Instructions for RD 3560-8

TENANT CERTIFICATION

This form is completed for each tenant in all Rural Rental Housing, Rural Cooperative Housing, and Labor Housing borrowers or their authorized representative to document the tenant income and calculate the appropriate rental charge.

The data contained on this form is transmitted to Rural Development through the Management Interactive Network Connection (MINC) and uploaded into the Multifamily Housing Information System (MFIS). The MINC system can be accessed at https://usdaminc.sc.egov.usda.gov/. If you are not required to use the MINC system, submit the original executed copy of the completed form in hard copy or facsimile to the Centralized Servicing Center at PO Box 979082, St. Louis, MO 63197 or fax 314-457-4471.

Borrowers or their authorized representative must complete all of the items specified in the following table.

Part I - Project And Unit Identification

Fld Name / Item No.	Instruction
1 Effective Date	Enter the date this tenant certification is effective. Mark the block, as appropriate to indicate the type of action.
2 Project Name	Enter the project name.
3 Project ID	Enter the project’s ID (Example: 0123456789) and number (017). If you do not know the correct numbers to enter on Line 3, contact your Rural Development Servicing Office.
4 Unit Type	Enter the tenant household’s apartment unit size, according to the following: 0 efficiency, no bedrooms 1 one-bedroom 2 two-bedrooms 3 three-bedrooms 4 four-bedrooms When there is more than one type of each size of apartment unit, and there is a distinct rental rate for each type, begin the unit type code as follows: S Small M Medium L Large H Handicapped Design. For example: S1 – Small one-bedroom M1 – Medium one-bedroom

Fld Name / Item No.	Instruction
5 Unit Number	Enter this tenant household’s apartment unit number. The unit number may consist of up to six characters of either letters or numbers. For example: A 1 0 4 Apartment No. A-104 4 Apartment No. 4.

Fld Name /
Item No.

Instruction

Unit Number

Enter this tenant household’s apartment unit number. The unit number may consist of up to six characters of either letters or numbers. For example:

A 1 0 4 Apartment No. A-104

4 Apartment No. 4.

Part II - Tenant Household Information

Fld Name / Item No.	Instruction
6 Tenant Subsidy Code	Enter the appropriate code as follows: “0” No Deep Tenant Subsidy. Tenants receiving no deep tenant subsidy. “Deep tenant subsidy” is assistance that allows a tenant to contribute less than the basic rent for shelter costs (or note rate rent in those projects with note rate rent only). “1” Rural Development Rental Assistance (RA). “4” Other Public RA. Tenants receiving deep tenant subsidy from any Federal, State or local public agency, other than RHS or HUD. “5” Private RA. Tenants receiving deep tenant subsidy funded by a borrower (include rent incentives only when they will be provided for 12 months or longer). “6” HUD Voucher. Tenants receiving a HUD Voucher. “7” Other Types at Basic Rent. Tenants receiving any other type of deep tenant subsidy not listed above, which requires that the total funds available for rent from the tenant and subsidy provider equal basic rent.
7 Social Security Number	Corresponding to the name in Line 8, enter the social security number, when provided, or any Tenant, Co-Tenant or other household member that contributes to income. If the tenant, co-tenant or any other household member does not have a social security number but is eligible for housing, complete the field with all zeros or use the alien registration number.
8 Household Member Name List	Enter the name of each tenant household member. Foster children are not considered to be members of the tenant household and are not to be entered on this line. Always place the “tenant’s” (person who signs the lease as tenant) name first and the “co- tenant’s” (a person who signs the lease as co-tenant) name next.

Fld Name / Item No.	Instruction
8a Number of Foster Children	Enter the number of foster children who will reside in the unit or unborn children anticipated to reside in the unit this certification period. The number of foster or unborn children will be used only to determine the appropriate size unit.
9 Sex	Corresponding to the name in Line 8, enter the sex of each tenant household member.
10 Date of Birth	Corresponding to the name in Line 8, enter the date of birth of each tenant household member. For example: 12 02 55 — December 2, 1955.
11 Race	Enter the appropriate code for the race of all household members. You are to obtain this information from the tenant household’s completed application for occupancy or from the previous tenant certification. One or more choices for race may be selected. If the tenant, co-tenant, or any household members chooses not to furnish the information, you are required to note the race on the basis of visual observance or surname. Choices for Race – 1 – American Indian or Alaskan Native 2 – Asian 3 – Black or African American 4 – native Hawaiian or Pacific Islander 5 – White
12 Ethnicity	Enter the appropriate code for the ethnicity of all household members. You are to obtain this information from the tenant household’s completed application for occupancy or from the previous tenant certification. One choice for ethnicity may be selected. If the tenant, co-tenant, or any household members chooses not to furnish the information, you are required to note the race on the basis of visual observance or surname. a – Hispanc/Latino b – Non-Hispanic/Latino
12a Race Determin-ation Code	Enter the appropriate race determination code: C – Customer provided (the tenant entered the information on the application) E – Employee observed (the tenant chose not to provide this information so management noted race/ethnicity based on visual observation or surname.) See 7 CFR 3560.154(a)(9)/
13 Minor, Disabled, Handicapped or Full Time Student 18 or Older	Corresponding to the name in Line 8, enter the appropriate code for each tenant household member other than the tenant or co- tenant who is a minor, handicapped, disabled or full-time student 18 or older. Add all the marked boxes and place the total in the box marked “Total”. Always code handicapped or disabled minors as handicapped or disabled rather than minors. Always code students under 18 as minors rather than full-time students. Code for Line 13: M Minor H Individual with handicap D Individual with disability F Full-Time Student 18 or Older The terms minor, individual with handicap and individual with disability are defined in Paragraph 6.5 B. of HB-2-3560.
14 Elderly, Disabled, or Handicapped	Corresponding to the name in Line 8, enter the appropriate code for the tenant or co-tenant if either is considered elderly, or an individual with handicap or disability. If any spaces are coded, check the bottom box to indicate that the household has an elderly family status. Always code an elderly person with a handicap or disability as an individual with handicap or individual with disability rather than elderly. Code for Line 14: E Elderly H — Tenant or cotenant with handicap D — Individual with disability The terms elderly, individual with handicap and individual with disability are defined in Paragraph 6.5 B of HB-2-3560.

Fld Name /
Item No.

Instruction

Number of Foster Children

Enter the number of foster children who will reside in the unit or unborn children anticipated to reside in the unit this certification period. The number of foster or unborn children will be used only to determine the appropriate size unit.

Sex

Corresponding to the name in Line 8, enter the sex of each tenant household member.

Date of Birth

Corresponding to the name in Line 8, enter the date of birth of each tenant household member.

For example: 12 02 55 — December 2, 1955.

11 Race

Enter the appropriate code for the race of all household members. You are to obtain this information from the tenant household’s completed application for occupancy or from the previous tenant certification. One or more choices for race may be selected. If the tenant, co-tenant, or any household members chooses not to furnish the information, you are required to note the race on the basis of visual observance or surname.

Choices for Race –

1 – American Indian or Alaskan Native

2 – Asian

3 – Black or African American

4 – native Hawaiian or Pacific Islander

5 – White

12 Ethnicity

Enter the appropriate code for the ethnicity of all household members. You are to obtain this information from the tenant household’s completed application for occupancy or from the previous tenant certification. One choice for ethnicity may be selected. If the tenant, co-tenant, or any household members chooses not to furnish the information, you are required to note the race on the basis of visual observance or surname.

a – Hispanc/Latino

b – Non-Hispanic/Latino

12a Race Determin-ation Code

Enter the appropriate race determination code:

C – Customer provided (the tenant entered the information on the application)

E – Employee observed (the tenant chose not to provide this information so management noted race/ethnicity based on visual observation or surname.) See 7 CFR 3560.154(a)(9)/

Minor, Disabled, Handicapped or Full Time Student 18 or Older

Corresponding to the name in Line 8, enter the appropriate code for each tenant household member other than the tenant or co- tenant who is a minor, handicapped, disabled or full-time student 18 or older. Add all the marked boxes and place the total in the box marked “Total”. Always code handicapped or disabled minors as handicapped or disabled rather than minors. Always code students under 18 as minors rather than full-time students.

Code for Line 13:

M Minor

H Individual with handicap

D Individual with disability

F Full-Time Student 18 or Older

The terms minor, individual with handicap and individual with disability are defined in Paragraph 6.5 B. of HB-2-3560.

Elderly, Disabled, or Handicapped

Corresponding to the name in Line 8, enter the appropriate code for the tenant or co-tenant if either is considered elderly, or an individual with handicap or disability. If any spaces are coded, check the bottom box to indicate that the household has an elderly family status. Always code an elderly person with a handicap or disability as an individual with handicap or individual with disability rather than elderly.

Code for Line 14:

E Elderly

H — Tenant or cotenant with handicap

D — Individual with disability

The terms elderly, individual with handicap and individual with disability are defined in Paragraph 6.5 B of HB-2-3560.

Part III – Asset Income

Fld Name / Item No.	Instruction
15 Net Family Assets	Enter all net family assets. “Net Family Assets” is defined in Paragraph 6.9 of HB-2-3560.
16 Imputed Income	To obtain the imputed income from assets, multiply net family assets (Line 15) by the local interest rate on bank passbook savings and enter the result. Be sure to enter the project’s current passbook savings rate in the space provided. Note: If net family assets entered in Line 15 do not exceed $5,000, enter zero on this line.
17 Income from Assets	Enter actual income received from net family assets.

Part IV - Income Calculations

Fld Name / Item No.	Instruction
18 Income	Insert the tenant household’s total annual income from each of the sources specified in Line 18a thru 18e, and enter the total from all sources in Line 18f. Annual income is defined in Attachment 6-A of HB-2-3560.
18 g Household has Exempt Income	This block should be check if some or all of the income for the household is exempt for purposes of rent determination. See Attachment 6-A of HB-2-3560 for a list.
19 Adjustments to Income	Enter any adjustments to income. Add Lines 19a thru 19d and enter the total on Line 19e. Adjustments to income are described in the definition of Adjusted annual income in Paragraph 6.8 C of HB-2-3560. a. Multiply $480 times the number indicated in the “Total” box of Line 13. b. $400 when “elderly” family status is indicated in Line 14 (Limited to $400 per tenant household). c. When Line 14 indicates elderly status, all allowable medical expenses in excess of 3 percent of annual income (Line 18f) may be entered. When Line 14 does not indicate elderly status, only attendant care and apparatus expenses for handicapped or disabled household members in excess of 3 percent of annual income may be entered. d. Child care expenses. e. Total adjustments.
20 Adjusted Annual Income	Subtract the total adjustments to income (Line 19e) from annual income (Line 18f) and enter the difference. When adjusted income is less than zero, enter zero on this line.

Part V – Income Level

Fld Name / Item No.	Instruction
21 Number of Household Members	Enter the total number of household members described in Line 8. Do not include foster or unborn children.

Fld Name /
Item No.

Instruction

Number of Household Members

Enter the total number of household members described in Line 8. Do not include foster or unborn children.

Fld Name / Item No.	Instruction
22 Current Eligibility Income Level	This line determines if the tenant household income is eligible to receive RA and remain in the project. Go to the income tables in Appendix 9 of HB-1-3550 and determine the income level based on the adjusted annual income (Line 20) and the total number of household members (Line 21). You are to code the income level as follows: V Very Low-Income L Low-Income M Moderate-Income A Above Moderate (Ineligible).
23 Date of Initial Project Entry	Enter the date this tenant household initially occupied this Rural Development financed project.
24 Eligibility Annual Income	For all tenant households who initially occupy this Rural Development financed project after October 1, 1986, enter the first “Eligibility” income level from Line 22 of the initial “Tenant Certification” form. (During subsequent re-certification this can be obtained from Line 24 of the preceding tenant certification). This is to be maintained throughout the tenant household’s tenancy for comparative purposes. Use the same coding system for income levels described in Line 22.

Part VI - Certification By Tenant

The Tenant and Co-Tenant (if any) must certify to the accuracy of PARTS II through IV by dating and signing in the appropriate space.

Page 2

Part VII - Preliminary Calculations

Fld Name / Item No.	Instruction
25 Adjusted Monthly Income	Enter the adjusted monthly income [adjusted annual income (Line 20) divided by 12] on Line 25a. Determine 30 percent (30%) of adjusted monthly income by multiplying Line 25a by.30 as shown on the Form. Enter 30% of adjusted monthly income on Line 25b.
26 Monthly Income	Enter the monthly income [annual income (Line 18f) divided by 12] on Line 26a. Determine 10 percent (10%) of monthly income by multiplying Line 26a by.10 as shown on the Form. Enter 10% of monthly income on Line 26b.

Fld Name /
Item No.

Instruction

Adjusted Monthly Income

Enter the adjusted monthly income [adjusted annual income (Line 20) divided by 12] on Line 25a. Determine 30 percent (30%) of adjusted monthly income by multiplying Line 25a by.30 as shown on the Form. Enter 30% of adjusted monthly income on Line 25b.

Monthly Income

Enter the monthly income [annual income (Line 18f) divided by 12] on Line 26a. Determine 10 percent (10%) of monthly income by multiplying Line 26a by.10 as shown on the Form. Enter 10% of monthly income on Line 26b.

Fld Name / Item No.	Instruction
27 Designated Monthly Welfare Shelter Payment	Enter the designated monthly welfare shelter payment if applicable. This will be the amount the tenant household actually receives from the Public Assistance Agency for shelter.
28 Highest of Line 25b, Line 26b, or line 27	Compare Lines 25b, 26b and 27 and enter the highest amount.
29 Gross Basic Rent	Calculate the gross basic rent, which is the approved basic rent plus any utility allowance, when required. Basic and note rate rents must be shown on the project budget (Form RD 3560-7) for the year and approved according to Paragraph 4.21 of HB-2-3560. Utility allowances, when required, are determined and approved Paragraph 7.3 of HB-2-3560. Any change in rental rates must be processed according to Paragraph 4.28 of HB-2-3560. Any change in utility allowances must be processed according to Paragraph 7.3 of HB-2-3560. a. Enter the approved basic rent. b. Enter the approved utility allowances (if any). c. Add Lines 29a and 29b and enter the total.
30 Gross Note Rate Rent	Calculate the gross note rate rent, which is the approved rent plus any utility allowance, when required. a. Enter the approved basic rent. b. Enter the approved utility allowances (if any). c. Add Lines 30a and 30b and enter the total.

Fld Name /
Item No.

Instruction

Designated Monthly Welfare Shelter Payment

Enter the designated monthly welfare shelter payment if applicable. This will be the amount the tenant household actually receives from the Public Assistance Agency for shelter.

Highest of Line 25b, Line 26b, or line 27

Compare Lines 25b, 26b and 27 and enter the highest amount.

Gross Basic Rent

Calculate the gross basic rent, which is the approved basic rent plus any utility allowance, when required. Basic and note rate rents must be shown on the project budget (Form RD 3560-7) for the year and approved according to Paragraph 4.21 of HB-2-3560. Utility allowances, when required, are determined and approved Paragraph 7.3 of HB-2-3560. Any change in rental rates must be processed according to Paragraph 4.28 of HB-2-3560. Any change in utility allowances must be processed according to Paragraph 7.3 of HB-2-3560.

a. Enter the approved basic rent.

b. Enter the approved utility allowances (if any).

c. Add Lines 29a and 29b and enter the total.

Gross Note Rate Rent

Calculate the gross note rate rent, which is the approved rent plus any utility allowance, when required.

a. Enter the approved basic rent.

b. Enter the approved utility allowances (if any).

c. Add Lines 30a and 30b and enter the total.

Part VIII. Determining Gross Tenant Contribution (GTC)

· Check the box that applies to this tenant household and follow the directions for that decision.

NOTE #1: When attempting to provide RA to a new tenant (initial occupancy after October 1, 1986), compare Lines 28 and 29c. If Line 28 is greater or no RA is available to the tenant, check Decision “B” or “C”, because RA cannot assist the tenant.

NOTE #2: Be sure that the “surcharge” mentioned in Line C 2, is the rental surcharge for ineligible tenants described in Paragraph 7.4 D.1 of HB-2-3560. The surcharge is used only by Plan I projects.

Part IX - Determining Net Tenant Contribution (NTC)

Fld Name / Item No.	Instruction
31 GTC	Enter the GTC as directed by Decisions A, B, or C of Part VIII.
32 Utility Allowance	Enter the approved utility allowance for this unit.
33 Final NTC	Subtract the utility allowance (Line 32) from the gross tenant contribution (Line 31) and enter the difference. The final net tenant contribution is the amount of “rent” the tenant pays the borrower monthly. When the utility allowance is greater than the gross tenant contribution, the borrower will pay that difference to the tenant (the NTC will be negative).

Part X - Certification By Borrower

· The responsible party or their representative must sign and date when satisfied the accompanying statement is accurate.

NOTE: The completion of a new Tenant Certification is not required when project rents or utility allowances change, or when the tenant household moves to a different unit within the project. To recognize these changes, notate Lines 29 and 30, and re-compute Lines 31 thru 33 and 30 when applicable. When a tenant who was eligible for RA, but did not receive it, now is being assigned RA during a certification effective period, correct PART VIII and adjust the remainder of the Form accordingly.