of the n The owner may not assign the HAP contract to anew premises; or (d) Is drug-related criminal activity or violent owner without the prior written consent of the PHA. criminal activity; b. If the owner requests PHA consent to assign the HAP contract to a new owner, the owner shall supply any (6) Has a history air practice ofrenting units that fail to information as requirrd by the PHA pertinent to the meet State or local housing codes; or proposed assignment (7) Has not paid State or local real estate taxes, fines or c. The HAP contract may not be assigned to a new owner assessments that is debarred, suspended or subject to a limited g The new, owner must agree to be bound by and comply denial of participation under HUD regulations (see 24 with the HAP contract The agreement must be in Code of Federal Regulations Part 24). writing, and in a form acceptable to the PHA. The new d_ The HAP contract may not be assigned to a new owner owner must give the PHA a copy of the executed if HUD has prohibited such assignment because: agreement (1) The Federal government has instituted an administrative or judicial action against the owner or proposed new owner for violation ofthe 15. Foreclosure. In the case of any foreclosure, the immediate _ Far Housing Act or other Federal equal the foreclosure to the is interest a the property phe shall opportunity requirements, and such action is lest en the assume such interest shhlrjeil to the lease between the prior assume - pending; m owner and the tenant and to the HAP contract between the prior owner and the PHA for the occupied unit This provision does not (2) A court or administrative agency has determined affect any State or local law that provides longer time periods or that the owner or proposed new owner violated other additional protections for tenants. This provision will sunset on December 31, 2012 unless extended by law. form HUD -52641 (6/2009) Previous editions are obsolete Page 7 of 12 ref Handbook 7420.8 16. Written Notices. Any notice by the PHA or the owner in connection with Ibis contract must be in writing. 17. Entire Agreement: Interpretation a. The HAP contract contains the entire agreement between the owner and the PHA b The HAP contract shall be interpreted and implemented in accordance with all statutory requirements, and with all HUD requirements, including the HUD program regulations at 24 Code of Federal Regulations Part 982. form HUD -62641 (812009) Previous edit)ons are obsolete Page 8 of 12 ref Handbook 7420.8 Housing Assistance Payments Contract U.S. Department of Housing HAP Contract and Urban Development Office of Public and Indian Housing Section 8 Tenant -Based Assistance Housing Choice Voucher Program Part C of HAP Contract: Tenancy Addendum c. During the tam of the lease (including the initial term of the lease and any extension term), the rent to 1. Section 8 Voucher Program owner may at no time exceed: (1) The reasonable rent for the unit as most a The owner is leasing the contract unit to the tenant recently determined or redetermined by the for occupancy by the tenant's family with assistance PHA in accordance with HUD requirements, for a tenancy under the Section 8 housing choice or voucher program (voucher program) of the United (2) Rent charged by the owner for comparable States Department of Housing and . Urban unassisted units in the premises. Development (HUD). b. The owner has entered into a Housing Assistance Payments Contract (HAP contract) with the PHA 5, Family Payment to Owner' Y Ym and the voucher proVmnL Under the HAP a. The family is responsible for paying the owner any contract, the PHA will make housing assistance portion of the rent to owner that is not covered by payments to the owner to assist the tent in leasing the PHA housing assistance payment the unit from the owner. b. Each month, the PHA will make a housing assistance payment to the owner on behalf of the 2. Lease family in accordance with the HAP contract The a. The owner has given the PHA a copy of the lease, amount of the monthly housing assistance payment including any revisions agreed by the owner and the will be determined by the PHA in accordance with tenant The owner certifies that the terms of the HUD requirements for a tenancy under the Section 8 lease are in accordance with all provisions of the voucher program. HAP contract and that the lease includes the tenancy C. The monthly housing assistance payment shall be addendum credited against the monthly rent to owner for the b. The tenant shall have the right to enforce the contract unit d. The tent is not responsible for paying the portion tenancy addendum against the owner. If there is any conflict between the tenancy addendum and any of rent to owner covered by the PHA housing other provisions of the lease, the language of the assistance payment under the HAP contract between tenancy addendum shall control. the owner and the PHA, A PHA failure to pay the housing assistance payment to the owner is not a 3. Use of Contract Unit violation of the lease. The owner may not terminate the tenancy for nonpayment of the PEA housing a. During the lease term, the family will reside in the assistance payment contract unit with assistance under the voucher e. The owner may not charge or accept, from the program. family or from any other source, any payment for b. The composition of the household must be approved rent of the unit in addition to the rent to owner. Rent by the PHA. The family must promptly inform the to owner includes all hrnymg services, maintenance, PHA of the birth, adoption or count - awarded custody utilities and appliances to be provided and paid by of a child. Other persons may not be added to the the owner in accordance with the lease. household without prior written approval of the E The owner must immediately return any excess rent . owner and the PHA payment to the tenant c. The contract unit may only be used for residence by the PHA - approved household members. The unit 6. Other Fees and Charges must be the family's only residence. Members of the household may engage in legal profit making a Rea[ m owner does not include cost of any meals or activities incidental to primary use of the unit far supportive services or furniture which may be residence by members of the family. provided by the owner. d. The tenant may not sublease or let the unit b. The owner may not require the tenant or family C. The tenant may not assign the lease or transfer the members to pay charges for any meals or supportive unit services or furniture which may be provided by the owner. Nonpayment of any such charges is not 4. Rent to Owner grounds for termination of tenancy. Q. The owner may not charge the tenant extra amounts a. The initial rent to owner may not exceed the for items customarily included in rent to owner in amount approved by the PHA in accordance with the locality, or provided at no additional cost to HUD requirements. - unsubsidized tenants in the premises. b. Cbanges in the rent to owner shall be determined by the provisions of the lease. However, the owner may 7. Maintenance, Utilities, and Other Services not raise the rent during the initial term of the lease. a. Maintenance form HUD -52541 (8/2009) Prevlous editions are obsolete Page 9 of 12 ref Handbook 7420.8 (1) The owner must maintain the unit and (2) The owner may tenninare the tenancy during premises in accordance with the HQS. the term of the lease if any member of the (2) Maintenance and replacement (including household is: redecoration) must be in accordance with the (a) Fleeing to avoid prosecution, or custody standard practice for the building concerned as or confinement after conviction, for a established by the owner. crime, or attempt to commit a crime, that is a felony under the laws of the place b. Utilities and appliances from which the individual flees, or that, (I) The owner must provide all utilities needed to in the case of the State of New Jersey, is comply with the HQS. a high misdemeanor, or (2) The owner is not responsible for a breach of (b) Violating a condition of probation or the HQS caused by the tenant's failure to: parole under Federal or State law. (a) Pay for any utilities that are to be paid by (3) The owner may terminate the tenancy for the tenant criminal activity by a household member in accordance with this section if the owner (b) Provide and maintain any appliances that determines that the household member has are to be provided by the tenant committed the criminal activity, regardless of C. Family damage. The owner is not responsible for a whether the household member has been breach of the HQS because of damages beyond arrested or convicted for such activity. normal wear and tear caused by any member of the (4) The owner may terminate the tenancy during household or by a guest the term of the lease if my member of the d. Housing services. The owner must provide all household has engaged in abuse of alcohol housing services as agreed to in the lease. that threatens the heft safety or right to peaceful enjoyment of the premises by other 8. Termination of Tenancy by Owner residents. a. Requirements. The owner may only terminate the d. Other good cause for termination of tenancy tenancy in accordance with the lease and HUD (1) During the initial lease term, other good cause requirements, for termination of tenancy must be something b. Grounds. During the term of the lease (the initial the family did or failed to do. term of the lease or any extension term), the owner (2) During the initial lease term or during any may only terminate the tenancy because of: extension term, other good cause may include: (1) Serious or repeated violation of the lease; (a) Disturbmce of neighbors, (2) Violation of Federal, State, or local law that (b) Destruction of property, or imposes obligations on the tenant in connection with the occupancy or use of the (c) living or bousekeeping habits that cause unit and the premises; damage to the unit or premises. (3) Criminal activity or alcohol abuse (as (3) After the initial lease tern, such good cause provided in paragraph c); or may include: (4) Other good cause (as provided in paragraph (a) The tenant's fail= to accept the owner's d) offer of a new lease or revision; C. Criminal activity or alcohol abuse. (b) The owner's desire to use the unit for (1) The owner may terminate the tenancy timing personal or fly use or for a purpose - the term of the lease if my member of the other than use as a residential rental unit; household, a guest or mother person under a or resident's control commits my of the (c) A business or economic reason for following types of criminal activity: termination of the tenancy (such as sale of (a) Any criminal activity that threatens the the property, renovation of the unit, the health or safety o� or the right to owner's desire to rent the unit for a higher peaceful enjoyment of the premises by, rent). other resideats (including property (4) The examples of other good reuse in this management staff residing on the paragraph do not preempt any State or local premises); laws to the contrary. (b) Any criminal activity that threatens the health or safety o1; or the right to (5) In the case of an owner who is an immediate peaceful enjoyment of their residences successor in interest pursumt to foreclosure by, persons residing in the immediate during the term of the lease, requiring the vicinity of the premises; tenant to vacate the property prior to sale shall not constitute other good pause, except that the (c) Any violent criminal activity on or near owner may terminate the tenancy effective on the premises; or the date of transfer of the unit to the owner if (d) Any drag- related criminal activity on or the owner. (a) will occupy the unit as a near the premises. primary residence; and (b) has provided the tenant a notice to vacate at least 90 days before the effective date of such notice. This form HUD -62641 (6/2006) Previous editions are obsolete Page 10 of 12 ref Handbook 7420.8 provision shall not affect any State or local law more demanding standard than other tenants m that provides for longer time periods or determining whether to evict or terminate. addition protections for tenants. This provision will sunset on December 31, 2012 (6) Nothing in this section may be construed to limit unlessertended by law. the authority of an owner or manager to evict, or - the public housing agency to terminate assistance, a Protections for Victims of Abuse. to any tenant if the owner, manager, or public housing agency can demonstrate an actual and (1) An incident or incidents of actual or threatened imminent threat to other tenants or those employed domestic violence, dating violence, or stalking will at or providing service to the property if the tenant not be construed as serious or repeated violations of is not evicted or terminated from assistance. the lease or other "good cause' for termination of the assistance, tenancy, or occupancy rights of such (7) Nothing in this section shall be construed to a victim supersede any provision of any Federal, State, or local law, that provides greater protection than this (2) Criminal activity directly relating to abuse, engaged section for victims of domestic violence, dating in by a member of a tenant's household or any violence, or stalking. guest or other person order the tenant's control, shall not be cause for termination of assistance, £ Eviction by court action. The owner may only evict the tenancy, or occupancy rights if the tenant or an tenant by a court action. immediate member of the tenant's family is the victim or threatened victim of domestic violence, g• Owner notice of grounds dating violence, or stalking. (1) At or before the beginning of a court action to evict the tenant, the owner must give the (3) Notwithstanding any restrictions on admission, tenant a notice that specifies the grounds for occupancy, or terrainations of occupancy or termination of tenancy. The notice may be assistance, or any Federal, State or local law to the included in or combined with any owner contrary, a PHA, owner or manager may eviction notice. "bifurcate" a lease, or otbcnvise remove a (2) The owner must give the PHA a copy of any household member from a lease, without regard to owner eviction notice at the same time the whether a household member is a signatory to the owner notifies the tenant lease, in order to evict, remove, terminate (3) Eviction notice means a notice to vacate, or a occupancy rights, or terrains rc assistance to any complaint or other initial pleading used to individual who is a tenant or lawful occupant and begin an eviction action under State or local who engages in criminal acts of physical violence le.,. against family members or others. This action may be taken without evicting, removing, terminating 9. Lease: Relation to HAP Contract assistance to, or otherwise penalizing the victim of lawful if the HAP contract terminates for any reason, the lease terminates the violence who is also a tenant or automatically. occupant Such eviction, removal, termination of occupancy rights, or termination of assistance shall 10. PHA Termination of Assistance be effected in accordance with the procedures prescribed by Federal, State, and local law for the The PHA may teammate program assistance for the family for any termination of leases or assistance under the grounds authorized in accordance with HUD requirements. If the PHA housing choice voucher program. terminates program assistance for the family, the lease terminates automatically. (4) Nothing in this section may be construed to limit the authority of a public housing agency, owner, or 11. Family Move Out manager, when notified, to honor court orders The tenant must notify the PHA and the owner before the family moves addressing rights of access or control of the out of the unit property, including civil protection orders issued to protect the victim and issued to address the 12. Security Deposit distribution or possession of property among the a. The owner may collect a security deposit from the household members in cases where a family breaks tenant (However, the PHA may prohibit the owner UP. from collecting a security deposit in excess of private market practice, or in excess of amounts (5) Nothing in this section limits any otherwise charged by the owner to unassisted tenants. Any available authority of an owner or manager to evict such PHA - required restriction must be specified in or the public housing agency to terminate the HAP contract) assistance to a tenant for any violation of a lease b. When the family moves out of the contract unit, the not premised on the act or acts of violence in owner, subject to State and local law, may use the question against the tenant or a member of the security deposit, including any interest on the tenant's household, provided that the owner, deposit, as reimbursement for any unpaid rent manager, or public housing agency does not subject payable by the tenant, any damages to the unit or an individual who is or has been a victim of any other amounts that the tenant owes under the domestic violence, dating violence, or stalking to a lease. form HUD -52641 (8/2009) Previous editions are obsolete Page I I of 12 ref Handbook 7420.8 C. The owner must give the tenant a list of all items charged against the security deposit, and the amount of each item. After deducting the amount, if any. used to reimburse the owner, the owner must promptly refund the full amount of the unused balance to the tenant d. If the security deposit is not sufficient to cover amounts the tenant owes under the lease, the owner may collect the balance from the tenant 13. Prohibition of Discrimination In accordance with applicable equal opportunity statutes, Executive Orders, and regulations, the owner must not discriminate against any person because of race, color, religion, sex, national origin, age, familial status or disability in connection with the lease. 14. Conflict with Other Provisions of Lease a. The terms of the tenancy addendum are prescribed by HUD in accordance with Federal law and regulation, as a condition for Federal assistance to the tenant and tenant's family under the Section 8 voucher program b. In case of any conflict between the provisions of the tenancy addendum as required by HUD, and any other provisions of the lease or any other agreement between the owner and the tenant, the requirements of the HUD - required tenancy addendum shall control. 15. Changes in Lease or Rent a. The tenant and the owner may not make any change in the tenancy addendum However, if the tenant and the owner agree to any other changes in the lease, such changes must be in writing, and the owner must immediately give the PHA a copy of such changes. The lease, including any changes, must be in accordance with the requirements of the tenancy addendum b. In the following cases, tenant -based assistance sball not be continued unless the PHA has approved a new tenancy in accordance with program requirements and has executed a new HAP contract with the owner. (1) If there are any changes in lease requirements governing tenant or owner responsibilities for utilities or appliances; (2) If there are any changes in lease provisions governing the tern of the lease; (3) If the family moves to a new unit, even if the unit is in the same building or complex. c. PHA approval of the tenancy, and execution of a new HAP contract, are not required for agreed changes in the lease other than as specified in paragraph b. I The owner must notify the PHA of say cbsnges in the amount of the rent to owner at least sixty days before any such changes go into effect„ and the amount of the rent to owner following any such agreed change may not exceed the reasonable rent for the unit as most recently determined or redetermined by the PHA in accordance with HUD requirements. 16. Notices Any notice under the lease by the tenant to the owner or by the owner to the tenant must be in writing. 17. Definitions Contract unit The housing unit rented by the tenant with assistance under the program Family. The persons who may reside in the unit with assistance under the program. HAP contract The housing assistance payments contract between the PHA and the owner. The PHA pays housing assistance payments to the owner in accordance with the HAP contract - Household. The persons who may reside in the contract unit The household consists of the family and any PHA - approved live -in aide. (A live -in aide is a person who resides in the unit to provide necessary supportive services for a member ofthe family who is a person with disabilities) Housing quality standards (HQS). The HUD minimum quality standards for housing assisted under the Section 8 tenant -based programs.. HUD. The U.S. Department of Housing and Urban Development HUD requirements. HUD requirements for the Section 8 program. HUD requirements are issued by HUD headquarters, as regulations, Federal Register notices or other binding program directives. Lease. The written agreement between the owner and the tenant for the lease of the contract unit to the tenant the lease includes the tenancy addendum prescribed by HUD. PHA. Public Housing Agency. Premises. The building or complex in which the contract unit is located, including common areas and grounds. Program The Section 8 housing choice voucherprogram Rent to owner: The total monthly rent payable to the owner fir the contract unit The rent to owner is the sum of the portion of rent payable by the tenant plus the PHA housing assistance payment to the owner. Section 8. Section 8 of the United States Housing Act of 1937 (42 United States Code 14371), Tenant The family member (or members) who leases the unit from the owner. Voucher program. The Section 8 housing choice voucher program Under this program, HUD provides funds to a PHA for rent subsidy on behalf of eligible families. The tenancy under the lease will be assisted with rent subsidy for a tenancy.under the voucher program. form HUD-S2641 (8/2009) Previous editions are obsolete Page 12 of 12 ref Handbook 7420.8 � i:llll'J [YI In accordance with U.S. Department of Housing and UrbanDevelopmerrt (HUD) policy issued in the Federal register effective August 18, 1990, tl, following paragraphs are incorporated byreference into the Section 8 Certificate/voucher Lease: The Housing Authority of the City of Sou&B end, Indiana: 1. May deny or terminate assistance if the preponderance of evidence indicates that a famly member has engaged in ding- related criminal activity or violent criminal activity, regardless ofwhetherthe familymemberhas been arrested or convicted; and 2. Shall have the discretion to consider all of the circumstances in each case, including the seriousness of the offense, the extent of participation by family members, and the effects that denial or termination would have on family members not involved in the proscrib ed activity. The Housing Authority, in appropriate cases, may permit the remaining members of the family to continue receiving assistance and may impose a condition that fimiily memb ers determined to have engaged in the proscribed activities will not reside in the unit . The Hon' . �Oriiy may require a family member that has engaged in the illegal use of drags to submit evidence of successful completion of a treatment program as a condition to being allowed to reside in the unit Tenant Signature Date C) Landlord Signature Date m Section 8 Transfer Procedures If your rental unit has failed any Housing Quality Inspection, you have the option to transfer on the Section B Program. The following describes the procedure you should follow: 1) You must wait until payment has been discontinued before you can be issued a transfer voucher. But, after the unit has failed the inspection and the landlord has not made the repairs, in timely manner, you should immediately start searching for a new rental unit that will pass inspection. 2) Schedule an appointment with your Housing specialist for a transfer interview. You will receive a transfer voucher and a Request for Tenancy Approval (RTA). 3) After you have located a unit for rent, the RTA must be completed by you and the potential landlord. This RTA needs to be returned to the office before the expiration date of your new voucher. 4) Once your RTA has been properly completed and turned in to your Housing Specialist, and the rent amount is approved, your unit will be Inspected within 48 hours. 5) After the unit has been inspected, you will receive a letter stating whether the unit passed or failed the inspection. 6) If the rental unit passed the inspection the landlord and tenant will be contracted to schedule an appointment to sign the contract. If you decide to transfer one year after residing at the same rental unit, you must give your landlord a thirty (30) day written notice no later than the first day of any given month in which you decide to move. This notice Is to become effective at the end (or the last day) of the month you have chosen. THEN FOLLOW THE SAME PROCEDURE AS INDICATED ABOVE. Note: Prior to receiving a transfer voucher you must not owe the Housing Authority any monies; any rent due to your landlord must be paid (written proof from landlord). All utilities must be.paid up to date (you must show proof) and you must be able to have all of your utilities connected in your name. If after rental payments have been discontinued by the Housing Authority and you are still residing in the rental unit, you are RESPONSIBLE FOR YOUR OWN RENT. IF YOU FAIL TO CONTACT THE HOUSING AUTHORITY WITHIN 30 DAYS AFTER RENTAL ASSSISTANCE HAS DISCONTINUED (OR CANNOT BE FOUND IN GOOD STANDING ON THE PROGRAM WITHIN THIS TIME FRAME) ANDIOR YOU MOVE OUT OF YOUR RENTAL UNIT WITHOUT FOLLOWING THESE PROCEDURES. YOU WILL BE AUTIOMATICALLY TERMINATED FROM THE SECTION 8 PROGRAM. Transfer procedures have been explained to me and I have read and understand that I have the right to transfer under the HUD Rules and Regulations of the Section 8 Rental Assistance Program. I also understand that these procedures are final and must be followed in order to continue my Section 8 Rental Assistance. Section 8 Participant Date = N M X �! mZ Section 8 Landlord Date Section 8Landlord Cerdneadon REGARDfiTG PR OPHRTYADDRESS: Ownersh p of AseWed Unit I cmiify that I am the legally designated agent for the above referenced unit and that the prospective tenant has no ownership interest in this dwelling unit whatsoever. Approved Residents ufAssisted Unit i understand that the family members listed on the dwelling lease agreement as approved by the Housing Authority are the only individuals permitted to reside in the unit. I also understand that I am not permitted to five in the unit while I am receiving housing assistance payments. HousmE QuaL*fy Standards" _ I understand my obligations in compliance with the Housing Assistance Payment Contract (HAT) to perform necessary maintenance so the unit continues to comply with Housing Quality Standards. Security Deposit and tenant Rent Payments I understand my obligations in compliance with the Housing Assistance Payment ' Contract Wp) to perform necessary maintenance so the unit continues to comply with Housing Quality Standards. Security Deposit and Tenant Rent Payments I understand the amount of security deposit is not more than the equivalent of one months rent and is an agreement between the owner and tenant, and is payable by the tenant I also understand the tenants' portion of the contract rent is determined by the Housing -Authority, and that it is illegal to charge any additional amounts forrent which have not been specifically approved by the Housing Authority. Rep ortinE Vacancies to the HnnSIIlE Authority I understand that should the assisted unit become vacant, I am responsible to notify the Housing Authority immediately in writing. Mmfn straiive and Criminal Actions for Intentional Violations I understand that failure to comply with terms and responsibilities of the Housing Assistance Payments Contract is grounds for termination of participation in the Section 8 Program. I understand that knowingly falsifying material facts is a violation of state and . federal criminal law. • m� Signature of OwnedAgent Date m Z Warn.ing: Title 18 Code Section 1001 states that a parson is quality of a felony for knowingly and willingly mating false fraudulent statements to any Department or Agency of the United States. State Law may also provide penalties for false or fraudulent statements. Y?OLEANOi, 9D.AMiG `JIOyl iCE U.S. Department of Housing OMaAppmvW No. 2502 -0204 OR ST n31 MNG and Urban (Development Exp. DMM014 Office of Housing LEASE ADDENDUM VIoYLN'CE AGAINST WOm EN AiND JusTICE 1DEPARTNMN1 RFADTnoBjj&TioN ACT of 2005 TENANT LANDLORD UNIT NO. &ADDRESS This lease addendum adds the following paragraphs. to the Lease between the above referenced Tenant and Landlord. Purpose of the Addendum The lease for the above referenced unit is being amended to include the provisions of the Violence Against Women and Justice Department Reauthorization Act of 2005 (VAWA). Conflicts with Other Provisions of the Lease In case of any conflict between the provisions of this Addendum and other sections of the Lease, the provisions of this Addendum shall prevail. Term of the Lease Addendum The effective date of this Lease Addendum is This Lease Addendum shall continue to be in effect until the Lease is terminated. VAWA Protections I. The Landlord may not consider incidents of domestic violence, dating violence or stalling 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. 2. 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 teirnination 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. 3. The Landlord may request in writing that the victim, or a family member on the victim's behalf, certify that the individual is a victim of abuse and that the Certification of Domestic Violence, Dating Violence or Stalking, Form HUD- 91066, or other documentation as noted on the certification form, be completed and submitted within 14 business days, or an agreed upon extension date, to receive protection under the VAWA Failure to provide the certification or other supporting documentation within the specified timeframe may result in eviction Landlord Date Date Form HUD -91067 MMMM Description ofheident: In your own words, describe the incident (Attach more sheets if needed. Initial and number each attachment.): This is to certify that the information provided is true and coaect, and that the individual named above in Item 2 is a victim of domestic violence, dating violence, or stalking. The incident(s) in question is a bona fide incident(s) of such actual or threatened abuse. I acknowledge that submission of false information obuld jeopardize program eligibility and could be the basis for termination of Section 8 project -based assistance or eviction from assisted properly. Signature Executed on (Date) Pursuant to 42 U.S.C. 1437f(ee)(2)(A), all information provided to an owner or management agent related to the incident(s) of domestic violence, dating violence or stalking, including the fact that an individual is a victim of domestic violence, dating violence 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 Form HM -91066 (9!1008) CERTIF CATION 07 D® a STIC II,S. De a�ei3t of �ens�o —IOg E1�iC DAT1IIgO ®ANC P m OMB Approval No. 2602.0204 and Urban Development Fop. 03/3112014 OR STA]LFING Office, of Housing Public reporting burden for this collection of information is estimated to average 1 hour per response. This includes the time for collecting, reviewing, and reporting the date. laformation provided is to be used by owners and management agents administering Section S project-based assistance under the United States Housing Act of 1937 (42 U.S.C. 1437) to request a t mm to certify that the individual is a victim of domestic violence, dating violence, or stalking. The information is subject to the confidentiality requirements of the HUD Reform Legislation. This agency may not collect this information, and you are not required to complete this farm unless it displays a currently valid OMB control number. Purpose of Form: The Violence Against Women and Justice Department Reauthorization Act of 2005 protects qualified tenants and family members of tenants who are victims of domestic violence, dating violence, or stalling (collectively "domestic violence') from being evicted or terminated from housing assistance based on acts bfsuch violence against them. Use ofForm: If you have been a victim of domestic violence, you m a family member on your behalf most complete and submit this certification form, or submit the information desedbed below under "Alternate Documentation," which may be provided in lieu of the certificationfomt, within 14 business days of receiving the written request fir this certification form by the owner or management agent The certification farm or alternate documentation must be returned to the person and the address specified in the written request for the red i5cation fi®. If the requested certification form or the information that may be provided in lieu of the certification firm is not received by the 14t1t business day or any extension of the date provided by the owner or management agent, none of the protections afforded to vietims of domestic business under the Section S project -based assistance progrdm.wlll apply. Distribution m issu ®ce of this form does not serve as awritten request for certif catam Alternate Documentation: In lies of this certification form (Orin addition to it), the following documentation may be provided: (1) A federal, state, tribal, temtorial, or local police or court record; or (2) Documentation signed by an employee, agent or volunteer of a victim service provider, an attorney or medical professional, from whom the victim has sought assistance in addressing the domestic violence, dating violence or stalking, or the effects of abuse, in which the professional attest under penalty of perjury (2s U.S.0 1746) to the professional's belief that the incident(s) in question are bona fide incidents of abuse, and the victim has signed or attested to the doommeatation. TO BE COMPLETED BY OR ON BEHALF OF THE VICTIM OF DOMESTIC V10LENCE: 1. Date written request is received from owner or management agent: _ 2. Name of victim: 3. Your name (if different): 4. Name(s) of other family members listed on the lease: 5. Name of the abuser: 6. Relationship of the abuser to the victim: 7. Date of incident: S. Time of incident: 9. Location of incident: (Page two must be completed and attached to this form.) Form HUD -91066 MOM �� nn �°� 'em�ff Give Fom'io tl'le Form I� ReqC9G5'L Te.J:L(?ayG6' (Rev. January 2011) 5 Identification Nunaba and] CE„ rd loation requester. Do not DRW.Jnantoft2011) sury send tothe IRS. Irdemai Rawnue Smuirs Name Iw shown on your Income tax retum) N Business nab disregarded entity name, if different from above m m m a Check appropriate box for federal tax c c ciassHkation (required): Q Indviduaysole pmpdebr ❑ C Corporation ❑ S Corpornticn ❑ Partnership ❑ Tmst/estais m o ❑ Exempt payee ppy ❑ I Indted IlabNty. company F�rthe tax classification (C =C corporation.* S=S corporation, P--partnership) rr o C m y❑ U other (see Instructions) P w Address (number, street, and apt rx suite no.) Requesters name and address (opOOna) c m a W m City, state, and ZIP erode m u1 Ust account numbers) hem (optional) Taxpayer Identification Number LTIN) Faster your TIN in the appropriate box. The TIN provided must match the name given on the "Name" line I Social security number ,' ,' .' .' .' .' . • • i to avoid backup withholding. For Individuals, this Is your social security number (SSM. However, for a resident alien, sole proprietor, or disregarded entity, see the Part I Instructions on page 3. For other entitles, It Is your employer identification number (EIM. If you do not have a number, see Now to get a TIN on page 3. Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose lEmployeridentificafforfrximber. number to enter. m UP Ma Certification I I ' I L 11 Under penalties of perjury, I certify that 1. The number shown on this form Is my correct taxpayer Identification number (or I am waiting for a number to be issued to me), and 2 I am not subject to backup withholding because: (a)1 am exempt from backup withholding, or (b) I have not been notified by the Intemal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all Interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3. 1 am a U.S. citizen or other U,S, person (defined below). Certification Instructions. You must cross out Item 2 above If you have been notified by the IRS that you we currently subject to backup withholding because you have failed to report all Interest and dividends on your tax return. For real estate transactions, Item 2 does not apply. Fornodgaga, ' . interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an Individual retirement a m4smant (IFW. and' generally, payments other than Interest and dividends, you are not required to sign the certffication, but you must provide your corW(11 j,F,6/ai,,_ instructions on oaoe 4. H 9 S19naftwe of e I 11.5. person P Date G General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Purpose of Form A person who Is required to file an information return with the IRS must obtain your correct taxpayer Identification number (fIM to report, for example, Income paid to you, real estate transactions, mortgage Interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA. Use Forth W -9 only If you are a U.S. person (including a resident alien), to provide your correctTlN to the person requesting It (the requester) and, when applicable, to: 1. Certify that the TiN you are giving is correct (or you are waiting for a number to be Issued), 2. Certify that you are not subject to backup withholding, or S. Clelm exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S, person, your allocable share of any partnership Income from a U.S. trade or business Is not subject to the withholding tax an foreign partners' share of effectively connected Income, Nome. If a requester gives you a form other than your TIN, you must use the requester's form It it to this Form W -9. Definition of a U.S. person. For federal tax purposes, you we considered a U.S. person if you are: • An Individual who is a U.S. citizen or U.S. resident alien, • A partnership, corporation, company, or association created or organized In the United States or under the laws of the United States, • An estate (other than a foreign estate), or • A domestic trust (as defined in Regulations section 301.7701 -7). Special miss for partnerships. Partnerships that conduct a trade or business In the United States are generally required to pay a withholding tax on any foreign partners' share of Income from such business. Further, In certain cases where a Forth W -9 has not been received, a partnership Is required to presume that a partner is a foreign person, and pay the withholding tax Therefore, if you we a U.S. person that Is a partner in a partnership conducting a trade or business In the United States, provide Forth W -9 to the partnership to establish your U.S. status and avoid withholding on your share of partnership Income. Cat No. I=1X Forth Yfd-J (Rev. 1-2011) p it! TZ L M 10 TENANCY AD DEi muya Section 8 Teltant Eased Assistance Housing Choice Voucher Pr earam (To be attached to Tenant Lease) Section 8 Voucher Program a The Dauer is leasing the contract unit to the tenant liar orcvpaucy byflre te- s farmly with essistarw for a tenancy under the Section 8 housing choice voucher program (vouch= program) of the United States Department of Housing and Urban Development (HUD). b. The mvner has entered into a Housing Assistance Payments Callas[ (HAP o3aftaclj with the PHA under the voucher program. Under the HAP contract. the PHA will make housing assistance payments to the owner to assistt[n tensor in leasing the unit from the owner. 2. Lease The owner bas given the PHA a copy of the lease, including MY mvistons agreed by the owner and the tenant The owner certi5cs that the terms of the lease are in accordance with all provisions of the HAP contract and that the lease mehrdes the eocy addendum The tenant shall have the right to enforce the truancy addendum against the owner if there is any conflict beta era the tenancy arldend ,m and any other provisions of the lease, the language of the tenancy addendum shall control- 3. Use of Contract Unit a During the ]ease term, the fey will reside in the contract unit with assistance render the voucber program- b. TTn composition of the household must be approved by the PHA The family must promptly mftm the PHA ofthe birth, adoption ormurt awarded custody of a Auld. Other persons may not be added to the household without prior written approval of the ovmrrand the PHA- C. Ile contract unit may only be used for rrsideoa by the PHA -approved household members The unit must be the famdys only residenx Ivkmbca of the household may engage in legal profit making activities incidental to primary use of the unit fur residence by members ofthe family. d. The tenant may not sublease or het the unit C. The temutmay not assign the lease orfrausfrrthe unit 4. Rent to Owner E. The initin] rent to owner may not exceed the amount approved by the PHA in accordance with HUD mqu'vements b. Changes in the rani m owns shall he determ ined by Cnpmvisbm oftbe lease. However, fbe owner may not raise the rent during the initial term ofthe lease. D. During the term of the lease (including the initial term offhe least and any eodirnsion term] ft tent to ownermayat no time exceed U.B. Department of Housing and Urban Development OiBce ofPublic audindianHa, OMB Approval No. 7577 -0169 Exp. M012014 (1) The reasonable rent for the unit as most recently determined m redetermined by the PHA in accordance with HUD r,W"me..ts, W (2) Rem charged by the owacrfor comparable unassisted units in the *premises 5. Family Payment to Owner B. the family is responsible for paying tin o any Portion oftbe rent to owner that is not covered by the PHA housing assisfanrlpayment b. Each month, the PHA will make a housing assistance payment to the owner on behalf of the famIIy in accordance with the HAP conhact The amount of fhe morfhly housing assisrarve payment will be determined by the PHA in accordance with HUD ram for a tenancy under the Section 8 vo»dcrpragram c the moulbly hou in asc'sm, payment shall be credited against the maNhly, rent to olh= for the contract unit d. Tbe'tenant is notresponsrble for payingthe portion Of rent to owner covered by the PHA housing ascisfEoM payment under the HAP 000tract beMeen the owner end the PHA. A PHA fail= to pay the housing assistaexr payment to the owner is not a violation ofihe lease. The ownermay not terminate the tenancy for nonpayment of the PHA housing assistaocepaymeot M The owner may not charge, or accept, from the family or from any other soma, any payment for rent of the unit in addition to the rent to owner. Rent to Owner includes all bo sing services, roam_!+, : utr7ities and appliances to be provided and paid by the owner in accordance with the lease. f The owarmust Mamrduntelyrehaa any Mors; rent paymentto the tenant 6. Other Fees and Charges Rent to owner does not include cost of nay meals a supportive services or fvmiture which may be provided by the corner. The owner may not rerpdre the tenant or family members to Fay charges for any meals a supporthe a rvias or firmiti which may be pmvirkd by the owner. Nonpayment of any such charges is not grounds fortemrioationoftenancy. Tire owncrmay not charge the tenant extra amounts far items customadly included in lent to owner in the locality, or provided at no additional cast to vasubsidiud tenants in the premises. 7. Maintenance, Utilities, and Other Services a Maintenance (1) The owner must maintain the unit and premiers in armrdauce withthe HQS. (2) Nfanrtuarict: and replacement (including form HUD Previous editions are obsolete .52641 -A (Woos) ref Handbook 7420.8 redecoration) must be in accordance with the stzodard practice for the building c®cemed as eslablishedby the owner b Utilities and appliances (1) The ownermustpmvide allutTitiesaerkdb c arplywithtbeHQS. (2) The owner is not responvbk for abreach of tbeHQS caused bythe tenant's failure to: (a) Payforanyutifdiesthataretobepaidby the tenant (b) Provideandmaintam aoyappliazxrsffiat arc to be provided by the tenant c Family dammae. The owner is mtresponsible for a breach of the HQS because of damages beyond normal wcat and tear caused by my member of tle household or by a guest d Housing services. The owner must provide all housing services as agreedto inthe lease. 8. Termination of Tenancy by Owner a. Regnirements. The owner may only terming the tenancy in accordance with the lease and HUD mquirmvnlc b Grounds. Dining the tean of the lease (the initial tam ofthe lease or any o0tas!nn term), the owner mayonlyterm;nntr the tenancy because of. (1) Serious or repeated violation of the lease; (2) Violation of Federal, State, or local law that imposes obligations on the tenant in connection with the occupancy or use of the unit and the premises; (3) Criminal activity or alcohol abuse (as pmvidediaparogmph * or (4) Other good cause (as provided in paragraph d). c Criminal activity or alcohol abase. (1) The owner may terminate the tenancy during the term of the lease if any member of the household, a guest or another person under a resident's control commits any of the followingtypes of criminal activity: (al he,i0uactivitYfl�fh rightt the praceUeojoymeotafftpem=b y, otherresideots (Including 1mperty manaegement staffresddiog onthe pcmrssrs); (b) Anymminal ectivityfl�etibrraemflue bealth or safety ot; car the right to paceful rnjoymea of their r sdeaces by persons resid'mg in the immediak vicinity oftbe premises; (c) Any violrmcriminal activity onornear the penises; or (d) Any druuglllakdmmmal SWAY oaor near the premises. (2) The owner may terminate the tenancy during the term of the lease if any member of the householdis: (a) Fleeing to avoid proseuntion, or custody or confinement after conviction. for a ®e, or attempt m commit acrimq that is a felony under the laws of the place from which the individual fees, or that, in the case of the State of New Jersey, is atagh isdar eancanor (b) Violating a condition of probation or parole under Federal m State law. (3) The owner may term;narn the tenancy for criminal activity by a household member in accordance with this section if the owner determines that the household member bas committed the criminal activity, regardless of whether the household member bas been arrested or convicted for such activity. (4) The owra may te®inata the Innancy during the term of the lase if any member of the household has engaged is abuse of alcohol that threatens the healthy safety or right to peao.fil emjoymerl of the premises by other residents. d Other good cause for termination of tenancy (1) During the initial lease terry other good cause for teermmation of tenancy mast be something tee family did orfailedto do. (2) Dining the initial lease term or during any ealmsimteon, other good causeway include: (a) Disturbance of neighbors, (b) Destruction of property, or (e) Uvingorbousereepingbabitsibecause damage to the unit orptemiscs. (3) After the ainitial lease term, such good cause mayinclud;: (a) Thownam'swurttoacceptiboowoces oils ofancw lease orrevision; (b) The owner's desire to use the unit for personal or family use or for a purpose otlher than use as aresideotial rental u ni; or (c) A business or economic reason for termination of the tenancy (such as sate of the property, renovation of the umii, the owneds desire to rent the unit for a higbrr rent). (4) The examples of other good cause in this paragraph do totpeempt any Stele or local laws to the contrary. (5) In the case of an owner who is an immediate successor in interest pursuant to foreclosure during the tern of the lease, requiring the tenant to vacate the property prior to sale shall not constitute othe good ream, eurept Poat the owner may tenninate the tenancy effective on the date of transfer of the unit to the owner if the owner: (a) will occupy the unit as a primacy residers; and (b) has provided the tenant a nmicx to v=te at ]cast 90 days before the effective date of such notice. This provision shall not affect any State or local law that provides for longer time periods or addition protections for tenants. This provision will sunset on December A 2012 unless extended by law. form HUD-52641 -A (812009) Previous editions are obsolete ref Handbook 7420.8 e Protections for Victims ofAhnsa (1) An incident or incidents of actual or threatened domestic violence, dating vioteeoe, or sWkmg will not be construed as sous or mpeaM1d violations of the lease or other -good cause" for te®inatton of the assistance, teoaocy, w oceupaucytigbts of such avictim. (2) C�*"'mT activity directly relating to abuse, cnga„eed in by a member of a tenant's household or any guest or other person under the tersars contot Shall not be cause for termination of assistance, tenancy. or occupancy rights if the tenant or an ®mediate member of the tenants family is the victim or threatened victim of domestic violence, datmgmolwce, or stalling. (3) NotwithMa. nd any restrictions on admission, occupancy, or ttrminat• ns of occupancy or as95ance, or say Federal, State m local law to [be contrary, a PHA, owner or manager may "bifurcate" a lease, or otherwise remove a household member Sam a lease, without regard to whether a household member is a signntory to the lease, in order to evict, remove, terminate occupancy rights, or termate in a«icn,nr. to any bxNdual who is a tenant or lawful occupant and wbo engages in criminal acts of physical violence against family members or others. This action may be taken without evicting removing tnrminafi g assishance to, or otherwise peoaliang the victim of the violence who is also a tenant or lawful occupant Such eviction, removal, tem oration of ooarpaac5' rights, or termination of assistance shall be effected m accordance with the procedures prescribed by Federal, State, and local law fm the termination of ]eases or assistance under the ]musing choice voucher program (4) Nothing in this section may be construed to limit the aubmity of a public homng agency, owner, or manager, when noticed, to honor court orders addressing rights of access or control of the property, including civil protection orders issued to protect the victim and issued to address the distribution or possession of property among the bousehold members m cases where a family break, UP- (5) Nothing in this section limits any otherwise available aubority of an owner or manager to evict or the public housing agency to terminate anWance to a tcnani for any violation of a lease not premised on the act or acts of violence in question Against the tenant or a member of the teoaat's household, provided that the owner, manager, or public housing agency does not subject an individual who is or has been n victim of domestic viclmr daring violencq or Slalk,;ing to a more demanding standard than other tenants in defining whethwm eykd mterminate. (6) Nothing in this section may be construed to limit the avtbority of an owner or manager to evict or the public housing agency to tam in assisancc, to any tenant if the owner, manager, or public Previous edrdons are obsolete housing agency can demonstrate an actual and imminent threat to othericoaots or those employed at or providing service to the propertyfftbe tenant is not evicled or terminated fi'orn aacista (7) Nothing in this section shall be construed to supersede any provision of any FedemL State, or local law that provides greater protmarm than this section for victims of domestic violence, dating violence, or stalldog. Z Eviction by court anion The owner may ontymictthe tenant by a count action g. Owner notice of grounds (1) At or before the beginning of a court action to evict the tenant, the owner must give the tenant a notice that Specifies the grounds for ftclemallon of icy Ile notice may be included in or combined with any owner eviction notice. (2) The owner must give the PHA a copy of nay owner eviction notice at the same time the owner Entities the teoent (3) Evictba notice meam a notice to vacatr or a complaint or otber initial pleading used to begin an eviction action under State or local law. 9. Lease: Relation to HAP Contract If the HAP contract terminates for any reason, the lease terminans .Ttnmatically. 10. PHATermiumtionofAssistance The PHA may terminate program assistance for the family for any grounds anflvi • . i in accordance wath MM regmremcotr, If the PHA m-nn'natn program assistance for the family, the lease to o nar s ampmatically 11. Family Move Out The tenant must notify the FHA and the owner before the family moves out of Poe unit 12 Security Deposit a The owner may ,�FJaA�� deposit from the from co may pmlubd ft owner blasting a security deposit in excess of private mmiet practice, or m excess of amounts charged by the owner to unassisted tenants. Any such PRA-reTured restriction must be specified in the HAP contract) h When the family moves out of the motsct unfit the owrer, subject to Slate and local law, may use the security deposit including any interest on the deposit, as reimbursement for any unpaid rent payable by the tenant any damages to the unit or any other am ts oun that the tenant owes ruder the I ease. a The owner must give the tenant a list of all items charged agemsttthe accurity deposit and the ammnrt of each item ARer deducting the amount if art used to reimburse the owner, the owner must Promptly refund the till amount of the umtued halance to the tenant form h10D•152641 -A (=Dog) ref Handbook 7420'.a d. If the security deposit is not sufficient to cover amouatsibette, owes underthe least'theowner may colleexthe balance fromthe tenant 13. Prohibition of Discrimination In accordance wvh applicable equal opportunity statutes, ExeCut= Orders, and regulations, the owner must not disrmmmate agaiost any person because of racy color, religion, sex, national origin, agc, f=lw status or disability in conoectionwiththe leases 14. Conflict with other Provisions of Lease a The terms of the tenancy addendum are prescribed by HUD in accordance with Federal law and regulation, as a condition for Federal assistance to the tenant and tenant's family rmder Bee Section 8 wurLer program. b. In rue of any mutlid behmen the povisiom of the tenancy addendum as required by HUD, and any other provisions of Bee ]ease a any oter agreement between the owner and the t®aat, the rzqilremmits of the HUD - required tenancy addendum shell control. 15. Changes in Lease or Rent a The tenant and the owner may not make any change in tiro tenancy addmfimm. Hm+oveS if the tenant and the owner agree to any oiler changes in the lead such changes must be in writing, and the owner must immediately give the PHA a copy of such changes. The least' including any ehmmges, must be in accordance with the requirements of the tenancy addendum b. Inthefollowiutig cases, truant -based assistance shall not be continued unless the PHA has approved a new tenancy in accordance with program requirements and has executed a new HAP contract with the owner: (1) If Bile are any changes in lease requirements governing tenant or owner respotmlrilliles for utilities or appliances; (2) Ifthere are any changes in lease provisions govemingthetean ofthe lease; (3) If ft familymoves to anewunk avmffthe unit is inthe same buildingor comp c PHA approval of the tenancy, and execution of a new HAP contract, are not required for agreed changes in the lease other than as specified in h d The owner must notify the PHA of any changes m tiro amount of the rent to owner at least sbdy days before any such changes go Into effect, and the amount of the rent to owner following any such agreed change may not exceed the reasonable rent for the unit as most recently determined or rid by the PHA in accordance with HUD requfiemer s. 16. Notices Anynotice, fmleasebythetmanttothe�mbytheowner to the tconnt must be in writing. 17. Definitions Conbaetmdt Tbebousingtuil =tedbytbeteomuw min^' undertbeprogmm Previous editions are obsolete Family. Tbepersons who mayrrside in the unitwithasistance under theprogram. HAP contract Tlic heusmg assistance payments contract txsvetathe PHA and the owner. The PHA pays lousing amsemen payments to the owner in accordance with the HAP cordrwL Household. The persons who may reside in the contractim2 The household consists ofthe trolly and any PHA - approved live -in aide. (A iwe-in aide is ape<son wbo resides in tbe and to provide necessary supportive services for amemberofthe &33ilywbo is a person with disabilities.) Housing quality standards (HQS). The HUD minimum quality standards frs housing aszistod tinder the Section 8 Rat -based progams HUD. The U.S. Department ofHousmg and Urban Development HUD requirements HIID requirements for the Section 8 program. IM t *Iumments=issurdbyRMheadquadas, asregulahats, Federal Register notices or other binding program directives. lease The written agreement between the owner and the tenam for the Iease of ft ,rumot unit to the tenant. The lease includes tbetenancy adrkndrmm prescribed by HUD. PHA. PublicHousmg.4gency. Prmrisu. The building or complexinwbichthe touted unit is located including carmunies and grounds. Proe' rum. The Sec[ 8 houdag choice voucberpmgram Rentto owner. The totalmouBflymntpayabletoffie owe fnr6e contract unit The rent to owner is to sum ofthe portion of rent payable by the tmantplts the PHA housing assistance paymeRt0 the owner. Section 8. Secdon 8 oftheUruted States Housing Act of 19.37 (42 United States Code 14374 Tam t Ibe family m® ter (a members) wbo leases the colt from the owner. Voucher program. The Section 8 housing choice voucher pmgmm Undr'rih s program, HUD pmmvidrsfuodsto aPHAforreot subsidy on behalfcfeligNcfuu,j S. netenancy under the lent will be assisted with rr& subsidy for a tenancy M*Z the voucher program. form HUD- 52641 -A (8/2009) ref Handbook 7420.8 )