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{"sheet":"Eligibility Questionnaire","index":0,"n_rows":48,"n_cols":15,"rows_kept":48,"cut":false,"hidden":false,"merged":[[7,2,8,7],[6,14,6,21],[0,1,0,10],[1,1,1,10],[0,13,0,20],[1,13,1,20],[3,14,4,19],[3,2,5,7],[7,14,10,20],[12,14,16,20],[18,14,21,20],[26,14,28,20],[10,2,12,7],[20,2,22,7],[23,14,24,20],[14,2,16,7],[18,2,18,7],[24,2,24,7],[28,2,28,7],[36,14,36,20],[26,2,26,7],[39,13,42,20],[47,0,47,11],[47,12,47,21],[32,14,32,20],[34,14,34,20],[38,2,38,10],[30,14,30,20]]}
[null,"Income Verification Worksheets",null,null,null,null,null,null,null,null,null,null,null,"Income Verification Worksheets"]
[null,"Eligibility Questionnaire",null,null,null,null,null,null,null,null,null,null,null,"Eligibility Documentation Checklist"]
[]
[null,null,"If you answer “YES,” to any of the below questions, please attach the required documentation indicated by the corresponding number on the Income Eligibility Documentation Checklist (page 2).",null,null,null,null,null,null,null,null,null,null,null,"*  PROVIDE THE FOLLOWING INFORMATION, FOR ALL HOUSEHOLD MEMBERS, IF APPLICABLE:"]
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[]
[null,null,null,null,null,null,null,null,"Yes",null,"No",null,null,1,"Copies of paycheck stubs for the most recent 2 months, or other documentation of wages, salary, etc.  "]
[null,1,"Is any applicant of the household employed, have wages, salaries, overtime pay, commissions, fees, tips, bonuses, or other compensation for personal services? ",null,null,null,null,null,null,null,null,null,null,null,"For individuals who are self-employed:  Individuals who are self-employed must submit six (6) consecutive months' worth of personal bank statements, at a minimum.  Each bank statement must include the name of the applicant/resident, name of the banking establishment, the reporting period and all pages.  These statements will be used to document income in conbination with other documentation, as needed."]
[]
[]
[null,2,"Does any applicant of the household receive periodic payments from Social Security, annuities, insurance policies, retirement funds, pensions, disability or death benefits, or similar types of periodic payments?  "]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,2,"Provide documentation of periodic payments received from Social Security, annuities, insurance policies, retirement funds, pensions, disability or death benefits, and other similar types of periodic receipts, including a lump-sum amount or prospective monthly amounts for the delayed start of a periodic payment.  Do not include deferred periodic amounts from SSI and Social Security benefits that are received in a lump sum amount or in prospective monthly amounts."]
[]
[null,3,"Does any applicant of the household receive payments in lieu of earnings, such as unemployment compensation, disability compensation, worker’s compensation, or severance pay?   "]
[]
[]
[]
[null,4,"Has the applicant received a \"Housing Choice Voucher\" award to assist with rental costs?",null,null,null,null,null,null,null,null,null,null,3,"Provide documentation of unemployment benefits and disability compensation, worker’s compensation and severance pay.  Do not include lump sum additions to family assets, such as inheritances, insurance payments (including payments under health and accident insurance and worker’s compensation), capital gains and settlement for personal or property losses."]
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[null,5,"Does any applicant of the household receive periodic and determinable allowances?\nEX:  child support, spousal support/alimony, or regular contributions or gifts from persons not residing in the household, such as parents, grandparents, guardians, friends, etc.   "]
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[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,4,"Provide proof of \"Housing Choice Voucher\" award that includes the rental payment amount.  The award amount will be annualized and will be included as income when determining eligibility."]
[null,6,"Does any applicant of the household have IRA, Keogh, retirement, or pension fund accounts?   "]
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[null,7,"Does any applicant of the household receive income from personal property held as an investment?   ",null,null,null,null,null,null,null,null,null,null,5,"Provide proof of amount of periodic and determinable allowances:  child support payments, spousal support/alimony payments, and regular contributions or gifts received from persons not residing in the houseshold such as such as parents, grandparents, guardians, friends, etc. "]
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[null,8,"Is any applicant of the household a student, either part-time or full-time?"]
[]
[null,9,"Is any applicant of the household currently unemployed?",null,null,null,null,null,null,null,null,null,null,6,"Copies of the most recent IRA, Keogh, retirement, and pension fund account statements."]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,7,"Value of personal property held as an investment such as gems, jewelry, coin collections, antique cars, etc."]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,8,"Copies of financial aid statements and tuition statements.  Tuition will be subtracted from income."]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,9,"Provide documentation of unemployment benefits, if applicable or complete FORM C - \"Zero Income Certification.\""]
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[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"*  We reserve the right to request additional documentation in order to determine household income.  There may be instances where documentation may not be sufficient to determine income.  In these cases, eligibility will be determined on a case by case basis."]
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["Page 1",null,null,null,null,null,null,null,null,null,null,null,"Page 2"]

{"sheet":"FORM A - Unit Summary","index":1,"n_rows":40,"n_cols":9,"rows_kept":40,"cut":false,"hidden":false,"merged":[[6,2,6,4],[6,6,6,8],[7,2,7,4],[11,1,11,2],[0,1,0,8],[1,1,1,8],[2,1,2,8],[5,2,5,4],[5,6,5,8],[11,4,11,5],[20,5,20,6],[18,2,18,3],[19,2,19,3],[20,2,20,3],[12,4,12,5],[17,1,17,3],[17,5,17,7],[18,5,18,6],[19,5,19,6],[39,4,40,4],[21,2,21,3],[30,2,30,5],[30,6,31,7],[33,5,33,8],[39,1,40,3],[39,5,40,8],[21,5,21,6],[22,5,22,6],[26,1,26,3],[29,2,29,3],[29,6,29,7],[34,5,34,8],[32,1,32,3]]}
[null,"Income Verification Worksheets"]
[null,"Unit Income Summary"]
[null,"All information provided in this form is subject to audit by the City of Austin and must be accompanied by supporting documentation.  NHCD and/or their representatives reserves the right to request additional, supplemental documentation.  Complete this form for each unit that potentially meets programmatic guidelines.  Place a copy on top of each Individual Income Summary in each resident file for each unit.  "]
[]
[null,"Property Information:"]
[null,"Name:","abc",null,null,"Address:"]
[null,"Phone:"]
[null,"Email:",null,null,null,"Unit No:",12312]
[]
[null,"Lease Information: "]
[]
[null,"Original Lease Date:",null,null,"Date current lease begins:"]
[null,null,null,null,"Date current lease ends:"]
[]
[null,null,null,null,"Household (HH) size*:"]
[]
[]
[null,"Name of each person residing in unit:",null,null,null,"Income of each person residing in unit:"]
[null,null,null,null,".[ 1 ]"]
[null,null,null,null,".[ 2 ]"]
[null,null,null,null,".[ 3 ]"]
[null,null,null,null,".[ 4 ]"]
[null,null,null,null,"Unit Income:",{"$f":"SUM(F19:G22)","v":0}]
[]
[null,"Compliance Information:"]
[]
[null,"Income limit for the property:"]
[null,null,null,null,"(50%, 60%, 65% or 80%)"]
[null,null,"1st Lease",null,null,null,"Renewal Lease"]
[null,null,"Max INITIAL income allowed:",null,0,null,"Max RENEWAL income allowed: ",null,0]
[null,null,"  *Enter income limit from HUD MFI Chart for household size.",null,null,null,"*Enter 120% income limit from HUD MFI Chart for household size. ",null,1.2]
[]
[null,"Parental/Guardian support for living expenses:"]
[null,null,"Must be less than 30%:",{"$f":"SUM(E34/F23)","v":{"$error":"#DIV/0!"}},null,"Enter total support from all applicant members of the household."]
[]
[]
[null,null,null,"# Bdrms:"]
[]
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[null,"UNIT RENT:",null,null,null,"Rate based on NHCD published chart.  Base rent must include any \"non-optional\" fees.  Any \"optional\" fees, may be added to the base rent and must be itemized separately."]

{"sheet":"FORM B - Indiv Income Summary","index":2,"n_rows":45,"n_cols":8,"rows_kept":45,"cut":false,"hidden":false,"merged":[[11,5,11,6],[21,5,21,6],[0,1,0,8],[1,1,1,8],[11,2,11,3],[2,1,3,8],[18,5,18,6],[19,5,19,6],[17,5,17,6],[15,1,15,9],[24,5,24,6],[25,5,25,6],[20,5,20,6],[22,5,22,6],[35,1,35,4],[34,6,34,7],[26,7,30,8],[23,5,23,6],[26,5,26,6],[32,1,32,4]]}
[null,"Income Verification Worksheets"]
[null,"Individual Income Summary"]
[null,"Complete this form for each resident in each unit that potentially meets programmatic guidelines.  Place this form on top of all support documentation used to determine resident eligibility."]
[]
[]
[null,"Property Name:"]
[null,null,{"$f":"'FORM A - Unit Summary'!C6:E6","v":"abc"},null,null,null,"Unit No:",{"$f":"'FORM A - Unit Summary'!G8","v":12312}]
[]
[]
[null,"Lease Information: "]
[null,null,"Resident Name:",null,null,"Co-Resident Name:"]
[]
[]
[]
[]
[null,"Income Information:  Provide annual income from each of the documented sources from the Eligibility Checklist."]
[]
[null,null,"Item 1",null,"Employment Income:",0]
[null,null,"Item 2",null,"Other Income:",0]
[null,null,"Item 3",null,"Other Income:",0]
[null,null,"Item 4",null,"Other Income:",0]
[null,null,"Item 5",null,"Other Income:",0]
[null,null,"Item 6",null,"Other Income:",0]
[null,null,"Item 7",null,"Other Income:",0]
[null,null,"Item 8",null,"Financial Aid:",0]
[null,null,"Item 9",null,"Tuition applicant will pay (subtracted):",0]
[null,null,null,null,"Total Gross Income (calculated):",{"$f":"SUM(F18:G25)-F26","v":0},null,"Enter this amount on Unit Summary for the corresponding applicant."]
[]
[]
[]
[]
[null,null,null,null,null,null,"_______________________"]
[null,"Applicant Signature",null,null,null,null,"Date"]
[]
[]
[null,"Co-Applicant Signature",null,null,null,null,"Date"]
[]
[null,"I (We) hereby submit the application, income documentation and other furnished documents to be "]
[null,"considered to rent an affordable unit/bedroom.  Under penalty of law, I certify the documentation provided is "]
[null,"true and correct."]
[null,"I (We) agree to release whatever information the State Attorney General determines to be publicly available.  "]
[null,"I (We) agree to allow the City and/or its designee, to share information contained in my (our) file for the purpose of"]
[null,"income eligibility and related business. I(we) understand that any discrepancy or omissions later  found may disqualify me(us).  "]
[null,"If  such  a  discrepancy  or  omission  is  discovered  after  the lease has been executed  I (we)  "]
[null,"understand  that  1) our lease may be adjusted to the full market rent value or 2) we may be asked to vacate the unit."]

{"sheet":"FORM C - Zero Income Cert","index":3,"n_rows":39,"n_cols":11,"rows_kept":39,"cut":false,"hidden":false,"merged":[[38,2,38,6],[37,2,37,7],[37,9,37,10],[28,2,29,11],[30,2,30,11],[31,2,31,11],[32,2,32,11],[33,2,33,11],[34,2,34,11],[0,1,0,11],[1,1,1,11],[2,1,5,11],[17,4,17,11],[14,2,14,11],[11,4,11,7],[12,4,12,7],[27,4,27,11],[15,4,15,11],[16,4,16,11],[8,4,8,8],[11,1,11,2],[24,4,24,11],[25,4,25,11],[26,4,26,11],[22,4,22,11],[23,4,23,11],[20,4,20,11],[18,4,18,11],[19,4,19,11],[21,4,21,11]]}
[null,"Income Verification Worksheets"]
[null,"Zero Income Certificaton"]
[null,"This form should be completed by adult household members only (if appropriate.)  Applicant certifies that all information provided herein is true and correct as of the date set forth opposite signature.  Applicant further acknowledges any inaccuracy and/or misrepresentation provided herein may constititue fraud, which is punnishable by law."]
[]
[]
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[]
[null,"Property Name:"]
[null,null,null,null,{"$f":"'FORM A - Unit Summary'!C6","v":"abc"},null,null,null,null,"Unit No:",{"$f":"'FORM A - Unit Summary'!G8","v":12312}]
[]
[]
[null,"I,",null,null," ",null,null,null,", do hereby certify:"]
[null,null,null,null,"Print Applicant Name"]
[]
[null,"A.","I do not individually receive income from any of the following sources:"]
[null,null,"·",null,"Wages from employment (including commissions, tips, bonuses, fees, etc.);"]
[null,null,"·",null,"Income from operation of a business;"]
[null,null,"·",null,"Rental income from real or personal property;"]
[null,null,"·",null,"Interest or dividends from assets;"]
[null,null,"·",null,"Social Security payments;"]
[null,null,"·",null,"Supplemental Security Income payments;"]
[null,null,"·",null,"Payments from annuities, insurance policies, retirement funds, pensions, or death benefits;"]
[null,null,"·",null,"Unemployment or disability payments;"]
[null,null,"·",null,"Public assistance payments (other than food stamps);"]
[null,null,"·",null,"Periodic allowances from alimony or child support;"]
[null,null,"·",null,"Gifts received from persons not comprising the household;"]
[null,null,"·",null,"Sales from self-employed resources (Avon Mary Kay, pampered Chef, Shaklee, etc.,);"]
[null,null,"·",null,"Any other source not named above; AND"]
[null,"B.","I currently do not have income of any kind and there is no imminent change expected in my financial or employment status during the next 12 months; AND"]
[]
[null,"C.","I will be using the following sources of funds to pay for rent, utilities, and/or other necessities:"]
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[]
[]
[null,"C.","Upon becoming employed, I will submit the first 2 months worth of check stubs. "]
[]
[]
[]
[null,null,"Applicant Signature",null,null,null,null,null,null,"Date"]