Appendix 3

Acceptable Forms of Verification

+----------+---------+----------+----------+-----------+------------+
| Appendix |         |          |          |           |            |
| 3:       |         |          |          |           |            |
| Ac       |         |          |          |           |            |
| ceptable |         |          |          |           |            |
| Forms of |         |          |          |           |            |
| Veri     |         |          |          |           |            |
| fication |         |          |          |           |            |
+==========+=========+==========+==========+===========+============+
| **Factor | **[Acc  |          |          |           | **Ve       |
| to be    | eptable |          |          |           | rification |
| Ve       | S       |          |          |           | Tips**     |
| rified** | ources] |          |          |           |            |
|          | {.small |          |          |           |            |
|          | caps}** |          |          |           |            |
+----------+---------+----------+----------+-----------+------------+
|          | **Third |          | **D      | **Self    |            |
|          | Par     |          | ocuments | **-**Decl |            |
|          | ty^a^** |          | Provided | aration** |            |
|          |         |          | by       |           |            |
|          |         |          | App      |           |            |
|          |         |          | licant** |           |            |
+----------+---------+----------+----------+-----------+------------+
|          | **Writt | **O      |          |           |            |
|          | en^b^** | ral^c^** |          |           |            |
+----------+---------+----------+----------+-----------+------------+
| -   Age. | -       | -   None | -        |           |            |
|          |    None |     r    |    Birth |           |            |
|          |     re  | equired. |     Cer  |           |            |
|          | quired. |          | tificate |           |            |
|          |         |          |          |           |            |
|          |         |          | -   B    |           |            |
|          |         |          | aptismal |           |            |
|          |         |          |     Cer  |           |            |
|          |         |          | tificate |           |            |
|          |         |          |          |           |            |
|          |         |          | -        |           |            |
|          |         |          | Military |           |            |
|          |         |          |     D    |           |            |
|          |         |          | ischarge |           |            |
|          |         |          |          |           |            |
|          |         |          |   papers |           |            |
|          |         |          |          |           |            |
|          |         |          | -        |           |            |
|          |         |          |    Valid |           |            |
|          |         |          |          |           |            |
|          |         |          | passport |           |            |
|          |         |          |          |           |            |
|          |         |          | -        |           |            |
|          |         |          |   Census |           |            |
|          |         |          |          |           |            |
|          |         |          | document |           |            |
|          |         |          |          |           |            |
|          |         |          |  showing |           |            |
|          |         |          |     age  |           |            |
|          |         |          |          |           |            |
|          |         |          | -        |           |            |
|          |         |          |   Natura |           |            |
|          |         |          | lization |           |            |
|          |         |          |     cer  |           |            |
|          |         |          | tificate |           |            |
|          |         |          |          |           |            |
|          |         |          | -        |           |            |
|          |         |          |   Social |           |            |
|          |         |          |          |           |            |
|          |         |          | Security |           |            |
|          |         |          |          |           |            |
|          |         |          |   Admini |           |            |
|          |         |          | stration |           |            |
|          |         |          |          |           |            |
|          |         |          | Benefits |           |            |
|          |         |          |          |           |            |
|          |         |          | printout |           |            |
+----------+---------+----------+----------+-----------+------------+
| -        | -       | -   T    | -   Copy | -         | -          |
|  Alimony |    Copy | elephone |     of   | Notarized |    Amounts |
|     or   |     of  |     or   |     most |           |            |
|          |     sep |     i    |          | statement |    awarded |
|    child | aration | n-person |   recent |     or    |     but    |
|          |     or  |          |          |           |     not    |
| support. |         |  contact |   check, | affidavit |            |
|          | divorce |     with |     r    |           |   received |
|          |     ag  |     e    | ecording |    signed |     can be |
|          | reement | x-spouse |          |     by    |            |
|          |     p   |     or   |    date, |           |   excluded |
|          | rovided |          |          | applicant |     from   |
|          |     by  |   income |  amount, |     i     |     annual |
|          |     ex  |          |     and  | ndicating |     income |
|          | -spouse |   source |          |           |     only   |
|          |     or  |     do   |    check |    amount |     when   |
|          |         | cumented |          |           |            |
|          |   court |     in   |  number. | received. | applicants |
|          |     ind |     file |          |           |     have   |
|          | icating |     by   | -        | -   If    |     made   |
|          |         |     the  |   Recent |     ap    |            |
|          |    type |          |          | plicable, | reasonable |
|          |     of  |   owner. | original |           |            |
|          |     s   |          |          | notarized |    efforts |
|          | upport, |          |  letters |           |     to     |
|          |         |          |     from | statement |            |
|          | amount, |          |     the  |     or    |    collect |
|          |     and |          |          |           |            |
|          |         |          |   court. | affidavit |    amounts |
|          | payment |          |          |     from  |     due,   |
|          |     sc  |          |          |           |            |
|          | hedule. |          |          | applicant |  including |
|          |         |          |          |     i     |     filing |
|          | -       |          |          | ndicating |     with   |
|          | Written |          |          |     that  |     courts |
|          |     st  |          |          |           |     or     |
|          | atement |          |          |  payments |            |
|          |     p   |          |          |     are   |   agencies |
|          | rovided |          |          |     not   |     r      |
|          |     by  |          |          |     being | esponsible |
|          |     ex  |          |          |           |     for    |
|          | -spouse |          |          |  received |            |
|          |     or  |          |          |     and   |  enforcing |
|          |         |          |          |     d     |            |
|          |  income |          |          | escribing |  payments. |
|          |         |          |          |           |            |
|          |  source |          |          |   efforts |            |
|          |     ind |          |          |     to    |            |
|          | icating |          |          |           |            |
|          |     all |          |          |   collect |            |
|          |     of  |          |          |           |            |
|          |         |          |          |   amounts |            |
|          |  above. |          |          |     due.  |            |
|          |         |          |          |           |            |
|          | -   If  |          |          |           |            |
|          |         |          |          |           |            |
|          |    appl |          |          |           |            |
|          | icable, |          |          |           |            |
|          |         |          |          |           |            |
|          | written |          |          |           |            |
|          |     st  |          |          |           |            |
|          | atement |          |          |           |            |
|          |         |          |          |           |            |
|          |    from |          |          |           |            |
|          |         |          |          |           |            |
|          | court/a |          |          |           |            |
|          | ttorney |          |          |           |            |
|          |         |          |          |           |            |
|          |    that |          |          |           |            |
|          |     p   |          |          |           |            |
|          | ayments |          |          |           |            |
|          |     are |          |          |           |            |
|          |     not |          |          |           |            |
|          |         |          |          |           |            |
|          |   being |          |          |           |            |
|          |     r   |          |          |           |            |
|          | eceived |          |          |           |            |
|          |     and |          |          |           |            |
|          |         |          |          |           |            |
|          |    anti |          |          |           |            |
|          | cipated |          |          |           |            |
|          |         |          |          |           |            |
|          |    date |          |          |           |            |
|          |     of  |          |          |           |            |
|          |     res |          |          |           |            |
|          | umption |          |          |           |            |
|          |     of  |          |          |           |            |
|          |     pa  |          |          |           |            |
|          | yments. |          |          |           |            |
+----------+---------+----------+----------+-----------+------------+
| -        | -       | -   None | -   None | -   Cert  | -   Only   |
|   Assets |    None |     r    |     r    | ification |     count  |
|          |     re  | equired. | equired. |           |     assets |
| disposed | quired. |          |          |    signed |            |
|     of   |         |          |          |     by    |   disposed |
|     for  |         |          |          |           |     of     |
|     less |         |          |          | applicant |     within |
|     than |         |          |          |     that  |     a      |
|     fair |         |          |          |     no    |            |
|          |         |          |          |           |   two-year |
|   market |         |          |          |    member |     period |
|          |         |          |          |     of    |     prior  |
|   value. |         |          |          |           |     to     |
|          |         |          |          |    family |     e      |
|          |         |          |          |     has   | xamination |
|          |         |          |          |           |     or     |
|          |         |          |          |  disposed |     re-ex  |
|          |         |          |          |     of    | amination. |
|          |         |          |          |           |            |
|          |         |          |          |    assets |            |
|          |         |          |          |     for   |            |
|          |         |          |          |     less  |            |
|          |         |          |          |     than  |            |
|          |         |          |          |     fair  |            |
|          |         |          |          |           |            |
|          |         |          |          |    market |            |
|          |         |          |          |     value |            |
|          |         |          |          |           |            |
|          |         |          |          |    during |            |
|          |         |          |          |           |            |
|          |         |          |          | preceding |            |
|          |         |          |          |     two   |            |
|          |         |          |          |           |            |
|          |         |          |          |    years. |            |
|          |         |          |          |           |            |
|          |         |          |          | -   If    |            |
|          |         |          |          |     ap    |            |
|          |         |          |          | plicable, |            |
|          |         |          |          |     cert  |            |
|          |         |          |          | ification |            |
|          |         |          |          |           |            |
|          |         |          |          |    signed |            |
|          |         |          |          |     by    |            |
|          |         |          |          |     the   |            |
|          |         |          |          |     owner |            |
|          |         |          |          |     of    |            |
|          |         |          |          |     the   |            |
|          |         |          |          |     asset |            |
|          |         |          |          |           |            |
|          |         |          |          |  disposed |            |
|          |         |          |          |     of    |            |
|          |         |          |          |     that  |            |
|          |         |          |          |           |            |
|          |         |          |          |    shows: |            |
|          |         |          |          |           |            |
|          |         |          |          | > \- Type |            |
|          |         |          |          | > of      |            |
|          |         |          |          | > assets  |            |
|          |         |          |          | >         |            |
|          |         |          |          |  disposed |            |
|          |         |          |          | > of;     |            |
|          |         |          |          | >         |            |
|          |         |          |          | > \- Date |            |
|          |         |          |          | >         |            |
|          |         |          |          |  disposed |            |
|          |         |          |          | > of;     |            |
|          |         |          |          | >         |            |
|          |         |          |          | > \-      |            |
|          |         |          |          | > Amount  |            |
|          |         |          |          | >         |            |
|          |         |          |          | received; |            |
|          |         |          |          | > and     |            |
|          |         |          |          | >         |            |
|          |         |          |          | > \-      |            |
|          |         |          |          | > Market  |            |
|          |         |          |          | > value   |            |
|          |         |          |          | > of      |            |
|          |         |          |          | > asset   |            |
|          |         |          |          | > at the  |            |
|          |         |          |          | > time of |            |
|          |         |          |          | > dis     |            |
|          |         |          |          | position. |            |
+----------+---------+----------+----------+-----------+------------+
| -   A    | -       | -   T    | -        |           | -   The    |
| uxiliary | Written | elephone |   Copies |           |     owner  |
|     ap   |         |     or   |     of   |           |     must   |
| paratus. |   verif |     i    |          |           |            |
|          | ication | n-person | receipts |           |  determine |
|          |         |          |     or   |           |     if     |
|          |    from |  contact |          |           |            |
|          |         |     with | evidence |           |    expense |
|          |  source |          |     of   |           |     is to  |
|          |     of  |    these |          |           |     be     |
|          |         |          | periodic |           |            |
|          |   costs |  sources |          |           | considered |
|          |     and |     do   | payments |           |            |
|          |         | cumented |     for  |           |    medical |
|          | purpose |     in   |     ap   |           |     or     |
|          |     of  |     file | paratus. |           |            |
|          |     app |     by   |          |           | disability |
|          | aratus. |     the  |          |           |     a      |
|          |         |          |          |           | ssistance. |
|          | -       |   owner. |          |           |            |
|          | Written |          |          |           |            |
|          |         |          |          |           |            |
|          |  certif |          |          |           |            |
|          | ication |          |          |           |            |
|          |         |          |          |           |            |
|          |    from |          |          |           |            |
|          |         |          |          |           |            |
|          |  doctor |          |          |           |            |
|          |     or  |          |          |           |            |
|          |         |          |          |           |            |
|          | rehabil |          |          |           |            |
|          | itation |          |          |           |            |
|          |         |          |          |           |            |
|          |  agency |          |          |           |            |
|          |         |          |          |           |            |
|          |    that |          |          |           |            |
|          |     use |          |          |           |            |
|          |     of  |          |          |           |            |
|          |     ap  |          |          |           |            |
|          | paratus |          |          |           |            |
|          |     is  |          |          |           |            |
|          |     ne  |          |          |           |            |
|          | cessary |          |          |           |            |
|          |     to  |          |          |           |            |
|          |     emp |          |          |           |            |
|          | loyment |          |          |           |            |
|          |     of  |          |          |           |            |
|          |     any |          |          |           |            |
|          |         |          |          |           |            |
|          |  family |          |          |           |            |
|          |         |          |          |           |            |
|          | member. |          |          |           |            |
|          |         |          |          |           |            |
|          | -   In  |          |          |           |            |
|          |         |          |          |           |            |
|          |    case |          |          |           |            |
|          |         |          |          |           |            |
|          |   where |          |          |           |            |
|          |     the |          |          |           |            |
|          |     d   |          |          |           |            |
|          | isabled |          |          |           |            |
|          |         |          |          |           |            |
|          |  person |          |          |           |            |
|          |     is  |          |          |           |            |
|          |     em  |          |          |           |            |
|          | ployed, |          |          |           |            |
|          |     st  |          |          |           |            |
|          | atement |          |          |           |            |
|          |         |          |          |           |            |
|          |    from |          |          |           |            |
|          |     e   |          |          |           |            |
|          | mployer |          |          |           |            |
|          |         |          |          |           |            |
|          |    that |          |          |           |            |
|          |     ap  |          |          |           |            |
|          | paratus |          |          |           |            |
|          |     is  |          |          |           |            |
|          |     ne  |          |          |           |            |
|          | cessary |          |          |           |            |
|          |     for |          |          |           |            |
|          |         |          |          |           |            |
|          |    empl |          |          |           |            |
|          | oyment. |          |          |           |            |
+----------+---------+----------+----------+-----------+------------+
| -   Care | -       | -   T    | -        | -         | -   The    |
|     a    | Written | elephone |   Copies | Notarized |     owner  |
| ttendant |         |     or   |     of   |           |     must   |
|     for  |   verif |     i    |          | statement |            |
|          | ication | n-person | receipts |     or    |  determine |
| disabled |         |          |     or   |           |     if     |
|          |    from |  contact |     c    |    signed |     this   |
|   family |     at  |     with | ancelled |           |            |
|          | tendant |          |          | affidavit |    expense |
| members. |         |   source |   checks |           |     is to  |
|          | stating |     do   |     in   | attesting |     be     |
|          |         | cumented | dicating |     to    |            |
|          |  amount |     in   |          |           | considered |
|          |     re  |     file |  payment |   amounts |            |
|          | ceived, |     by   |          |     paid. |    medical |
|          |     fr  |     the  |   amount |           |     or     |
|          | equency |          |     and  |           |            |
|          |     of  |   owner. |     fr   |           | disability |
|          |     pa  |          | equency. |           |     a      |
|          | yments, |          |          |           | ssistance. |
|          |         |          |          |           |            |
|          |   hours |          |          |           |            |
|          |     of  |          |          |           |            |
|          |         |          |          |           |            |
|          |   care. |          |          |           |            |
|          |         |          |          |           |            |
|          | -       |          |          |           |            |
|          | Written |          |          |           |            |
|          |         |          |          |           |            |
|          |  certif |          |          |           |            |
|          | ication |          |          |           |            |
|          |         |          |          |           |            |
|          |    from |          |          |           |            |
|          |         |          |          |           |            |
|          |  doctor |          |          |           |            |
|          |     or  |          |          |           |            |
|          |         |          |          |           |            |
|          | rehabil |          |          |           |            |
|          | itation |          |          |           |            |
|          |         |          |          |           |            |
|          |  agency |          |          |           |            |
|          |         |          |          |           |            |
|          |    that |          |          |           |            |
|          |         |          |          |           |            |
|          |    care |          |          |           |            |
|          |     is  |          |          |           |            |
|          |     ne  |          |          |           |            |
|          | cessary |          |          |           |            |
|          |     to  |          |          |           |            |
|          |     emp |          |          |           |            |
|          | loyment |          |          |           |            |
|          |     of  |          |          |           |            |
|          |         |          |          |           |            |
|          |  family |          |          |           |            |
|          |         |          |          |           |            |
|          | member. |          |          |           |            |
+----------+---------+----------+----------+-----------+------------+
| -        | -       | -   T    | -        | -   For   | -          |
|    Child | Written | elephone |   Copies |     ver   |  Allowance |
|     care |         |     or   |     of   | ification |            |
|          |   verif |     i    |          |     of    |   provided |
| expenses | ication | n-person | receipts |           |     only   |
|     (i   |         |          |     or   |  "looking |     for    |
| ncluding |    from |  contact |     c    |     for   |     care   |
|     veri |         |     with | ancelled |           |     of     |
| fication |  person |          |          |    work," |            |
|     that |     who |    these |   checks |           |   children |
|     a    |     p   |          |     in   |   details |     12 and |
|          | rovides |  sources | dicating |     of    |            |
|   family |         |          |     p    |     job   |   younger. |
|          |    care |   (child | ayments. |           |            |
|   member |     ind |     care |          |    search | -   When   |
|     who  | icating |     p    | -   For  |           |     same   |
|     has  |         | rovider, |          |    effort |     care   |
|     been |  amount |     e    |   school |     as    |            |
|          |     of  | mployer, |     att  |           |   provider |
| relieved |     p   |          | endance, |  required |     takes  |
|     of   | ayment, |  school) |          |     by    |     care   |
|          |         |     do   |   school |           |     of     |
|    child |   hours | cumented |          |   owner's |            |
|     care |     of  |     in   | records, |           |   children |
|     is   |         |     file |     such |   written |     and    |
|          |   care, |     by   |     as   |           |            |
| working, |         |     the  |     paid |   policy. |   disabled |
|     a    |   names |          |     fee  |           |            |
| ttending |     of  |   owner. |     st   |           |    person, |
|          |     ch  |          | atements |           |     the    |
|  school, | ildren, |          |     that |           |     owner  |
|     or   |     fr  |          |     show |           |     must   |
|          | equency |          |     that |           |            |
|  looking |     of  |          |     the  |           |    prorate |
|     for  |     p   |          |     time |           |            |
|     empl | ayment, |          |     and  |           |   expenses |
| oyment). |     and |          |          |           |     ac     |
|          |         |          | duration |           | cordingly. |
|          | whether |          |     of   |           |            |
|          |     or  |          |          |           | -   Owners |
|          |     not |          |   school |           |     should |
|          |         |          |     at   |           |     keep   |
|          |    care |          | tendance |           |     in     |
|          |     is  |          |     re   |           |     mind   |
|          |     ne  |          | asonably |           |     that   |
|          | cessary |          |     cor  |           |     costs  |
|          |     to  |          | responds |           |     may be |
|          |     emp |          |     to   |           |     higher |
|          | loyment |          |     the  |           |     in     |
|          |     or  |          |          |           |     summer |
|          |     edu |          |   period |           |     months |
|          | cation. |          |     of   |           |     and    |
|          |         |          |          |           |     during |
|          | -       |          |    child |           |            |
|          |   Verif |          |          |           |    holiday |
|          | ication |          |    care. |           |            |
|          |     of  |          |          |           |   periods. |
|          |     emp |          |          |           |            |
|          | loyment |          |          |           | -   The    |
|          |     as  |          |          |           |     owner  |
|          |     r   |          |          |           |     must   |
|          | equired |          |          |           |            |
|          |         |          |          |           |  determine |
|          |   under |          |          |           |     which  |
|          |     Emp |          |          |           |     family |
|          | loyment |          |          |           |     member |
|          |         |          |          |           |     has    |
|          | Income. |          |          |           |     been   |
|          |         |          |          |           |            |
|          | -       |          |          |           |    enabled |
|          |   Verif |          |          |           |     to     |
|          | ication |          |          |           |     work.  |
|          |     of  |          |          |           |            |
|          |         |          |          |           | -   Care   |
|          | student |          |          |           |     for    |
|          |         |          |          |           |            |
|          |  status |          |          |           | employment |
|          |         |          |          |           |     and    |
|          |   (full |          |          |           |            |
|          |     or  |          |          |           |  education |
|          |     par |          |          |           |     must   |
|          | t-time) |          |          |           |     be     |
|          |     as  |          |          |           |            |
|          |     r   |          |          |           |   prorated |
|          | equired |          |          |           |     to     |
|          |         |          |          |           |            |
|          |   under |          |          |           |    compare |
|          |     Fu  |          |          |           |     to     |
|          | ll-Time |          |          |           |            |
|          |         |          |          |           |  earnings. |
|          | Student |          |          |           |            |
|          |         |          |          |           | -   Costs  |
|          | Status. |          |          |           |     must   |
|          |         |          |          |           |     be     |
|          |         |          |          |           |     "re    |
|          |         |          |          |           | asonable." |
+----------+---------+----------+----------+-----------+------------+
| -   Cit  |         |          |          | -         | -   Owners |
| izenship |         |          |          |  Citizens |     may    |
|          |         |          |          |     must  |            |
|          |         |          |          |     sign  |    require |
|          |         |          |          |     de    |            |
|          |         |          |          | claration | applicants |
|          |         |          |          |     c     | /residents |
|          |         |          |          | ertifying |     to     |
|          |         |          |          |     U.S.  |            |
|          |         |          |          |     Cit   |    provide |
|          |         |          |          | izenship. |     ve     |
|          |         |          |          |           | rification |
|          |         |          |          |           |     of     |
|          |         |          |          |           |     ci     |
|          |         |          |          |           | tizenship. |
+----------+---------+----------+----------+-----------+------------+
| -        | -       | -   T    | -   Pa   | -         | -   Use    |
|  Current |   Verif | elephone | ssbooks, | Notarized |            |
|     net  | ication |     or   |     c    |           |    current |
|          |         |     i    | hecking, | statement |            |
|   family |  forms, | n-person |     or   |     or    |    balance |
|          |         |          |          |           |     in     |
|  assets. | letters |  contact |  savings |    signed |            |
|          |     or  |     with |          |           |    savings |
|          |     do  |     app  |  account | affidavit |            |
|          | cuments | ropriate |     sta  |           |   accounts |
|          |     r   |          | tements, |   stating |     and    |
|          | eceived |  source, |     cert |     cash  |            |
|          |         |     do   | ificates |     value |    average |
|          |    from | cumented |     of   |     of    |            |
|          |     fi  |     in   |          |           |    monthly |
|          | nancial |     file | deposit, |    assets |            |
|          |         |     by   |          |     or    |    balance |
|          |  instit |     the  | property |           |     in     |
|          | utions, |          |     app  | verifying |            |
|          |         |   owner. | raisals, |     cash  |   checking |
|          |   stock |          |          |     held  |            |
|          |     b   |          |    stock |     at    |   accounts |
|          | rokers, |          |     or   |     ap    |     for    |
|          |         |          |     bond | plicant's |     last 6 |
|          |    real |          |     do   |     home  |            |
|          |         |          | cuments, |     or in |    months. |
|          |  estate |          |     or   |     safe  |            |
|          |         |          |          |           | -   Use    |
|          | agents, |          |    other |   deposit |     cash   |
|          |     em  |          |     f    |     box.  |     value  |
|          | ployers |          | inancial |           |     of all |
|          |     ind |          |     st   |           |     assets |
|          | icating |          | atements |           |     (the   |
|          |     the |          |     c    |           |     net    |
|          |         |          | ompleted |           |     amount |
|          | current |          |     by   |           |     the    |
|          |         |          |     f    |           |            |
|          |   value |          | inancial |           |  applicant |
|          |     of  |          |     inst |           |     would  |
|          |     the |          | itution. |           |            |
|          |         |          |          |           |    receive |
|          |  assets |          | -        |           |     if the |
|          |     and |          |   Copies |           |     asset  |
|          |     pe  |          |     of   |           |     were   |
|          | nalties |          |     real |           |            |
|          |     or  |          |          |           |  converted |
|          |     rea |          |   estate |           |     to     |
|          | sonable |          |     tax  |           |     cash). |
|          |         |          |     sta  |           |            |
|          |   costs |          | tements, |           | -          |
|          |     to  |          |     if   |           |  **NOTE:** |
|          |     be  |          |     tax  |           |     This   |
|          |     i   |          |     a    |           |     i      |
|          | ncurred |          | uthority |           | nformation |
|          |     in  |          |     uses |           |     can    |
|          |         |          |     app  |           |            |
|          |   order |          | roximate |           |    usually |
|          |     to  |          |          |           |     be     |
|          |         |          |   market |           |            |
|          | convert |          |          |           |   obtained |
|          |     no  |          |   value. |           |     simu   |
|          | nliquid |          |          |           | ltaneously |
|          |         |          | -        |           |     when   |
|          |  assets |          |   Quotes |           |            |
|          |         |          |     from |           |  verifying |
|          |    into |          |     at   |           |     income |
|          |         |          | torneys, |           |     from   |
|          |   cash. |          |          |           |     assets |
|          |         |          |    stock |           |     and    |
|          |         |          | brokers, |           |            |
|          |         |          |          |           | employment |
|          |         |          | bankers, |           |     (e.g., |
|          |         |          |     and  |           |     value  |
|          |         |          |     real |           |     of     |
|          |         |          |          |           |            |
|          |         |          |   estate |           |  pension). |
|          |         |          |          |           |            |
|          |         |          |   agents |           |            |
|          |         |          |     that |           |            |
|          |         |          |          |           |            |
|          |         |          |   verify |           |            |
|          |         |          |     p    |           |            |
|          |         |          | enalties |           |            |
|          |         |          |     and  |           |            |
|          |         |          |     re   |           |            |
|          |         |          | asonable |           |            |
|          |         |          |          |           |            |
|          |         |          |    costs |           |            |
|          |         |          |          |           |            |
|          |         |          | incurred |           |            |
|          |         |          |     to   |           |            |
|          |         |          |          |           |            |
|          |         |          |  convert |           |            |
|          |         |          |          |           |            |
|          |         |          |    asset |           |            |
|          |         |          |     to   |           |            |
|          |         |          |          |           |            |
|          |         |          |    cash. |           |            |
|          |         |          |          |           |            |
|          |         |          | -        |           |            |
|          |         |          |   Copies |           |            |
|          |         |          |     of   |           |            |
|          |         |          |     real |           |            |
|          |         |          |          |           |            |
|          |         |          |   estate |           |            |
|          |         |          |          |           |            |
|          |         |          |  closing |           |            |
|          |         |          |     d    |           |            |
|          |         |          | ocuments |           |            |
|          |         |          |     that |           |            |
|          |         |          |          |           |            |
|          |         |          | indicate |           |            |
|          |         |          |     dist |           |            |
|          |         |          | ribution |           |            |
|          |         |          |     of   |           |            |
|          |         |          |          |           |            |
|          |         |          |    sales |           |            |
|          |         |          |          |           |            |
|          |         |          | proceeds |           |            |
|          |         |          |     and  |           |            |
|          |         |          |     se   |           |            |
|          |         |          | ttlement |           |            |
|          |         |          |          |           |            |
|          |         |          |   costs. |           |            |
+----------+---------+----------+----------+-----------+------------+
| -   Di   | -       | -   T    |          | -   Not   | -   If a   |
| sability |   Verif | elephone |          |     app   |     person |
|          | ication |     or   |          | ropriate. |            |
|  status. |         |     i    |          |           |   receives |
|          |    from | n-person |          |           |     Social |
|          |         |          |          |           |            |
|          | medical |  contact |          |           |   Security |
|          |         |     with |          |           |            |
|          |   profe |          |          |           | Disability |
|          | ssional |  medical |          |           |     solely |
|          |         |     prof |          |           |     due to |
|          | stating | essional |          |           |     a drug |
|          |         |     v    |          |           |     or     |
|          |    that | erifying |          |           |            |
|          |     ind |          |          |           |    alcohol |
|          | ividual |    quali |          |           |            |
|          |     qu  | fication |          |           |   problem, |
|          | alifies |          |          |           |     the    |
|          |         |    under |          |           |     person |
|          |   under |     the  |          |           |     is not |
|          |     the |          |          |           |            |
|          |     def |  federal |          |           | considered |
|          | inition |     di   |          |           |            |
|          |     of  | sability |          |           |   disabled |
|          |         |     de   |          |           |     under  |
|          |    disa | finition |          |           |            |
|          | bility. |     and  |          |           |    housing |
|          |         |          |          |           |     law. A |
|          |         |    docum |          |           |     person |
|          |         | entation |          |           |     that   |
|          |         |     in   |          |           |     does   |
|          |         |     the  |          |           |     not    |
|          |         |     file |          |           |            |
|          |         |     of   |          |           |    receive |
|          |         |     the  |          |           |     Social |
|          |         |          |          |           |            |
|          |         |    conve |          |           |   Security |
|          |         | rsation. |          |           |            |
|          |         |          |          |           | Disability |
|          |         |          |          |           |     may    |
|          |         |          |          |           |     still  |
|          |         |          |          |           |            |
|          |         |          |          |           |    qualify |
|          |         |          |          |           |     under  |
|          |         |          |          |           |     the    |
|          |         |          |          |           |            |
|          |         |          |          |           | definition |
|          |         |          |          |           |     of a   |
|          |         |          |          |           |     person |
|          |         |          |          |           |     with   |
|          |         |          |          |           |     dis    |
|          |         |          |          |           | abilities. |
|          |         |          |          |           |            |
|          |         |          |          |           | -   Owners |
|          |         |          |          |           |     must   |
|          |         |          |          |           |     not    |
|          |         |          |          |           |     seek   |
|          |         |          |          |           |     to     |
|          |         |          |          |           |     verify |
|          |         |          |          |           |     i      |
|          |         |          |          |           | nformation |
|          |         |          |          |           |     about  |
|          |         |          |          |           |     a      |
|          |         |          |          |           |            |
|          |         |          |          |           |   person's |
|          |         |          |          |           |            |
|          |         |          |          |           |   specific |
|          |         |          |          |           |            |
|          |         |          |          |           | disability |
|          |         |          |          |           |     other  |
|          |         |          |          |           |     than   |
|          |         |          |          |           |            |
|          |         |          |          |           |  obtaining |
|          |         |          |          |           |     a      |
|          |         |          |          |           |     prof   |
|          |         |          |          |           | essional's |
|          |         |          |          |           |            |
|          |         |          |          |           |    opinion |
|          |         |          |          |           |     of     |
|          |         |          |          |           |     qua    |
|          |         |          |          |           | lification |
|          |         |          |          |           |     under  |
|          |         |          |          |           |     the    |
|          |         |          |          |           |            |
|          |         |          |          |           | definition |
|          |         |          |          |           |     of a   |
|          |         |          |          |           |     person |
|          |         |          |          |           |     with   |
|          |         |          |          |           |     dis    |
|          |         |          |          |           | abilities. |
+----------+---------+----------+----------+-----------+------------+
| -        | -       | -   T    | -        | -   Not   | -   The    |
| Dividend |   Verif | elephone |   Copies |     app   |     owner  |
|          | ication |     or   |     of   | ropriate. |     must   |
|   income |         |     i    |          |           |     obtain |
|     and  |    form | n-person |  current |           |     enough |
|          |     co  |          |     sta  |           |     i      |
|  savings | mpleted |  contact | tements, |           | nformation |
|          |     by  |     with |     bank |           |     to     |
|  account |         |     app  |     pa   |           |            |
|          |   bank. | ropriate | ssbooks, |           | accurately |
| interest |         |          |     cert |           |            |
|          |         |   party, | ificates |           |    project |
|  income. |         |     do   |     of   |           |     income |
|          |         | cumented |          |           |     over   |
|          |         |     in   | deposit, |           |     next   |
|          |         |     file |     if   |           |     12     |
|          |         |     by   |     they |           |            |
|          |         |     the  |     show |           |    months. |
|          |         |          |          |           |            |
|          |         |   owner. | required |           | -   Verify |
|          |         |          |     inf  |           |            |
|          |         |          | ormation |           |   interest |
|          |         |          |          |           |     rate   |
|          |         |          |   (i.e., |           |     as     |
|          |         |          |          |           |     well   |
|          |         |          |  current |           |     as     |
|          |         |          |     rate |           |     asset  |
|          |         |          |     of   |           |     value. |
|          |         |          |     in   |           |            |
|          |         |          | terest). |           |            |
|          |         |          |          |           |            |
|          |         |          | -        |           |            |
|          |         |          |   Copies |           |            |
|          |         |          |     of   |           |            |
|          |         |          |     Form |           |            |
|          |         |          |     1099 |           |            |
|          |         |          |     from |           |            |
|          |         |          |     the  |           |            |
|          |         |          |     f    |           |            |
|          |         |          | inancial |           |            |
|          |         |          |     inst |           |            |
|          |         |          | itution, |           |            |
|          |         |          |     and  |           |            |
|          |         |          |     veri |           |            |
|          |         |          | fication |           |            |
|          |         |          |     of   |           |            |
|          |         |          |     p    |           |            |
|          |         |          | rojected |           |            |
|          |         |          |          |           |            |
|          |         |          |   income |           |            |
|          |         |          |     for  |           |            |
|          |         |          |     the  |           |            |
|          |         |          |     next |           |            |
|          |         |          |     12   |           |            |
|          |         |          |          |           |            |
|          |         |          |  months. |           |            |
|          |         |          |          |           |            |
|          |         |          | -        |           |            |
|          |         |          | Broker's |           |            |
|          |         |          |     q    |           |            |
|          |         |          | uarterly |           |            |
|          |         |          |     st   |           |            |
|          |         |          | atements |           |            |
|          |         |          |          |           |            |
|          |         |          |  showing |           |            |
|          |         |          |          |           |            |
|          |         |          |    value |           |            |
|          |         |          |     of   |           |            |
|          |         |          |     stoc |           |            |
|          |         |          | ks/bonds |           |            |
|          |         |          |     and  |           |            |
|          |         |          |          |           |            |
|          |         |          | earnings |           |            |
|          |         |          |          |           |            |
|          |         |          | credited |           |            |
|          |         |          |     to   |           |            |
|          |         |          |     the  |           |            |
|          |         |          |     ap   |           |            |
|          |         |          | plicant. |           |            |
+----------+---------+----------+----------+-----------+------------+
| -   Em   | -       | -   T    | -   W-2  | -         | -   Always |
| ployment |   Verif | elephone |          | Notarized |            |
|          | ication |     or   |   Forms, |     s     |    verify: |
|   Income |         |     i    |     if   | tatements |            |
|     i    |    form | n-person |     a    |     or    |  frequency |
| ncluding |     co  |          | pplicant |     a     |     of     |
|          | mpleted |  contact |     has  | ffidavits |     gross  |
|    tips, |     by  |     with |     had  |           |     pay    |
|     gra  |     em  |     e    |     same |    signed |     (i.e., |
| tuities, | ployer. | mployer, |          |     by    |            |
|     o    |         |     sp   | employer |           |    hourly, |
| vertime. |         | ecifying |     for  | applicant |            |
|          |         |          |     at   |     that  |  biweekly, |
|          |         |   amount |          |           |            |
|          |         |     to   |    least |  describe |   monthly, |
|          |         |     be   |     two  |           |     b      |
|          |         |     paid |          |    amount | imonthly); |
|          |         |     per  |    years |     and   |     a      |
|          |         |     pay  |     and  |           | nticipated |
|          |         |          |     i    |    source |            |
|          |         |   period | ncreases |     of    |  increases |
|          |         |     and  |     can  |           |     in pay |
|          |         |          |     be   |   income. |     and    |
|          |         |   length |     ac   |           |            |
|          |         |     of   | curately |           |  effective |
|          |         |     pay  |     pr   |           |     dates; |
|          |         |          | ojected. |           |            |
|          |         |  period. |          |           |  overtime. |
|          |         |          | -        |           |            |
|          |         | Document | Paycheck |           | -          |
|          |         |     in   |          |           |    Require |
|          |         |     file |    stubs |           |     most   |
|          |         |     by   |     or   |           |     recent |
|          |         |     the  |          |           |     6-8    |
|          |         |          |  earning |           |     c      |
|          |         |   owner. |     sta  |           | onsecutive |
|          |         |          | tements. |           |     pay    |
|          |         |          |          |           |     stubs; |
|          |         |          |          |           |     do not |
|          |         |          |          |           |     use    |
|          |         |          |          |           |     check  |
|          |         |          |          |           |            |
|          |         |          |          |           |    without |
|          |         |          |          |           |     stub.  |
|          |         |          |          |           |            |
|          |         |          |          |           | -   For a  |
|          |         |          |          |           |     fee,   |
|          |         |          |          |           |            |
|          |         |          |          |           | additional |
|          |         |          |          |           |     i      |
|          |         |          |          |           | nformation |
|          |         |          |          |           |     can be |
|          |         |          |          |           |            |
|          |         |          |          |           |   obtained |
|          |         |          |          |           |     from   |
|          |         |          |          |           |     The    |
|          |         |          |          |           |     Work   |
|          |         |          |          |           |     Number |
|          |         |          |          |           |     800    |
|          |         |          |          |           | -996-7556; |
|          |         |          |          |           |     First  |
|          |         |          |          |           |            |
|          |         |          |          |           |   American |
|          |         |          |          |           |            |
|          |         |          |          |           |   Registry |
|          |         |          |          |           |     800    |
|          |         |          |          |           | -999-0350; |
|          |         |          |          |           |     and    |
|          |         |          |          |           |            |
|          |         |          |          |           |    Verifax |
|          |         |          |          |           |     800    |
|          |         |          |          |           | -969-5100. |
|          |         |          |          |           |     Fees   |
|          |         |          |          |           |     are    |
|          |         |          |          |           |     valid  |
|          |         |          |          |           |            |
|          |         |          |          |           |    project |
|          |         |          |          |           |            |
|          |         |          |          |           |  expenses. |
|          |         |          |          |           |     I      |
|          |         |          |          |           | nformation |
|          |         |          |          |           |     does   |
|          |         |          |          |           |     not    |
|          |         |          |          |           |            |
|          |         |          |          |           |    replace |
|          |         |          |          |           |     t      |
|          |         |          |          |           | hird-party |
|          |         |          |          |           |     ver    |
|          |         |          |          |           | ification. |
+----------+---------+----------+----------+-----------+------------+
| -        | -       | -   None | -        |           | -   An     |
|   Family |    None |     r    |    Birth |           |     owner  |
|     comp |     re  | equired. |     cert |           |     may    |
| osition. | quired. |          | ificates |           |     seek   |
|          |         |          |          |           |     ve     |
|          |         |          | -        |           | rification |
|          |         |          |  Divorce |           |     only   |
|          |         |          |          |           |     if the |
|          |         |          |  actions |           |     owner  |
|          |         |          |          |           |     has    |
|          |         |          | -        |           |     clear  |
|          |         |          | Drivers' |           |            |
|          |         |          |          |           |    written |
|          |         |          | licenses |           |            |
|          |         |          |          |           |    policy. |
|          |         |          | -        |           |            |
|          |         |          | Employer |           |            |
|          |         |          |          |           |            |
|          |         |          |  records |           |            |
|          |         |          |          |           |            |
|          |         |          | -        |           |            |
|          |         |          |   Income |           |            |
|          |         |          |     tax  |           |            |
|          |         |          |          |           |            |
|          |         |          |  returns |           |            |
|          |         |          |          |           |            |
|          |         |          | -        |           |            |
|          |         |          | Marriage |           |            |
|          |         |          |     cert |           |            |
|          |         |          | ificates |           |            |
|          |         |          |          |           |            |
|          |         |          | -        |           |            |
|          |         |          |   School |           |            |
|          |         |          |          |           |            |
|          |         |          |  records |           |            |
|          |         |          |          |           |            |
|          |         |          | -        |           |            |
|          |         |          |   Social |           |            |
|          |         |          |          |           |            |
|          |         |          | Security |           |            |
|          |         |          |          |           |            |
|          |         |          |   Admini |           |            |
|          |         |          | stration |           |            |
|          |         |          |          |           |            |
|          |         |          |  records |           |            |
|          |         |          |          |           |            |
|          |         |          | -        |           |            |
|          |         |          |   Social |           |            |
|          |         |          |          |           |            |
|          |         |          |  service |           |            |
|          |         |          |          |           |            |
|          |         |          |   agency |           |            |
|          |         |          |          |           |            |
|          |         |          |  records |           |            |
|          |         |          |          |           |            |
|          |         |          | -        |           |            |
|          |         |          |  Support |           |            |
|          |         |          |          |           |            |
|          |         |          |  payment |           |            |
|          |         |          |          |           |            |
|          |         |          |  records |           |            |
|          |         |          |          |           |            |
|          |         |          | -        |           |            |
|          |         |          |  Utility |           |            |
|          |         |          |          |           |            |
|          |         |          |    bills |           |            |
|          |         |          |          |           |            |
|          |         |          | -        |           |            |
|          |         |          | Veterans |           |            |
|          |         |          |          |           |            |
|          |         |          |   Admini |           |            |
|          |         |          | stration |           |            |
|          |         |          |     (VA) |           |            |
|          |         |          |          |           |            |
|          |         |          |  records |           |            |
+----------+---------+----------+----------+-----------+------------+
| -        | -   Dis | -   T    | -        | -         | -   Unless |
|   Family | ability | elephone |  Elderly |   Elderly |     the    |
|          |         |     or   |          |           |            |
|    type. | Status: |     i    |   Status |   Status: |  applicant |
|          |     st  | n-person |          |     Ap    |            |
| (Inf     | atement |          |    (when | plicant's |   receives |
| ormation |         |  contact |          |           |     income |
| verified |    from |     with |    there | signature |     or     |
| only to  |     ph  |          |     is   |     on    |            |
| d        | ysician |   source |     re   |     ap    |   benefits |
| etermine |     or  |     do   | asonable | plication |     for    |
| eli      |         | cumented |          |     is    |     which  |
| gibility |   other |     in   |    doubt |           |            |
| for      |     r   |     file |     that | generally |    elderly |
| project, | eliable |     by   |     a    |     su    |     or     |
| pref     |         |     the  | pplicant | fficient. |            |
| erences, | source, |          |     is   |           |   disabled |
| and      |     if  |   owner. |     at   |           |     status |
| allo     |     b   |          |          |           |     is a   |
| wances.) | enefits |          |    least |           |     re     |
|          |         |          |     62): |           | quirement, |
|          |    docu |          |          |           |     such   |
|          | menting |          |    birth |           |     status |
|          |         |          |     cert |           |     must   |
|          |  status |          | ificate, |           |     be     |
|          |     are |          |     b    |           |            |
|          |     not |          | aptismal |           |  verified. |
|          |     re  |          |     cert |           |            |
|          | ceived. |          | ificate, |           | -   Status |
|          |     See |          |          |           |     of     |
|          |     pa  |          |   social |           |            |
|          | ragraph |          |          |           |   disabled |
|          |         |          | security |           |     family |
|          |    3.25 |          |          |           |            |
|          |     B.1 |          | records, |           |    members |
|          |     for |          |          |           |     must   |
|          |         |          | driver's |           |     be     |
|          |   restr |          |          |           |            |
|          | ictions |          | license, |           |   verified |
|          |     on  |          |          |           |     for    |
|          |         |          |   census |           |     e      |
|          |    this |          |          |           | ntitlement |
|          |         |          |  record, |           |     to     |
|          |    form |          |          |           |     \$480  |
|          |     of  |          | official |           |            |
|          |         |          |          |           |  dependent |
|          |  verifi |          |   record |           |            |
|          | cation. |          |     of   |           |  deduction |
|          |         |          |          |           |     and    |
|          | -       |          |    birth |           |            |
|          |   Displ |          |     or   |           | disability |
|          | acement |          |          |           |            |
|          |         |          |    other |           | assistance |
|          | Status: |          |          |           |            |
|          |         |          |    autho |           | allowance. |
|          | Written |          | ritative |           |            |
|          |     st  |          |          |           | -   Owner  |
|          | atement |          | document |           |     may    |
|          |     or  |          |     or   |           |     not    |
|          |         |          |          |           |     ask    |
|          |    cert |          |  receipt |           |     the    |
|          | ificate |          |     of   |           |     nat    |
|          |     of  |          |     SSI  |           | ure/extent |
|          |         |          |     old  |           |     of     |
|          |   displ |          |     age  |           |     d      |
|          | acement |          |          |           | isability. |
|          |     by  |          | benefits |           |            |
|          |     the |          |     or   |           |            |
|          |         |          |     SS   |           |            |
|          |    appr |          |     b    |           |            |
|          | opriate |          | enefits. |           |            |
|          |         |          |          |           |            |
|          |   gover |          | -   D    |           |            |
|          | nmental |          | isabled, |           |            |
|          |     aut |          |          |           |            |
|          | hority. |          |   blind: |           |            |
|          |         |          |          |           |            |
|          |         |          | evidence |           |            |
|          |         |          |     of   |           |            |
|          |         |          |          |           |            |
|          |         |          |  receipt |           |            |
|          |         |          |     of   |           |            |
|          |         |          |     SSI  |           |            |
|          |         |          |     or   |           |            |
|          |         |          |     Di   |           |            |
|          |         |          | sability |           |            |
|          |         |          |     b    |           |            |
|          |         |          | enefits. |           |            |
+----------+---------+----------+----------+-----------+------------+
| -   F    | -       | -   T    | -        |           |            |
| ull-time |   Verif | elephone |   School |           |            |
|          | ication |     or   |          |           |            |
|  student |         |     i    | records, |           |            |
|          |    from | n-person |     such |           |            |
|   status |     the |          |     as   |           |            |
|     (of  |     Adm |  contact |     paid |           |            |
|          | issions |     with |     fee  |           |            |
|   family |     or  |          |     st   |           |            |
|          |         |    these | atements |           |            |
|   member |    Regi |          |     that |           |            |
|     18   | strar's |  sources |     show |           |            |
|     or   |         |     do   |     a    |           |            |
|          |  Office | cumented |     su   |           |            |
|   older, |     or  |     in   | fficient |           |            |
|     e    |         |     file |          |           |            |
| xcluding |   dean, |     by   |   number |           |            |
|          |     cou |     the  |     of   |           |            |
|    head, | nselor, |          |          |           |            |
|          |     a   |   owner. |  credits |           |            |
|  spouse, | dvisor, |          |     to   |           |            |
|     or   |         |          |     be   |           |            |
|          |   etc., |          |     co   |           |            |
|   foster |     or  |          | nsidered |           |            |
|     ch   |         |          |     a    |           |            |
| ildren). |    from |          |     f    |           |            |
|          |     VA  |          | ull-time |           |            |
|          |         |          |          |           |            |
|          | Office. |          |  student |           |            |
|          |         |          |     by   |           |            |
|          |         |          |     the  |           |            |
|          |         |          |     edu  |           |            |
|          |         |          | cational |           |            |
|          |         |          |     ins  |           |            |
|          |         |          | titution |           |            |
|          |         |          |     a    |           |            |
|          |         |          | ttended. |           |            |
+----------+---------+----------+----------+-----------+------------+
| -   Imm  | -       | -        | -   Ap   | -   No    | -   Owners |
| igration |   Verif |    None. | plicant/ | ncitizens |     must   |
|          | ication |          | resident |     must  |            |
|  Status. |     of  |          |     must |     sign  |    require |
|          |     e   |          |          |     de    |     n      |
|          | ligible |          |  provide | claration | oncitizens |
|          |         |          |     app  |     c     |            |
|          |    immi |          | ropriate | ertifying | requesting |
|          | gration |          |     imm  |     the   |            |
|          |         |          | igration |     f     | assistance |
|          |  status |          |     d    | ollowing: |     to     |
|          |         |          | ocuments |           |            |
|          |    must |          |     to   | >         |    provide |
|          |     be  |          |          |  Eligible |     ve     |
|          |     r   |          | initiate | > im      | rification |
|          | eceived |          |          | migration |     of     |
|          |         |          |    verif | > status; |            |
|          |    from |          | ication. | > or      |   eligible |
|          |     DHS |          |          | >         |     i      |
|          |         |          |          | >         | mmigration |
|          | through |          |          |  Decision |            |
|          |     the |          |          | > not to  |    status. |
|          |     DHS |          |          | > claim   |            |
|          |         |          |          | >         |            |
|          |    SAVE |          |          |  eligible |            |
|          |         |          |          | > status. |            |
|          |  system |          |          |           |            |
|          |     or  |          |          |           |            |
|          |         |          |          |           |            |
|          | through |          |          |           |            |
|          |     se  |          |          |           |            |
|          | condary |          |          |           |            |
|          |         |          |          |           |            |
|          |   verif |          |          |           |            |
|          | ication |          |          |           |            |
|          |         |          |          |           |            |
|          |   using |          |          |           |            |
|          |     DHS |          |          |           |            |
|          |         |          |          |           |            |
|          |    Form |          |          |           |            |
|          |         |          |          |           |            |
|          |  G-845. |          |          |           |            |
+----------+---------+----------+----------+-----------+------------+
| -        | -       | -   T    | -        |           | -   Checks |
|   Income |   Award | elephone |  Current |           |     or     |
|     mai  |     or  |     or   |     or   |           |            |
| ntenance |         |     i    |          |           |  automatic |
|     p    | benefit | n-person |   recent |           |     bank   |
| ayments, |         |          |          |           |            |
|     b    |   notif |  contact |    check |           |    deposit |
| enefits, | ication |     with |          |           |     slips  |
|          |         |          |    stubs |           |     may    |
|   income | letters |   income |     with |           |     not    |
|          |     p   |          |          |           |            |
|    other | repared |  source, |    date, |           |    provide |
|     than |     and |     do   |          |           |     gross  |
|          |         | cumented |  amount, |           |            |
|    wages |  signed |     in   |     and  |           |    amounts |
|          |     by  |     file |          |           |     of     |
|   (i.e., |         |     by   |    check |           |            |
|          |    auth |     the  |          |           |   benefits |
| welfare, | orizing |          |   number |           |     if     |
|          |         |   owner. |          |           |            |
|   Social | agency. |          | recorded |           |  applicant |
|          |         | -   *    |     by   |           |     has    |
| Security | -       | *NOTE:** |     the  |           |            |
|          |   TRACS |     For  |          |           | deductions |
|  \[SS\], |     or  |     all  |   owner. |           |     made   |
|     Supp |         |     oral |          |           |     for    |
| lemental |    REAC |          | -        |           |            |
|          |     may |    verif |    Award |           |   Medicare |
| Security |         | ication, |          |           |            |
|          | provide |     file |  letters |           | Insurance. |
|   Income |         |          |     or   |           |            |
|          |   verif |    docum |          |           | -   Pay    |
| \[SSI\], | ication | entation | computer |           |     stubs  |
|     Di   |     for |     must |          |           |     for    |
| sability |         |          | printout |           |     the    |
|          |  social |  include |     from |           |     most   |
|  Income, |     se  |          |          |           |     recent |
|     Pe   | curity. |   facts, |    court |           |     four   |
| nsions). |         |     time |     or   |           |     to six |
|          |         |     and  |          |           |     weeks  |
|          |         |     date |   public |           |     should |
|          |         |     of   |          |           |     be     |
|          |         |          |  agency. |           |            |
|          |         | contact, |          |           |  obtained. |
|          |         |     and  | -        |           |            |
|          |         |     name |   Copies |           | ```{=html} |
|          |         |     and  |     of   |           | <!-- -->   |
|          |         |          |     v    |           | ```        |
|          |         |    title | alidated |           | -          |
|          |         |     of   |     bank |           |    Copying |
|          |         |          |          |           |     of     |
|          |         |    third |  deposit |           |     U.S.   |
|          |         |          |          |           |            |
|          |         |   party. |   slips, |           |   Treasury |
|          |         |          |     with |           |     checks |
|          |         |          |          |           |     is not |
|          |         |          |   identi |           |            |
|          |         |          | fication |           | permitted. |
|          |         |          |     by   |           |            |
|          |         |          |          |           | -   Award  |
|          |         |          |    bank. |           |            |
|          |         |          |          |           |    letters |
|          |         |          | -   Most |           | /printouts |
|          |         |          |          |           |     from   |
|          |         |          |   recent |           |     court  |
|          |         |          |     q    |           |     or     |
|          |         |          | uarterly |           |     public |
|          |         |          |          |           |     agency |
|          |         |          |  pension |           |     may be |
|          |         |          |          |           |     out of |
|          |         |          |  account |           |     date;  |
|          |         |          |     st   |           |            |
|          |         |          | atement. |           |  telephone |
|          |         |          |          |           |     ve     |
|          |         |          |          |           | rification |
|          |         |          |          |           |     of     |
|          |         |          |          |           |     lette  |
|          |         |          |          |           | r/printout |
|          |         |          |          |           |     is     |
|          |         |          |          |           |     re     |
|          |         |          |          |           | commended. |
+----------+---------+----------+----------+-----------+------------+
| -        | -       | -   T    | -   Copy |           | -   Only   |
| Interest |   Verif | elephone |     of   |           |     the    |
|     from | ication |     or   |     the  |           |            |
|     sale |         |     i    |     c    |           |   interest |
|     of   |    form | n-person | ontract. |           |     income |
|     real |     co  |          |          |           |     is     |
|          | mpleted |  contact | -   Copy |           |            |
| property |     by  |     with |     of   |           |   counted; |
|          |     an  |     app  |     the  |           |     the    |
|   (e.g., |         | ropriate |     amor |           |            |
|          |    acco |          | tization |           |    balance |
| contract | untant, |   party, |     s    |           |     of the |
|     for  |     at  |     do   | chedule, |           |            |
|          | torney, | cumented |     with |           |    payment |
|    deed, |         |     in   |     su   |           |            |
|     ins  |    real |     file | fficient |           |    applied |
| tallment |         |     by   |     inf  |           |     to the |
|          |  estate |     the  | ormation |           |            |
|    sales |         |          |     for  |           |  principal |
|     c    | broker, |   owner. |     the  |           |     is     |
| ontract, |     the |          |          |           |     merely |
|          |         |          |    owner |           |     a      |
|    etc.) |  buyer, |          |     to   |           |     l      |
|          |     or  |          |     d    |           | iquidation |
|          |     a   |          | etermine |           |     of the |
|          |     fi  |          |     the  |           |     asset. |
|          | nancial |          |          |           |            |
|          |         |          |   amount |           | -   The    |
|          |    inst |          |     of   |           |     owner  |
|          | itution |          |          |           |     must   |
|          |         |          | interest |           |     get    |
|          |   which |          |     to   |           |     enough |
|          |     has |          |     be   |           |     i      |
|          |         |          |          |           | nformation |
|          |  copies |          |   earned |           |     to     |
|          |     of  |          |          |           |            |
|          |     the |          |   during |           |    compute |
|          |         |          |     the  |           |     the    |
|          |   amort |          |     next |           |     actual |
|          | ization |          |     12   |           |            |
|          |     s   |          |          |           |   interest |
|          | chedule |          |  months. |           |     income |
|          |         |          |          |           |     for    |
|          |    from |          | -   *    |           |     the    |
|          |         |          | *NOTE:** |           |     next   |
|          |   which |          |     Copy |           |     12     |
|          |     i   |          |     of a |           |            |
|          | nterest |          |          |           |    months. |
|          |         |          |    check |           |            |
|          |  income |          |     paid |           |            |
|          |     for |          |     by   |           |            |
|          |     the |          |     the  |           |            |
|          |         |          |          |           |            |
|          |    next |          |    buyer |           |            |
|          |     12  |          |     to   |           |            |
|          |         |          |     the  |           |            |
|          |  months |          |     a    |           |            |
|          |     can |          | pplicant |           |            |
|          |     be  |          |     is   |           |            |
|          |     ob  |          |     not  |           |            |
|          | tained. |          |     acc  |           |            |
|          |         |          | eptable. |           |            |
+----------+---------+----------+----------+-----------+------------+
| -        | -       | -   T    | -        | -         | -          |
|  Medical |   Verif | elephone |   Copies | Notarized |    Medical |
|     e    | ication |     or   |     of   |           |            |
| xpenses. |     by  |     i    |     c    | statement |   expenses |
|          |     a   | n-person | ancelled |     or    |     are    |
|          |         |          |          |           |     not    |
|          | doctor, |  contact |   checks |    signed |            |
|          |     h   |     with |     that |           |  allowable |
|          | ospital |          |          | affidavit |     as     |
|          |     or  |    these |   verify |     of    |            |
|          |         |          |          |     trans |  deduction |
|          | clinic, | sources, | payments | portation |     unless |
|          |     d   |     do   |     on   |           |            |
|          | entist, | cumented |     out  |  expenses |  applicant |
|          |         |     in   | standing |           |     is an  |
|          |    phar |     file |          |  directly |            |
|          | macist, |     by   |  medical |           |    elderly |
|          |         |     the  |          |   related |     or     |
|          |   etc., |          |    bills |     to    |            |
|          |     of  |   owner. |     that |           |   disabled |
|          |     es  |          |     will |   medical |            |
|          | timated |          |          |     t     |    family. |
|          |         |          | continue | reatment, |     Status |
|          | medical |          |     for  |     if    |     must   |
|          |         |          |     all  |     there |     be     |
|          |   costs |          |     or   |     is no |            |
|          |     to  |          |     part |     other |  verified. |
|          |     be  |          |     of   |           |            |
|          |     i   |          |     the  |    source |            |
|          | ncurred |          |     next |     of    |            |
|          |     or  |          |     12   |     veri  |            |
|          |         |          |          | fication. |            |
|          | regular |          |  months. |           |            |
|          |     p   |          |          |           |            |
|          | ayments |          | -        |           |            |
|          |     e   |          |   Copies |           |            |
|          | xpected |          |     of   |           |            |
|          |     to  |          |          |           |            |
|          |     be  |          |   income |           |            |
|          |         |          |     tax  |           |            |
|          |    made |          |          |           |            |
|          |     on  |          |    forms |           |            |
|          |         |          |     (    |           |            |
|          |    outs |          | Schedule |           |            |
|          | tanding |          |     A,   |           |            |
|          |         |          |     IRS  |           |            |
|          |   bills |          |     Fo   |           |            |
|          |         |          | rm 1040) |           |            |
|          |   which |          |     that |           |            |
|          |     are |          |          |           |            |
|          |     not |          |  itemize |           |            |
|          |         |          |          |           |            |
|          | covered |          |  medical |           |            |
|          |     by  |          |     e    |           |            |
|          |     ins |          | xpenses, |           |            |
|          | urance. |          |     when |           |            |
|          |         |          |     the  |           |            |
|          |         |          |          |           |            |
|          |         |          | expenses |           |            |
|          |         |          |     are  |           |            |
|          |         |          |     not  |           |            |
|          |         |          |          |           |            |
|          |         |          | expected |           |            |
|          |         |          |     to   |           |            |
|          |         |          |          |           |            |
|          |         |          |   change |           |            |
|          |         |          |     over |           |            |
|          |         |          |     the  |           |            |
|          |         |          |     next |           |            |
|          |         |          |     12   |           |            |
|          |         |          |          |           |            |
|          |         |          |  months. |           |            |
|          |         |          |          |           |            |
|          |         |          | -   R    |           |            |
|          |         |          | eceipts, |           |            |
|          |         |          |     c    |           |            |
|          |         |          | ancelled |           |            |
|          |         |          |          |           |            |
|          |         |          |  checks, |           |            |
|          |         |          |     pay  |           |            |
|          |         |          |          |           |            |
|          |         |          |   stubs, |           |            |
|          |         |          |          |           |            |
|          |         |          |    which |           |            |
|          |         |          |          |           |            |
|          |         |          | indicate |           |            |
|          |         |          |          |           |            |
|          |         |          |   health |           |            |
|          |         |          |     i    |           |            |
|          |         |          | nsurance |           |            |
|          |         |          |          |           |            |
|          |         |          |  premium |           |            |
|          |         |          |          |           |            |
|          |         |          |   costs, |           |            |
|          |         |          |     or   |           |            |
|          |         |          |          |           |            |
|          |         |          | payments |           |            |
|          |         |          |     to a |           |            |
|          |         |          |          |           |            |
|          |         |          | resident |           |            |
|          |         |          |     at   |           |            |
|          |         |          | tendant. |           |            |
|          |         |          |          |           |            |
|          |         |          | -        |           |            |
|          |         |          | Receipts |           |            |
|          |         |          |     or   |           |            |
|          |         |          |          |           |            |
|          |         |          |   ticket |           |            |
|          |         |          |          |           |            |
|          |         |          |    stubs |           |            |
|          |         |          |     that |           |            |
|          |         |          |          |           |            |
|          |         |          |   verify |           |            |
|          |         |          |          |           |            |
|          |         |          |   transp |           |            |
|          |         |          | ortation |           |            |
|          |         |          |          |           |            |
|          |         |          | expenses |           |            |
|          |         |          |          |           |            |
|          |         |          | directly |           |            |
|          |         |          |          |           |            |
|          |         |          |  related |           |            |
|          |         |          |     to   |           |            |
|          |         |          |          |           |            |
|          |         |          |  medical |           |            |
|          |         |          |     e    |           |            |
|          |         |          | xpenses. |           |            |
+----------+---------+----------+----------+-----------+------------+
| -   Need | -       |          |          |           | -   If the |
|     for  |  Letter |          |          |           |            |
|     an   |         |          |          |           |    owner's |
|     a    |    from |          |          |           |     policy |
| ssistive |         |          |          |           |     is to  |
|          | medical |          |          |           |     verify |
|  animal. |     pr  |          |          |           |     this   |
|          | ovider. |          |          |           |     need,  |
|          |         |          |          |           |     owner  |
|          |         |          |          |           |     must   |
|          |         |          |          |           |            |
|          |         |          |          |           |  implement |
|          |         |          |          |           |     policy |
|          |         |          |          |           |     con    |
|          |         |          |          |           | sistently. |
+----------+---------+----------+----------+-----------+------------+
| -   Net  | -   Not | -   Not  | -   Form |           |            |
|          |         |     app  |     1040 |           |            |
|   Income |    appl | licable. |     with |           |            |
|     for  | icable. |          |          |           |            |
|     a    |         |          | Schedule |           |            |
|     b    |         |          |     C,   |           |            |
| usiness. |         |          |     E,   |           |            |
|          |         |          |     or   |           |            |
|          |         |          |     F.   |           |            |
|          |         |          |          |           |            |
|          |         |          | -   F    |           |            |
|          |         |          | inancial |           |            |
|          |         |          |     Stat |           |            |
|          |         |          | ement(s) |           |            |
|          |         |          |     of   |           |            |
|          |         |          |     the  |           |            |
|          |         |          |          |           |            |
|          |         |          | business |           |            |
|          |         |          |          |           |            |
|          |         |          | (audited |           |            |
|          |         |          |     or   |           |            |
|          |         |          |     un   |           |            |
|          |         |          | audited) |           |            |
|          |         |          |     i    |           |            |
|          |         |          | ncluding |           |            |
|          |         |          |     an   |           |            |
|          |         |          |     acco |           |            |
|          |         |          | untant's |           |            |
|          |         |          |     cal  |           |            |
|          |         |          | culation |           |            |
|          |         |          |     of   |           |            |
|          |         |          |          |           |            |
|          |         |          |    strai |           |            |
|          |         |          | ght-line |           |            |
|          |         |          |     depr |           |            |
|          |         |          | eciation |           |            |
|          |         |          |          |           |            |
|          |         |          |  expense |           |            |
|          |         |          |     if   |           |            |
|          |         |          |     acc  |           |            |
|          |         |          | elerated |           |            |
|          |         |          |     depr |           |            |
|          |         |          | eciation |           |            |
|          |         |          |     was  |           |            |
|          |         |          |     used |           |            |
|          |         |          |     on   |           |            |
|          |         |          |     the  |           |            |
|          |         |          |     tax  |           |            |
|          |         |          |          |           |            |
|          |         |          |   return |           |            |
|          |         |          |     or   |           |            |
|          |         |          |     f    |           |            |
|          |         |          | inancial |           |            |
|          |         |          |     st   |           |            |
|          |         |          | atement. |           |            |
|          |         |          |          |           |            |
|          |         |          | -   Any  |           |            |
|          |         |          |     loan |           |            |
|          |         |          |     app  |           |            |
|          |         |          | lication |           |            |
|          |         |          |          |           |            |
|          |         |          |  listing |           |            |
|          |         |          |          |           |            |
|          |         |          |   income |           |            |
|          |         |          |          |           |            |
|          |         |          |  derived |           |            |
|          |         |          |     from |           |            |
|          |         |          |          |           |            |
|          |         |          | business |           |            |
|          |         |          |          |           |            |
|          |         |          |   during |           |            |
|          |         |          |     the  |           |            |
|          |         |          |     p    |           |            |
|          |         |          | receding |           |            |
|          |         |          |     12   |           |            |
|          |         |          |          |           |            |
|          |         |          |  months. |           |            |
|          |         |          |          |           |            |
|          |         |          | -   For  |           |            |
|          |         |          |          |           |            |
|          |         |          |   rental |           |            |
|          |         |          |     p    |           |            |
|          |         |          | roperty, |           |            |
|          |         |          |          |           |            |
|          |         |          |   copies |           |            |
|          |         |          |     of   |           |            |
|          |         |          |          |           |            |
|          |         |          |   recent |           |            |
|          |         |          |     rent |           |            |
|          |         |          |          |           |            |
|          |         |          |  checks, |           |            |
|          |         |          |          |           |            |
|          |         |          |    lease |           |            |
|          |         |          |     and  |           |            |
|          |         |          |          |           |            |
|          |         |          | receipts |           |            |
|          |         |          |     for  |           |            |
|          |         |          |     e    |           |            |
|          |         |          | xpenses, |           |            |
|          |         |          |     or   |           |            |
|          |         |          |     IRS  |           |            |
|          |         |          |          |           |            |
|          |         |          | Schedule |           |            |
|          |         |          |     E.   |           |            |
+----------+---------+----------+----------+-----------+------------+
| -   R    | -   No  | -   T    | -   Not  | -         | -          |
| ecurring | tarized | elephone |     app  | Notarized |   Sporadic |
|          |     st  |     or   | licable. |           |     con    |
|    contr | atement |     i    |          | statement | tributions |
| ibutions |     or  | n-person |          |     or    |     and    |
|     and  |     af  |          |          |           |     gifts  |
|          | fidavit |  contact |          | affidavit |     are    |
|   gifts. |         |     with |          |           |     not    |
|          |  signed |          |          |    signed |            |
|          |     by  |   source |          |     by    |    counted |
|          |     the |     do   |          |           |     as     |
|          |         | cumented |          | applicant |            |
|          |  person |     in   |          |           |    income. |
|          |     pr  |     file |          |   stating |            |
|          | oviding |     by   |          |           |            |
|          |     the |     the  |          |  purpose, |            |
|          |     ass |          |          |           |            |
|          | istance |   owner. |          |    dates, |            |
|          |         |          |          |     and   |            |
|          |  giving |          |          |     value |            |
|          |     the |          |          |     of    |            |
|          |     p   |          |          |           |            |
|          | urpose, |          |          |    gifts. |            |
|          |         |          |          |           |            |
|          |  dates, |          |          |           |            |
|          |     and |          |          |           |            |
|          |         |          |          |           |            |
|          |   value |          |          |           |            |
|          |     of  |          |          |           |            |
|          |         |          |          |           |            |
|          |  gifts. |          |          |           |            |
+----------+---------+----------+----------+-----------+------------+
| -        | None    | None     | -   Form | -         |            |
| Self-emp | ava     | av       |     10   | Notarized |            |
| loyment, | ilable. | ailable. | 40/1040A |           |            |
|          |         |          |          | statement |            |
|    tips, |         |          |  showing |     or    |            |
|     gra  |         |          |          |           |            |
| tuities, |         |          |   amount | affidavit |            |
|     etc. |         |          |          |           |            |
|          |         |          |   earned |    signed |            |
|          |         |          |     and  |     by    |            |
|          |         |          |     em   |           |            |
|          |         |          | ployment | applicant |            |
|          |         |          |          |           |            |
|          |         |          |  period. |   showing |            |
|          |         |          |          |           |            |
|          |         |          |          |    amount |            |
|          |         |          |          |           |            |
|          |         |          |          |    earned |            |
|          |         |          |          |     and   |            |
|          |         |          |          |     pay   |            |
|          |         |          |          |           |            |
|          |         |          |          |   period. |            |
+----------+---------+----------+----------+-----------+------------+
| -        | -       | -   None | -        | -   Cert  | -   I      |
|   Social |    None |     r    | Original | ification | ndividuals |
|          |     re  | equired. |          |     that  |     who    |
| security | quired. |          |   Social |           |     have   |
|          |         |          |          |  document |            |
|  number. |         |          | Security |     is    |    applied |
|          |         |          |     card |           |     for    |
|          |         |          |          |  complete |     le     |
|          |         |          | -        | /accurate | galization |
|          |         |          | Driver's |           |     under  |
|          |         |          |          |    unless |     the    |
|          |         |          |  license |           |     I      |
|          |         |          |     with |  original | mmigration |
|          |         |          |     SSN  |           |     Reform |
|          |         |          |          |    Social |     and    |
|          |         |          | -        |           |            |
|          |         |          |   Identi |  Security |    Control |
|          |         |          | fication |     card  |     Act of |
|          |         |          |     card |     is    |     1986   |
|          |         |          |          |           |     will   |
|          |         |          |   issued | provided. |     be     |
|          |         |          |     by a |           |     able   |
|          |         |          |          |           |     to     |
|          |         |          | federal, |           |            |
|          |         |          |          |           |   disclose |
|          |         |          |   State, |           |     their  |
|          |         |          |     or   |           |     social |
|          |         |          |          |           |            |
|          |         |          |    local |           |   security |
|          |         |          |          |           |            |
|          |         |          |  agency, |           |    numbers |
|          |         |          |     a    |           |     but    |
|          |         |          |          |           |     unable |
|          |         |          |  medical |           |     to     |
|          |         |          |     i    |           |     supply |
|          |         |          | nsurance |           |     cards  |
|          |         |          |     p    |           |     for    |
|          |         |          | rovider, |           |     docu   |
|          |         |          |     or   |           | mentation. |
|          |         |          |     an   |           |     Social |
|          |         |          |          |           |            |
|          |         |          | employer |           |   security |
|          |         |          |     or   |           |            |
|          |         |          |          |           |    numbers |
|          |         |          |    trade |           |     are    |
|          |         |          |          |           |            |
|          |         |          |   union. |           |   assigned |
|          |         |          |          |           |     to     |
|          |         |          | -        |           |     these  |
|          |         |          | Earnings |           |            |
|          |         |          |     st   |           |    persons |
|          |         |          | atements |           |     when   |
|          |         |          |     on   |           |     they   |
|          |         |          |          |           |     apply  |
|          |         |          |  payroll |           |     for    |
|          |         |          |          |           |            |
|          |         |          |    stubs |           |   amnesty. |
|          |         |          |          |           |     The    |
|          |         |          | -   Bank |           |     cards  |
|          |         |          |     s    |           |     go to  |
|          |         |          | tatement |           |     DHS    |
|          |         |          |          |           |     until  |
|          |         |          | -   Form |           |     the    |
|          |         |          |     1099 |           |            |
|          |         |          |          |           |    persons |
|          |         |          | -        |           |     are    |
|          |         |          |  Benefit |           |            |
|          |         |          |          |           |    granted |
|          |         |          |    award |           |            |
|          |         |          |          |           |  temporary |
|          |         |          |   letter |           |     lawful |
|          |         |          |          |           |            |
|          |         |          | -   Re   |           |   resident |
|          |         |          | tirement |           |            |
|          |         |          |          |           |    status. |
|          |         |          |  benefit |           |     Until  |
|          |         |          |          |           |     that   |
|          |         |          |   letter |           |     time,  |
|          |         |          |          |           |     their  |
|          |         |          | -   Life |           |            |
|          |         |          |     i    |           | acceptable |
|          |         |          | nsurance |           |     doc    |
|          |         |          |          |           | umentation |
|          |         |          |   policy |           |     is a   |
|          |         |          |          |           |     letter |
|          |         |          | -        |           |     from   |
|          |         |          |    Court |           |     the    |
|          |         |          |          |           |     DHS    |
|          |         |          |  records |           |            |
|          |         |          |          |           | indicating |
|          |         |          |          |           |     that   |
|          |         |          |          |           |     social |
|          |         |          |          |           |            |
|          |         |          |          |           |   security |
|          |         |          |          |           |            |
|          |         |          |          |           |    numbers |
|          |         |          |          |           |     have   |
|          |         |          |          |           |     been   |
|          |         |          |          |           |            |
|          |         |          |          |           |  assigned. |
+----------+---------+----------+----------+-----------+------------+
| -        | -       | -   None | -   None | -         | -   Owner  |
|   Unborn |    None |     r    |     r    |   Applica |     may    |
|     c    |     re  | equired. | equired. | nt/tenant |     not    |
| hildren. | quired. |          |          |     self- |     verify |
|          |         |          |          | certifies |            |
|          |         |          |          |     to    |    further |
|          |         |          |          |     p     |     than   |
|          |         |          |          | regnancy. |            |
|          |         |          |          |           |  self-cert |
|          |         |          |          |           | ification. |
+----------+---------+----------+----------+-----------+------------+
| -   Unem | -       | -   T    | -        |           | -          |
| ployment |   Verif | elephone |   Copies |           |  Frequency |
|          | ication |     or   |     of   |           |     of     |
|    compe |         |     i    |          |           |            |
| nsation. |    form | n-person |   checks |           |   payments |
|          |     co  |          |     or   |           |     and    |
|          | mpleted |  contact |          |           |            |
|          |     by  |     with |  records |           |   expected |
|          |         |          |     from |           |     length |
|          | source. |   agency |          |           |     of     |
|          |         |     do   |   agency |           |            |
|          |         | cumented |          |           |    benefit |
|          |         |     in a | provided |           |     term   |
|          |         |     file |     by   |           |     must   |
|          |         |     by   |     a    |           |     be     |
|          |         |     an   | pplicant |           |            |
|          |         |          |          |           |  verified. |
|          |         |   owner. |  stating |           |            |
|          |         |          |          |           | -   Income |
|          |         |          |  payment |           |     not    |
|          |         |          |          |           |            |
|          |         |          |  amounts |           |   expected |
|          |         |          |     and  |           |     to     |
|          |         |          |          |           |     last   |
|          |         |          |   dates. |           |     full   |
|          |         |          |          |           |     12     |
|          |         |          | -        |           |     months |
|          |         |          |  Benefit |           |     must   |
|          |         |          |     noti |           |     be     |
|          |         |          | fication |           |            |
|          |         |          |          |           | calculated |
|          |         |          |   letter |           |     based  |
|          |         |          |          |           |     on 12  |
|          |         |          |   signed |           |     months |
|          |         |          |     by   |           |     and    |
|          |         |          |     aut  |           |            |
|          |         |          | horizing |           |    interim |
|          |         |          |          |           |     recer  |
|          |         |          |  agency. |           | tification |
|          |         |          |          |           |            |
|          |         |          |          |           |  completed |
|          |         |          |          |           |     when   |
|          |         |          |          |           |            |
|          |         |          |          |           |   benefits |
|          |         |          |          |           |     stop.  |
+----------+---------+----------+----------+-----------+------------+
| -        | -       | -   T    | -        | -   Not   | -   Actual |
|  Welfare |   Verif | elephone |  Maximum |     app   |            |
|          | ication |     or   |          | ropriate. |    welfare |
| payments |         |     i    |  shelter |           |            |
|          |    form | n-person |     a    |           |    benefit |
| (as-paid |     co  |          | llowance |           |     amount |
|          | mpleted |  contact |          |           |     not    |
|   states |     by  |     with | schedule |           |            |
|          |         |          |     with |           | sufficient |
|   only). | welfare |   income |          |           |     as     |
|          |     dep |          |  ratable |           |     proof  |
|          | artment |  source, |     r    |           |     of     |
|          |     ind |     do   | eduction |           |     income |
|          | icating | cumented |          |           |     in     |
|          |         |     in   | schedule |           |            |
|          | maximum |     file |          |           |  "as-paid" |
|          |         |     by   | provided |           |     states |
|          |  amount |     the  |     by   |           |     or     |
|          |         |          |     ap   |           |            |
|          |  family |   owner. | plicant. |           | localities |
|          |     may |          |          |           |     since  |
|          |     r   |          |          |           |     income |
|          | eceive. |          |          |           |     is     |
|          |         |          |          |           |            |
|          | -       |          |          |           |    defined |
|          | Maximum |          |          |           |     as     |
|          |         |          |          |           |            |
|          | shelter |          |          |           |    maximum |
|          |     s   |          |          |           |            |
|          | chedule |          |          |           |    shelter |
|          |     by  |          |          |           |            |
|          |     ho  |          |          |           |    amount. |
|          | usehold |          |          |           |            |
|          |         |          |          |           |            |
|          |    size |          |          |           |            |
|          |         |          |          |           |            |
|          |    with |          |          |           |            |
|          |         |          |          |           |            |
|          | ratable |          |          |           |            |
|          |     re  |          |          |           |            |
|          | duction |          |          |           |            |
|          |     sc  |          |          |           |            |
|          | hedule. |          |          |           |            |
+----------+---------+----------+----------+-----------+------------+
| -   Zero | -   Not | -   Not  | -   Not  | -         | -   Owners |
|          |         |     app  |     app  |   Applica |     may    |
|  Income. |    appl | licable. | licable. | nt/Tenant |            |
|          | icable. |          |          |     self- |    require |
|          |         |          |          | certifies |     applic |
|          |         |          |          |     to    | ant/tenant |
|          |         |          |          |     zero  |     to     |
|          |         |          |          |           |     sign   |
|          |         |          |          |   income. |     ve     |
|          |         |          |          |           | rification |
|          |         |          |          |           |            |
|          |         |          |          |           |    release |
|          |         |          |          |           |     of     |
|          |         |          |          |           |     i      |
|          |         |          |          |           | nformation |
|          |         |          |          |           |     forms  |
|          |         |          |          |           |     for    |
|          |         |          |          |           |     state, |
|          |         |          |          |           |     local, |
|          |         |          |          |           |     and    |
|          |         |          |          |           |            |
|          |         |          |          |           |    federal |
|          |         |          |          |           |            |
|          |         |          |          |           |   benefits |
|          |         |          |          |           |            |
|          |         |          |          |           |  programs, |
|          |         |          |          |           |     as     |
|          |         |          |          |           |     well   |
|          |         |          |          |           |     as the |
|          |         |          |          |           |     HUD    |
|          |         |          |          |           |     9887   |
|          |         |          |          |           |     and    |
|          |         |          |          |           |     HUD    |
|          |         |          |          |           |            |
|          |         |          |          |           |    9887-A. |
|          |         |          |          |           |            |
|          |         |          |          |           | -   Owners |
|          |         |          |          |           |     may    |
|          |         |          |          |           |            |
|          |         |          |          |           |    require |
|          |         |          |          |           |     the    |
|          |         |          |          |           |     tenant |
|          |         |          |          |           |     to     |
|          |         |          |          |           |            |
|          |         |          |          |           |   reverify |
|          |         |          |          |           |     zero   |
|          |         |          |          |           |     income |
|          |         |          |          |           |     status |
|          |         |          |          |           |     at     |
|          |         |          |          |           |     least  |
|          |         |          |          |           |     every  |
|          |         |          |          |           |     90     |
|          |         |          |          |           |     days.  |
+----------+---------+----------+----------+-----------+------------+