HUD’s Office of Affordable Housing Programs (OAHP) has updated the sample self-certification of income form originally published in June 2020. The revised form supersedes previous form and is valid for use through September 30, 2021, the extended HOME COVID-19 waiver period.
View the Updated HOME Sample Self-Certification of Income Form.
Participating Jurisdictions (PJs) can use the sample self-certification of income form to document the annual income of:
- New applicants of HOME-assisted rental units
- New applicants of HOME Tenant-Based Rental Assistance (TBRA) programs, including emergency and short-term TBRA
- Existing TBRA tenants requiring assistance under an emergency TBRA program
- Existing tenants of HOME rental units up for income re-examination (annual and 6th year redeterminations)
- Prior applicants denied assistance due to the inclusion of excludable unemployment benefits
Visit the HUD Exchange HOME COVID-19 Guidance page for additional information and resources.