16-2024-CC-005410-AXXX-MA Div: CC-C
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`ACCEPTED: DUVAL COUNTY, JODY PHILLIPS, CLERK, 04/01/2024 10:03:36 AM
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`Exhibit A
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`c.
`
`b.
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`MODEL LEASE FOR SUBSIDIZED PROGRAMS
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`Parties and Dwelling Unit: The parties to this Agreement are OakwoodVilla, referred to as the Landlord, and
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`referred to as the Tenant. The Landlord leases to the Tenant(s) unit number 2-102, located at
`32211 in the project known as OakwoodVilla.
`Length of Time (Term): Theinitial term of this Agreementshall begin on April 1, 2023 and end on March 31, 2024. Aftera theinitial term
`ends, the Agreementwill continue for successive terms of one month each unless automatically terminated as permitted by paragraph 23
`of this Agreement.
`Rent: The Tenant agrees to pay a rent of $0,00 per month. This amount is due on the 1st day of the month at 4pm. The Tenant
`understandsthat this monthly rentis less than the market (unsubsidized) rent due onthis unit. This lowerrentis available either because
`the mortgage on this project is subsidized by the Department of Housing and Urban Development (HUD) and/or because HUD makes
`monthly payments to the Landlord on behalf of the Tenant. The amount,if any, that HUD makes available monthly on behalf of the Tenant
`is called the tenant assistance payment and is shown on the "Assistance Payment" line of the Owner’ s Certification of Compliance with
`HUD's TenantEligibility and Rent Procedures form which is AttachmentNo.1 to this Agreement.
`Changesin the Tenant's Share of the Rent: The Tenant agrees that the amount of rent the Tenant pays and/or the amount of
`assistance that HUD pays on behalf of the Tenant may be changed during the term ofthis Agreementif:
`a.
`HUDor the Contract Administrator (such as a Public Housing Agency) determines, in accordance with HUD procedures, that an
`increasein rents is needed;
`HUDor the Contract Administrator changes any allowance forutilities or services considered in computing the Tenant's share of the
`rent;
`the income, the numberofpersonsin the Tenant's household or other factors considered in calculating the Tenant's rent change and
`HUDproceduresprovide that the Tenant'srent or assistance paymentbe adjusted to reflect the change;
`changesin the Tenant's rent or assistance paymentare required by HUD's recertification or subsidy termination procedures
`HUD's procedures for computing the Tenant's assistance paymentor rent change; or
`the Tenantfails to provide information onhis/her income,family composition or other factors as required by the Landlord.
`f.
`The Landlord agrees to implement changes in the Tenant's rent or tenant assistance payment only in accordancewith the time frames
`and administrative procedures set forth in HUD's handbooks,instructions and regulationsrelated to administration of multifamily subsidy
`programs. The Landlord agreesto give the Tenantat least 30 days advance written notice of any increase in the Tenant's rent except as
`noted in paragraphs 11, 15 or 17. The Notice will state the new amount the Tenantis required to pay, the date the new amountis
`effective, and the reasonsfor the changein rent. The Notice will also advise the Tenant that he/she may meetwith the Landlord to discuss
`the rent change.
`Charges for Late Payments and Returned Checks:If the Tenant does notpaythe full amountof the rent shown in paragraph 3 by the
`end of the 5th day of the month, the Landlord mayCollect a fee of $5.00 on the 6th dayof the month. Therefore, the Landlord maycollect
`$1.00 for each additional day the rent remains unpaid during the monthit is due, not to exceed $30.00. The Landlord may not terminate
`this Agreementforfailure to pay late charges, but may terminate this Agreement for non-paymentofrent, as explained in paragraph 23.
`The Landlord may collect a fee equal to actual cost on the second or any additional time a check is not honored for payment (bounces).
`The chargesdiscussedin this paragraphare in addition to the regular monthly rent payable by the Tenant.
`Condition of Dwelling Unit: By signing this Agreement, the Tenant acknowledgesthatthe unit is safe, clean and in good condition. The
`Tenant agreesthatall Appliances and equipmentin the unit are in good working order, except as described on the Unit Inspection Report
`whichis AttachmentNo. 2 to this Agreement. The Tenantalso agreesthat the Landlord has madeno promisesto decorate, alter, repair or
`improve the unit, exceptaslisted on the Unit Inspection Report.
`Charges for Utilities and Services: The following charts describe howthe costofutilities and services related to occupancyof the unit
`will be paid. The Tenantagreesthat these charts accurately describe theutilities and services paid by the Landlord and those paid by the
`Tenant.
`a. The Tenant must payforthe utilities in column (1). Payments should be madedirectly to the appropriateutility company. The itemsin
`column (2) are includedin the Tenant's rent.
`
`Utility Tenant pays directly:
`X) HEAT
`& ELECTRICAL
`&} WATER
`& SEWER
`& GARBAGE
`b. The Tenant agrees to pay the Landlord the amount shownin column(3) on the date the rent is due. The Landlord certifies that HUD
`had authorized him/herto collect the type of charges shownin column(3) and that the amounts shown in column (3) do not exceed
`the amounts authorized by HUD.
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`Utility Included in Tenant Rent:
`Qo
`Q
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`Amounts Tenant Pays to Landord in Addition to Rent
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`Security Deposits: The Tenant has deposited $94.00 with the Landlord. The Landlord will hold this security deposit for the period the
`Tenant occupies the unit. After the Tenant has movedfrom the unit, the Landlord will determine whether the Tenantis eligible for a refund
`of any or all of the security deposit. The amount of the refund will be determined in accordance with the following conditions and
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`procedures.
`a. The Tenantwill be eligible for a refund of the security Deposit only if the Tenant provided the Landlord with the 30-day written notice
`of intent to move required by paragraph23, unless the Tenantwas unable to give the notice for reasons beyond his/hercontrol
`b. After the Tenant has moved from the unit, the Landlord will inspect the unit and complete another Unit Inspection Report. The
`Landlord will permit the Tenantto participate in the inspection,if the Tenant so requests.
`c. The Landlord will
`refund to the Tenant
`the amount of
`the security deposit plus
`, less any amount neededto paythe costof:
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`interest computed at 0% beginning
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`(1) unpaid rent;
`(2) damagesthat are not due to normal wearandtear andare notlisted on the Unit Inspection Report;
`(3) charges for late paymentof rent and returned checks, as described in paragraph 5; and
`(4) charges for unreturned keys, as described in paragraph 9.
`d. The Landlord agreesto refund the amount computedin paragraph 8c within72hours after the Tenant has permanently moved outof
`the unit, returned possessionof the unit to the Landlord, and given his/her new address to the Landlord. The Landlord will also give
`the Tenanta written list of charges that were subtracted from the deposit. If the Tenant disagrees with the Landlord concerning the
`amounts deducted and asks to meet with the Landlord, the Landlord agrees to meet with the Tenant and informally discuss the
`disputed charges.
`If the unit is rented by more than one person, the Tenants agreethat they will work out the details of dividing any refund among
`themselves. The Landlord may paythe refund to any Tenant identified in Paragraph 1 of this Agreement.
`The Tenant understands that the Landlord will not count the Security Deposit towards the last month's rent or towards repair charges
`owedby the Tenantin accordance with paragraph 11.
`Keys and Locks: The Tenant agreesnotto install additional or different locks or gates on any doors or windowsof the unit without the
`written permission of the Landlord. If the Landlord approves the Tenant's requestto install such locks, the Tenant agrees to provide the
`Landlord with a key for each lock. When this Agreement ends, the Tenant agreesto return all keys to the dwelling unit to the Landlord.
`The Landlord may charge the Tenant $5,00 for each key not returned.
`Maintenance:
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`e.
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`f.
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`10.
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`a. The Landlord agreesto:
`(1)
`regularly clean all commonareasofthe project;
`(2) maintain the commonareas andfacilities in a safe condition;
`(3) arrangefor collection and removalof trash and garbage;
`(4) maintain all equipment and appliances in safe and working order;
`(5) make necessary repairs with reasonable promptness;
`(6) maintain exterior lighting in good working order:
`(7) provide extermination services, as necessary; and
`(8) maintain grounds and shrubs,
`b. The Tenant agreesto:
`(1) keep the unit clean;
`(2) useall appliances,fixtures and equipmentin a safe mannerand only for the purposes for which they are intended;
`(3) notlitter the grounds or commonareasofthe project;
`(4) not destroy, deface, damage or remove anypart of the unit, common areas,or project grounds;
`(5) give the Landlord promptnotice of any defects in the plumbing,fixtures, appliances, heating and cooling equipmentor any other
`part of the unit or related facilities; and
`remove garbage and other waste from theunit in a clean and safe manner.
`(6)
`Damages: Whenever damageis caused by carelessness, misuse, or neglect on the part of the Tenant, his/her family or visitors, the
`Tenant agreesto pay:
`a.
`the costof all repairs and do so within 30 days after receipt of the Landlord's demandfor the repair charges; and
`b.
`rent for the period the unit is damaged whether or not the unit is habitable. The Tenant understands that HUD will not make
`assistance payments for any period in which the unit
`is not habitable_ For any such period,
`the Tenant agrees to pay the
`HUD-approved marketrent rather than the Tenant rent shownin paragraph3 of this agreement.
`Restrictions on Alterations: No alteration, addition, or improvements shall be madein or to the premises withoutthe prior consent of the
`Landlord in writing. The Landlord agrees to provide reasonable accommodation to an otherwiseeligible tenant's disability,
`including
`making changesto rules, policies, or procedures, and making and paying forstructural alterations to a unit or common areas. The
`Landlord is not required to provide accommodations that constitute a fundamentalalteration to the Landlord's program or which would
`pose a substantial financial and administrative hardship. See the regulations at 24 CFR Part 8.
`In addition,
`if a requested structural
`modification does pose a substantial financial and administrative hardship, the Landlord must then allow the tenant to make and pay for
`the modification in accordance with the Fair Housing Act.
`General Restrictions: The Tenant mustlive in the unit and the unit mustbe the Tenant's only place of residence. The Tenantshall use
`the premises only as a private dwelling for himself/herself and the individualslisted on the Owner's Certification of Compliance with HUD's
`TenantEligibility and Rent Procedures, Attachment 1. The Tenant agrees to permit other individuals to reside in the unit only after
`obtaining the prior written approval of the Landlord. The Tenant agrees notto:
`a.
`sublet or assign the unit, or any part of the unit;
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`11,
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`12.
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`13.
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`14.
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`15.
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`16.
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`17.
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`usethe unit for unlawful purposes;
`engagein or permit unlawfulactivities in the unit, in the common areas or on the project grounds;
`c.
`d. have pets or animals of any kind in the unit without the prior written permission of the Landlord, but the landlord will allow the tenantto
`keep an animal needed as a reasonable accommodation to the tenant's disability, and will allow animals to accompanyvisitors with
`disabilities who need such animals as an accommodationto their disabilities; or
`e. makeorpermit noises or acts thatwill disturb the rights or comfort of neighbors. The Tenant agrees to keep the volume of any radio,
`phonograph,television or musicalinstrument at a level which will not disturb the neighbors.
`Rules: The Tenant agrees to obey the House Rules which are AttachmentNo.3 to this Agreement. The tenant agrees to obey additional
`rules established after the effective date of this Agreementif:
`a.
`the rules re reasonably related to the safety, care and cleanliness of the building and the safety, comfort and convenience of the
`Tenants; and
`the Tenantreceives written notice of the proposedrule at least 30 days beforetheruleis enforced.
`b.
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`Regularly Scheduled Recertifications: Every year around
`, the Landlord will request the Tenant to report the
`income and composition of the Tenant's household and to supply any other information required by HUDfor the purposes of determining
`the Tenant's rent and assistance payment,if any. The Tenant agrees to provide accurate statements of this information and to do so by
`the date specified in the Landlord's request. The landlordwill verify the information supplied by the Tenant andusetheverified information
`to recompute the amountof the Tenant's rent and assistance payment, if any.
`a.
`Ifthe Tenant does not submit the required recertification information by the date specified in the Landlord's request, the Landlord may
`imposethe following penalties. The Landlord may implement these penalties only in accordance with the administrative procedures
`and time frames specified in HUD's regulations, handbooks and instructions related to the administration of multifamily subsidy
`programs.
`(1) Require the Tenantto pay the higher, HUD-approved marketrentfor the unit.
`(2)
`Implement anyincreasein rent resulting from the recertification processing without providing the 30-day notice otherwise required
`by paragraph4 of this Agreement.
`b. The Tenant may request to meet with the Landlord to discuss any change in rent or assistance payment resulting from the
`recertification processing. If the Tenant requests such a meeting, the Landlord agrees to meet with the Tenant and discuss how the
`Tenant's rent and assistance payment,if any, were computed.
`Reporting Changes Between Regularly Scheduled Recertifications:
`a.
`If any ofthe following changesoccur, the Tenant agrees to advise the Landlord immediately.
`(1) Any household member movesoutofthe unit.
`(2) An adult memberof the household who was reported as unemployed on the most recent certification or recertification obtains
`employment.
`(3) The household's income cumulatively increases by $200 or more a month.
`b. The Tenant mayreport any decreasein income or any change in other factors considered in calculating the Tenant's rent. Unless the
`Landlord has confirmation that the decreasein incomeor changein other factors will last less than one month,the Landlord will verify
`the information and make the appropriate rent reduction. However,if the Tenant's incomewill be partially or fully restored within two
`months, the Landlord may delay the certification process until the new incomeis known,but the rent reduction will be retroactive and
`the Landlord may not evict the Tenant for nonpaymentof rent due during the period of the reported decrease and the completion of
`the certification process. The Tenant hasthirty days after receiving written notice of any rent due for the above described time period
`to pay or the Landlord canevict for nonpayment of rent.
`If the Tenant does not advise the Landlord of these interim changes,
`the Landlord may increase the Tenant's rent
`to the
`HUD-approved market rent. The Landlord may doso only in accordance with the time frames and administrative procedures set forth
`in HUD's regulations, handbooks and instructions on the administration of multifamily subsidy programs.
`d. The Tenant may request to meet with the Landlord to discuss how any changein incomeorotherfactors affected his/her rent or
`assistance payment,if any. If the Tenant requests such a meeting, the Landlord agrees to meet with the Tenant and explain how the
`Tenant's rent or assistance payment,if any, was computed.
`Removalof Subsidy:
`a. The Tenant understands that assistance imade available on his/her behalf may be terminated if events in either items 1 or 2 below
`occur. Termination of assistance meansthat the Landlord may makethe assistance available to another Tenant and the Tenant's rent
`will be recomputed.In addition,if the Tenant's assistance is terminated becauseofcriterion (1) below, the Tenant will be required to
`pay the HUD-approved marketrentfor the unit.
`(1) The Tenant doesnotprovide the Landlord with the information or reports required by paragraph 15 or 16 within 10 calendar days
`after receipt of the Landlord's notice of intent to terminate the Tenant's assistance payment.
`(2) The amount the Tenant would be required to pay towardsrent andutilities under HUDrules and regulations equals the Family
`Gross Rent shown on Attachment1. |
`b. The Landlord agrees to give the Tenant written notice of the proposedtermination. The notice will advise the Tenant that, during the
`ten calendar daysfollowing the date of the notice, he/she may request to meet with the Landlord to discuss the proposed termination
`of assistance.If the Tenant requests a discussion of the proposed termination, the Landlord agrees to meet with the Tenant.
`c. Termination of assistance shall not affect the Tenant's other rights under this Agreement, including the right to occupy the unit.
`Assistance may subsequently be reinstatedif the Tenant submits the incomeor other data required by HUD procedures,the Landlord
`determines the Tenantis eligible for assistance, and assistance is available.
`
`c.
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`18.
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`19.
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`20.
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`21.
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`22.
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`23.
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`c.
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`Tenant Obligation To Repay:If the tenant submits false information on any application, certification or requestfor interim adjustment or
`doesnot report interim changes in family income or other factors as required by paragraph 16 of this Agreement, and as a result, is
`charged a rent less than the amount required by HUD's rent formulas, the Tenant agrees to reimburse the Landlord for the difference
`between the rent he/she should have paid and the rent he/she was charged. The Tenantis not required to reimburse the Landlord for
`undercharges causedsolely by the Landlord'sfailure to follow HUD's procedures for computing rent or assistance payments.
`Size of Dwelling: The Tenant understands that HUD requires the Landlord to assign units in accordance with the Landlord's written
`occupancy standards. These standardsinclude consideration ofunit size, relationship of family members, age andsex of family members
`and family preference. If the Tenantis or becomeseligible for a different size unit, and the tequired size unit becomesavailable, the
`Tenantagreesto:
`a. movewithin. 30 days after the Landlord notifies him/herthat unit of the required size is available within the project; or
`b.
`remain in the sameunit and pay the HUD-approved market rent.
`Accessby Landlord:
`a. The Landlord agrees to enter the unit only during reasonable hours, to provide reasonable advance notice of his/her intent to enter
`the unit, and to enter the unit only after receiving the Tenant's consent to do so, except whenurgencysituations make such notices
`impossible or except under paragraph (c) below.
`b. The Tenant consents in advanceto the following entries into the unit:
`i.
`The tenant agreesto permit the Landlord, his/her agents or other persons, whenauthorized by the Landlord, to enter the unit for
`the purpose of making reasonable repairs and periodic inspections.
`ii. After the Tenant has given a notice ofintent to move, the Tenant agrees to permit the Landlord to show the unit to prospective
`tenants during reasonable hours.
`Ifthe Tenant moves before this Agreement ends, the Landlord mayenterthe unit to decorate, remodel, alter or otherwise prepare the
`unit for re-occupancy.
`Discrimination Prohibited: The Landlord agrees notto discriminate based uponrace, color, religion, creed, National origin, sex, age,
`familial status, and disability.
`Changein Rental Agreement: The Landlord may, with the prior approval of HUD,change the terms and conditions of this Agreement.
`Any changeswill becomeeffective only at the end of the initial term or a successive term. The Landlord mustnotify the Tenant of any
`change and must offer the Tenant a new Agreement or an amendmentto the existing Agreement. The Tenant mustreceive the notice at
`least 60 days before the proposedeffective date of the change. The Tenant may accept the changed terms and conditions by signing the
`new Agreementor the amendmentto the existing Agreement and returning it to the Landlord. The Tenant mayreject the changed terms
`and conditions by giving the Landlord written notice that he/sheintends to terminate the tenancy. The Tenant must give such notice at
`least 30 days before the proposed changewill go into effect. If the Tenant doesnot accept the amended agreement, the Landlord may
`require the Tenantto movefrom theproject., as provided in paragraph 23.
`Termination of Tenancy:
`a. To terminate this Agreement, the Tenant mustgive the Landlord 30-days written notice before moving from the unit
`b. Any termination of this Agreement by the Landlord must be carried out in accordance with HUD regulations, State and local law, and
`the termsof this Agreement.
`c. The Landlord may terminate this Agreementfor the following reasons:
`4.
`the Tenant's material noncompliance with the terms ofthis Agreement;
`2.
`the Tenant's materialfailure to carry out obligations under any State Landlord and TenantAct,
`3.
`drug related criminal activity engaged in on or near the premises, by any tenant, household member, or guest, and any such
`activity engagedin on the premisesby any other person underthe tenant's control;
`determination made by the Landlord that a household memberis illegally using a drug;
`determination made by the Landlord that a pattern ofillegal use of a drug interferes with the health, safety, or right to peaceful
`enjoymentof the premisesby otherresidents,
`criminal activity by a tenant, any memberofthe tenant's household,a guestor another person underthe tenant's control:
`(a). that threatens the health, safety, or right to peaceful enjoyment of the premises by other residents (including property
`managementstaff residing on the premises); or
`(b). that threatens the health, safety, or right to peaceful enjoyment oftheir residences by personsresiding in the immediate
`vicinity of the premises;
`if the tenantis fleeing to avoid prosecution, or custody or confinement after conviction, for a crime, or attempt to commit a crime,
`that is a felony underthe lawsof the place from which the individualflees, or that in the caseof the State of New Jersey,is a high
`misdemeanor,
`if the tenantis violating a condition of probation or parole under Federalor State law;
`determination made by the Landlord that a household member's abuseorpattern of abuse of alcohol threatens the health, safety,
`orright to peaceful enjoymentof the premises by otherresidents;
`if the Landlord determinesthat the tenant, any memberof the tenant's household, a guest or another person underthe tenant's
`control has engagedin the criminal activity, regardless of whether the tenant, any memberof the tenant's household, a guest or
`another person underthe tenant's control has been arrested or convicted for suchactivity.
`d. The Landlord may terminate this Agreementfor other good cause, which includes, but is not limited to, the tenant's refusal to accept
`changeto this agreement. Terminations for "other good cause” mayonly be effective as of the end of anyinitial or successive term.
`
`4.
`5.
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`6.
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`7.
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`8.
`
`40.
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`e.
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`24.
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`25.
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`The term material noncompliance with the lease includes: (1) one or more substantial violations of the lease; (2) repeated minor
`violations of the lease that (a) disruptthelivability of the project; (b) adversely affect the health or safety of any personortheright of
`any tenant to the quiet enjoyment to the leased premises and related project facilities, (c) interfere with the managementof the
`project, or (d) have an adversefinancial effect on the project (3) failure of the tenant to timely supply all required information on the
`income and composition,oreligibility factors, of the tenant household (including, but notlimited to, failure to meet the disclosure and
`verification requirements for Social Security Numbers,orfailure to sign and submit consentformsfor the obtaining of wage and claim
`information from State Wage Information Collection Agencies), and (4) Non-payment of rent or any other financial obligation due
`under the lease beyond anygrace period permitted under State law. The payment of rent or any otherfinancial obligation due under
`the leaseafter the due date but within the grace period permitted underState law constitutes a minorviolation.
`If the Landlord proposesto terminate this Agreement, the Landlord agrees to give the Tenant written notice and the groundsfor the
`proposed termination. If the Landlord is terminating this agreement for "other good cause,” the termination notice must be mailed to
`the Tenant and hand- delivered to the dwelling unit in the manner required by HUDatleast 30 days before the date the Tenantwill be
`required to move from the unit and in accordance with State law requirements. Notices of proposed termination for other reasons
`must be given in accordance with any time frames set forth in State and local
`law. Any HUD- equired notice period may run
`concurrently with any notice period required by State orlocal law.All termination notices must:
`*—specify the date this Agreementwill be terminated;
`*—state the groundsfor termination with enoughdetail for the Tenantto prepare a defense;
`+
`advise the Tenant that he/she has 10 days within which to discuss the proposed termination of tenancy with the Landlord. The
`10-day period will begin on the earlier of the date the notice was hand-deliveredto the unit or the day after the date the noticeis
`mailed.If the Tenant requests the meeting, the Landlord agreesto discuss the proposed termination with the Tenant; and
`advise the Tenantofhis/herright to defend the action in court.
`*
`If an evictionisinitiated, the Landlord agreesto rely only upon those groundscitedin the termination notice required by paragraph e.
`f.
`Hazards: The Tenant shall not undertake, or permit his/her family or guests to undertake, any hazardous acts or do anything that will
`increase the project's insurance premiums. Such action constitutes a material non-compliance.If the unit is damagedbyfire, wind,or rain
`to the extent that the unit cannotbelived in and the damageis not caused or made worse by the Tenant, the Tenant will be responsible
`for rent only up to the date of the destruction. Additional rent will not accrue until the unit has been repaired to a livable condition.
`Penalties for Submitting False Information: Knowingly giving the Landlord false information regarding income or other factors
`considered in determining Tenant's eligibility and rent is a material noncompliance with the lease subject to termination of tenancy. In
`addition, the Tenant could become subject to penalties available under Federal law. Those penalties include fines up to $10,000 and
`imprisonmentfor up to five years.
`Contents of this Agreement: This Agreementandits Attachments makeupthe entire agreement between the Landlord and the Tenant
`regarding the unit. If any Court declares a particular provision of this Agreementto beinvalid orillegal, all other terms of this Agreement
`will remain in effect and both the Landlord and the Tenantwill continue to be bound by them.
`Attachments to the Agreement: The Tenantcertifies that he/she has received a copy of this Agreement andthefollowing Attachments
`to this Agreement and understandsthat these Attachments are part of this Agreement.
`a. Owner's Certification of Compliance with HUD's TenantEligibility and Rent Procedures, form HUD-50059
`Tenants’ rights to organize: Landlord agreesto allow tenant and tenant organizers to conduct onthe property the activities related to the
`establishment or operation of a tenant organization set out in accordance with HUD requirements.
`Tenant IncomeVerification: The Tenant mustpromptly provide the Landlord with anyletter or other notice by HUD to a memberofthe
`family that providesinformation concerning the amount or verification of family income in accordance with HUD requirements.
`The lease agreementwill terminate automatically,if the Section 8 Housing Assistance contract terminates for any reason.
`Signatures:
`
`30.
`31.
`
`26.
`
`27.
`
`28.
`
`29.
`
`
`-.
`>
`7
`/ } Lj, /p
`
`es
`i
`Lil VALPD/
`t
`\
`Anaflabia Bazain Perez (Resident)
`Date
`(Owner/Agentt)
`Date
`Public reporting burden - HUDis not requesting approval of any burden hours for the model leases since use of leases are a standard
`business practice in the housing rental
`industry. This information is required to obtain benefits. The request and required supporting
`documentation are sent to HUDor the Contract Administrator (CA) for approval. The lease is a contract between the owner of the project and
`the tenant(s) that explains the terms for residing in the unit. Leases are a standard businesspractice in the housing rental industry. Owners
`are required to use the HUD modellease whichincludes terms normally covered by leases usedin the housingrental industry plus terms
`required by HUDfor the program under which the project wasbuilt and/or the program providing rental assistance to the tenants.
`This information is authorized by 24 CFR 5.360, 236.750, 880.606, 883.701, 884.215, 886.127, 891.425, 891.625 and 891.765 cover lease
`requirements andprovisions. This information is considered non-sensitive and does not require any special protection.
`
`

`

`Owner's Certification of Compliance
`p
`with HUD's TenantEligibility
`and Rent Procedures
`
`U.S. Department of Housin
`and Urban Development
`Office of Housing —
`Federal Housing Commissioner
`Section A. Acknowledgements
`
`g
`
`NOTfor submission to the Federal Government
`Landlord's Official Record ofCertification
`
`OMBApproval Number 2502-0204
`
`Readthis before you complete and sign this form HUD-50059
`Public Reporting Burden.Thereporting burdenforthis collection of information is estimated to average 55 minutes per response,including the
`time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the
`collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information including
`suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (2502-0204), Washington, DC
`20503. The information is being collected by HUD to determine an applicant's eligibility, the recommended unit size, and the amount the
`tenant(s) must pay toward rent and utilities. HUD uses this information to assist in managing certain HUD properties,
`to protect
`the
`Government's financialinterest, and to verify the accuracyof the information furnished. HUDor a Public Housing Authority (PHA) may conduct a
`computer match to verify the information you provide. This information may be released in accordance with HUD’s Computer Matching
`Agreement (CMA) betweenthe Social Security Administration and the Department of Health and Human Services. You mustprovideall of the
`information requested,
`including the Social Security Numbers (SSNs), unless exempted by 24 CFR 5.216, you, and all other household
`members,have and use. Giving the SSNsofall household members, unless exempted by 24 CFR 5.216,is mandatory; not providing the SSNs
`will affect your eligibility approval. Failure to provide anyinformation mayresult in a delay or rejection of your eligibility approval.
`
`Privacy Act Statement. The Department of Housing and Urban Development (HUD)is authorizedto collectthis information by the U.S. Housing
`Act of 1937, as amended (42 U.S.C. 1437 et. seq.); the Housing and Urban-Rural Recovery Act of 1983 (P.L. 98-181); the Housing and
`Community Development Technical Amendments of 1984 (P.L. 98-479); and by the Housing and Community Development Act of 1987 (42
`U.S.C. 3543).
`
`Tenant(s)' Certification - I/We certify that the information in Sections C, D, and E ofthis form are true and complete to the best of my/our
`knowledge andbelief. I/We understand that I/we can be fined up to $10,000, or imprisoned upto five years, or lose the subsidy HUD pays and
`have my/our rent increased, if we furnish false or incomplete information.
`
`Owner's Certification - | certify that this Tenant's eligibility, rent and assistance payments have been computed in accordance with HUD's
`regulations and administrative procedures andthatall required verifications were obtained.
`
`Warning to OwnersandTenants.By signing this form, you are indicating that you have read the above Privacy Act Statement and are agreeing
`with the applicable Certification.
`
`False Claim Statement. Warning: U.S. Code,Title 31, Section