Property Name: / Unit: / HOH Last Name:
HUD Section 8 HUD Section 8/236 HUD/USDA(515/Section8) USDA-RD/RA BMIR/Market
Effective Date: Move-in Program Change A/R I/R/Unscheduled Assign RA
GROSS + ADJUSTED INCOME CALCULATION:
INCOME / Gross Income (Total from all attached income calculator tapes): / $
ASSETS / Total Cash Value of all Assets: / *$
Total Actual Income of Assets: / $
Imputed Asset Income: Impute if total Cash Value Of Assets is at or above $5000
*$ / X / .06% / $
Asset Income: The higher amount of actual income received from assets or imputed asset income from above / + / $
Total Gross Annual Income (GAI): / = / $
DEDUCTIONS / Total of all Medical Expenses: / + / $
Total of all Handicap Care Expenses: / + / $
Less 3% of Gross Annual Income (above): / - / $
Total Allowable Deductions: / - / $
ALLOWANCES / Dependents: Number of Dependents: / X $480 / = / - / $
Childcare Expense: For children under 13 years / - / $
Elderly Household: One $400 Allowance Per Household / - / $
Adjusted Gross income AGI / = / $
RENT CALCULATION:
HUD ONLY: 214 Prorated Rent for Ineligible NON-Citizen Yes No
HUD ONLY: Minimum Rent Hardship Exception Requested (attach TC-50) No Yes, Approved: Yes No
Total Tenant Payment (TTP)(AGI from above divided by 12 x 30%before utility allowance is deducted) / $
Less Utility Allowance: (If applicable) / - / $
Tenant Rent: (TR) (Net Rent) / = / $
Assistance Payment: (AP) / + / $
Bedroom size: ______Contract/Basic/Market Rent: (TR + AP) / = / $
PHA SECTION 8 VOUCHER HOLDERS: If applicable
Less Utility Allowance (If applicable) / - / $
Tenant Rent: (TR) (Net Rent) / + / $
Assistance Payment: (AP) / + / $
Bedroom size: ______Contract/Basic/Market Rent: (TR + AP) / = / $
Contract Effective Date:
INCOME LIMITS: Complete as applicable to the property based on the number of household members (include unborn children)
HUD / HUD 30% Ex Low Limit: (Applies at M/I only) / $
HUD Income Limit: (VL or L) / $
USDA-RD / USDA-RD Income Limit: (515& 515/S8) VL, Low or Moderate / $
HOUSING TAX CREDIT
(From Rental Amounts and Income Ranges chart) / Risk Share HOME Special Needs Families with Children
HTC Income Limit: ______%HTC / $
HTC 140% Limit: (Applies after M/I only) / $
HTC Maximum Gross Rent: (From Rent Schedule) / $
Applicant/Resident Worksheet (2/15) Page ____ of _____ TC-59hr