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HOUSING CHOICE VOUCHER PROGRAM – FORMS FOR LANDLORDS

On this page are descriptions of the various forms that landlords might encounter when participating in the HCV program. The forms are divided into two sections: standard HUD and IRS forms, and forms that PHAs develop internally based on their own policies and procedures. Please note, PHAs have flexibility in how they administer their HCV program. The information on this webpage provides a general idea of the types of forms, and content of the forms that landlords will encounter, but we strongly encourage all landlords to contact their local PHA and request their HCV program forms.

STANDARD FORMS

The below are standard forms, with links, that PHAs are required to use when administering their HCV program.

WHAT: A form that the landlord and PHA complete that governs the housing assistance payments under the Housing Choice Voucher Program. It is a HUD contract that governs the relationship of the PHA and the landlord. It consists of three parts: Part A: Contract Information, Part B: Body of Contract, and Part C: Tenancy Addendum. The Tenancy Addendum is in addition to the rental lease that the landlord will require from the family; however, where the Addendum covers an item in the rental lease and differs from the rental lease, the Addendum takes precedence.

Expect to be asked to provide:

  • Name of family
  • Address of unit including any apartment number
  • Names of household members; indicate if any of these people is an approved live-in aide
  • First and last date of the initial lease term
  • The initial monthly rent to the landlord during the initial lease term
  • The initial amount of the monthly housing assistance payment
  • The type of utilities and appliances to be supplied by the landlord and also the utilities and appliances to be supplied by the tenant
  • Signature, date, and mailing address for payments
 

WHAT: A form that the family gives to the landlord. The landlord completes and returns to the PHA to initiate the process of family move-in.

Expect to be asked to provide:

  • Name of PHA
  • Address of unit, and number of bedrooms, and year constructed
  • Request start lease date
  • Proposed rent
  • Amount of security deposit
  • Date the unit will be available for inspection
  • Unit structure type
  • Unit subsidy (if any)
  • The type of utilities and appliances to be supplied by the landlord and also the utilities and appliances to be supplied by the family
  • Certification that unit rent is comparable other unassisted owned units
  • Certification that landlord is not family member related to family as described in RFTA
  • Unit’s lead-based paint status
  • Signatures, dates, telephone numbers, and mailing addresses of landlord and family
 

WHAT: A form that the landlord attaches in its entirety to the rental lease that the landlord requires of the family. If the Addendum differs from an item in the rental lease, the Addendum takes precedence.

The landlord does not fill out this form.

 

WHAT: A form of the Department of Treasury Internal Revenue Service (IRS) that the landlord sends to the PHA providing information that will allow the PHA to submit federal tax-related information to the IRS.

Expect to be asked to provide:

  • Name
  • Business name (if any)
  • Federal tax classification
  • Exemptions (if any)
  • Address
  • Account numbers (optional)
  • Taxpayer identification number (either social security number of employer identification number)
  • Signature and date
 

WHAT: The inspection checklist (HUD-52580) contains a checklist of the areas of a housing unit that should be inspected under any HUD-established physical inspection standards such as the housing quality standards (HQS).

The inspection form (HUD 52580-A) contains a description of item pass or fail conditions as well as a checklist of the areas of a housing unit that should be inspected under any HUD-established physical inspection standards such as the housing quality standards (HQS).

The landlord does not fill out this form.

 

WHAT: The document that a prospective family receives from the PHA that allows the family to access HUD housing rental subsidy. It includes information important for the landlord such as the date that the voucher (or the voucher extension) expires and the unit size for which the family is approved. In addition, it provides information about the program, actions required before the lease is executed, family responsibilities, and program requirements.

The landlord does not fill out this form.

 

WHAT: A form that the landlord and PHA complete that governs the housing assistance payments under the HCV Program. It is a HUD contract that governs the relationship of the PHA and the landlord. It consists of three parts: Part A: Contract Information, Part B: Body of Contract, and Part C: Tenancy Addendum. The Tenancy Addendum is in addition to the rental lease that the landlord will require from the family; however, where the Addendum covers an item in the rental lease, the Addendum takes precedence.

Expect to be asked to provide:

  • Name of family
  • Address of the manufactured home space and zoning designation of that space
  • Names of household members. Indicate if any of these people is an approved live-in aide
  • First and last date of the initial lease term
  • The initial space monthly rent to the landlord during the initial lease term; this includes maintenance and management charges for the space, and charges for landlord-paid utilities
  • The initial amount of the monthly housing assistance payment
  • The type of utilities and appliances to be supplied by the landlord and also the utilities and appliances to be supplied by the family
  • Signature, date, and mailing address for payments

OTHER COMMON PHA FORMS

The below are descriptions of non-standard forms that each PHA develops internally. While each PHA’s forms may look different, the descriptions provide a general sense of the purpose and the information that may be collected on each form.

What: A form that the landlord provides to a PHA requesting that the PHA allow additional time for the landlord to complete certain specific deficiencies that were noted during a prior HQS inspection. Deficiencies may be weather or non-weather related. The form would allow property to remain eligible for the HCV program. All other deficiencies would be required to be completed within re-inspection time of 24 hours or 30 days, depending on the deficiency.

Expect to be asked to provide:

  • Name of family and voucher number
  • Address of property
  • Date of HQS inspection
  • Specific list of deficiencies for which extension is requested
  • Written explanation and third-party documents that support claim that deficiency correction is beyond landlord control (non-weather related extension)
  • Landlord contact information
 

What: A form that landlords in the HCV program complete and return to the PHA to request a rent increase after the initial lease term. The landlord must submit the request to the PHA at least 60 days before the rent increase will go into effect.

Expect to be asked to provide:

  • Family name and voucher number
  • Address of the property
  • Landlord complete contact information
  • Landlord vendor ID
  • Lease renewal date
  • Current rent
  • Requested rent
  • Proposed effective date
  • Unit information
    • Number of bedrooms
    • Number of bathrooms
    • Unit size by square feet
    • Building type
    • Types of utilities in the unit, fuel source, and the party responsible for paying each
    • List of amenities included in rent: stove, water in unit or complex, pool, refrigerator, central or window air conditioning, and other items
    • Type of parking provided, if any
    • Exterior amenities
  • Quality of unit
    • Newly constructed or completely renovated
    • Well maintained and/or partially renovated
    • Adequate but some repairs may be needed soon
  • Signature of landlord and date

PHA will decide to approve increase or decrease, or deny request. PHA will make a note of the reason for the decision.

 

What: Notice advising that the Housing Choice Voucher assistance is being terminated due to the family’s noncompliance with requirements of the program. Notice of family’s noncompliance with requirements of the program is also copied to the landlord. The landlord may also receive notice from the PHA that they are in noncompliance with the HAP Contract, and HAP payments will be terminated. The HCV family will be given notice to relocate. Notice of landlord’s noncompliance with requirements of the program is also copied to the family.

Expect to read:

  • Specific reason why assistance is being terminated
  • Date of termination of assistance
  • If the family is not compliant, notice includes instructions for tenant to appeal the decision including deadline for request and contact person
  • Statement that the family will owe the landlord full rent after effective date of termination
  • Contact information
 

What: Landlord provides form adapted from the Environmental Protection Agency (EPA) and federally approved lead-based paint information pamphlet to families who want to rent housing built before 1978.

Expect to provide the following:

  • Disclose whether the unit has known lead-based paint and related hazards, or landlord has no knowledge of hazards in the unit
  • Disclose whether landlord has provided proposed family with all available records and reports related to lead-based paint and related hazards or has no reports and records related to any lead-based paint and related hazards
  • List of the reports and records provided to the family
  • Family initials receipt of copies of reports and records (as appropriate)
  • Family initials receipt of lead-based paint pamphlet
  • Signature and date of landlord and family

For more information visit https://www.hud.gov/program_offices/healthy_homes/enforcement/disclosure

 

What: Form for the landlord and family to complete together at the time of move-in and again at the time of move-out to observe and note the condition of each room of the housing unit. This form is for the protection of the landlord and the family; it is not part of the HCV program. This form does not take the place of an HQS inspection.

Expect to be asked to provide:

  • Landlord name and contact information
  • Family name
  • Property address
  • Property unit size
  • Move-in inspection date
  • Move-out inspection date
  • Condition and cost to correct for
    • Entrance/Halls
      • Steps and landings
      • Handrails
      • Doors
      • Hardware/Locks
      • Floors/Coverings
      • Walls/Coverings
      • Ceilings
    • Windows/Coverings
    • Lighting
    • Electrical outlets
    • Closets
    • Fire alarms/equipment
  • Living Room and Dining Room
    • Floors/Coverings
    • Walls/Coverings
    • Ceilings
    • Windows/Coverings
    • Lighting
    • Electrical outlets
  • Kitchen
    • Range
    • Refrigerator
    • Sink/Faucets
    • Floors/Coverings
    • Walls/Coverings
    • Ceilings
    • Windows/Coverings
    • Lighting
    • Electrical outlets
    • Cabinets
    • Closets/Pantry
    • Exhaust fan
    • Fire alarms/Equipment
  • Bedroom(s)
    • Doors and Locks
    • Floors/Coverings
    • Walls/Coverings
    • Ceilings
    • Windows/Coverings
    • Closets
    • Lighting
    • Electrical outlets
  • Bathroom(s)
    • Sink/Faucets
    • Shower/Tub
    • Curtain rack/Door
    • Towel rack
    • Toilet
    • Doors and Locks
    • Floors/Coverings
    • Walls/Coverings
      • Ceilings
      • Windows/Coverings
      • Closets
      • Cabinets
      • Exhaust fan
      • Lighting
      • Electrical outlets
    • Other Equipment
      • Heating Equipment
      • Air-conditioning unit(s)
      • Hot-water heater
      • Smoke/Fire alarms
      • Thermostat
      • Door bell
    • Lighting is inclusive of fixtures, bulbs, switches, and timers
    • Closets are inclusive of floor/walls/ceiling, shelves/rods, lighting
    • Sink/Faucets and Shower/Tub are inclusive of water pressure and hot water
  • Landlord and family signature and acceptance of responsibilities (move-in)
  • Landlord and family signature and agreement/disagreement with inspection items
 

What: Form that owner/manager submits to the PHA with supporting documentation to have the HAP contract reassigned due to new ownership or management of the unit or a change in the name, address or other payment information.

Expect to be asked to provide:

  • Type of change requested
    • Ownership of unit
    • Management of unit
    • Address
    • Phone number/email
    • Name
  • Owner contact information
  • Effective date of the HAP Contract Assignment
  • Whether that new owner is a parent, child, grandparent, grandchild, sister or brother to any member of the assisted family.
  • Payment address including name of contact
  • For new ownership, provide attached W9 and recorded Deed of Trust
  • For new management, if tax ID changes, provide attached management agreement and W9
  • Owner/manager signature and date
 

What: Form that the family will submit to the PHA as notice that the family will be moving from the current location. The form certifies that the family:

  • Provided a copy of this written notice to the landlord
  • Is no longer bound by a current lease agreement as of the move-out date on the notice
  • Will not owe the landlord at the time of move-out
  • Will make arrangements to cover final utility bills, as appropriate
  • Will vacate the unit on the move-out date and return keys or other devices
  • Understands its family obligations under the Voucher program, and that failure to carry out family responsibilities may result in termination

Expect to read:

  • Family name and contact information
  • Unit address
  • Move-out date

Expect to be asked to provide:

  • Signature and date