PART-TIME OR FULL-TIME STUDENT CERTIFICATION

For HUD Section 8 AssistedApplicants/Residentsand

USDA-RD Rental Assisted Applicants/Residents

______Apartments

Student or Applicant’s Name: ______

Address:______Unit #:______

Telephone/Cell Phone #:______Date:______

In order for Management to determine whether or not you are eligible for housing assistance, you must read and then complete the following Questionnaire and supply the required documentation. We will verify the information that you provide. If you do not submit the required information, you and your household will automatically be considered ineligible for housing and/or housing assistance.

Are you a part-time or full-time student at an institution of higher education? ____ YES____NO

See the ** Student definition below before you answer this question.

If you have answered “no”, please skip the following and sign on page 3.

HUD and USDA-RD Definitions applicable to student eligibility:

**Student: Is enrolled either part-time or full-time in an institution of higher education – post-secondary vocational institutions; accredited post-secondary colleges and universities, etc.

Parents: The biological or adoptive parents, or guardians (e.g. grandparents, aunt/uncle, godparents, etc.) of the individual.

Dependent Child: A member of the household (except foster children and foster adults) other than the head or spouse, who is under 18 years of age; or, a person 18 years of age or older with a disability or is a full-time student in the household.

Financial assistance: Any financial assistance that a student receives in excess of tuition: Higher Education Act Assistance – Grants, Scholarships, Federal Work Study programs; Assistance from Private sources - provided from a parent, guardian or other family member whether residing within the household or not; Assistance from an Institution of Higher Education – assistance programs offered by the Institution, GI Bill. Loans are “not” part of financial assistance income.

Independent Student: The U.S. Department of Education’s definition of an independent student: 1) be at least 24 years old by December 31 of the award year for which aid is sought; 2) be an orphan or a ward of the court through the age of 18; 3) be a veteran of the U.S. Armed forces; 4) have legal dependents other than a spouse – for example, dependent children or an elderly dependent parent; 5) be a graduate or professional student; or 6) be married.

Determining the Eligibility of Students or Households with Students:

HUD/USDA-RD has established certain criteria that students (individually or as part of a household) must meet to be eligible for housing rental assistance. No rental assistance can be provided to persons or households that do not meet the criteria:

  1. The individual must be of legal contract age under state law.
  1. The individual is disabled and was receiving Section 8 or USDA-RD rental assistance as of 11/30/05.
  1. The individual must have established a household separate from parents or legal guardians for at least one year prior to application for occupancy.
  1. The individual’s parents are either receiving section 8 or USDA-RD rental assistance or are income eligible to receive rental assistance.
  1. The individual meets the U.S. Department of Education’s definition of an independent student. (See definition above.)
  1. The individual must not be claimed as a dependent by parents or legal guardians pursuant to IRS regulations.
  1. The individual has a dependent child. (See definition above.)
  1. Any financial assistance received in excess of tuition may be counted towards the income eligibility of the student or of the household where the student resides.
  1. The individual must obtain a certification of the amount of financial assistance that will be provided by parents, guardians or others signed by the individual providing the support. This certification is required even if no assistance will be provided. The financial assistance provided by persons not living in the unit is part of annual income that must be verified to determine eligibility and rent.

WARNING: Section 1001 of Title 18 of the United States Code provides: “Whoever, in any matter within any jurisdiction of any department or agency of the United States knowingly or willfully falsifies, conceals or covers up…a material fact, or makes any false, fictitious or fraudulent statements or representation, or makes any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry, shall be fined not more than $10,000 or imprisoned not more than 5 years or both.”

QUESTIONNAIRE FOR STUDENTS

YES NO

1.Are you 18 years of age or older?………………………………………………______

2.Have you maintained a separate household from your parents and/or

Guardians for at least a year before applying to our apartment community?______

3.Are you disabled and have you been receiving Section 8 or USDA-RD

rental assistance since November 30, 2005?………………………………….______

4.Are any of the following statements true?YESNO

I am an orphan or ward of the court and 18 years old or younger………….______

I am a veteran of the U.S. Armed Forces……………………………………..______

I have legal dependents other than a spouse (e.g. child or elderly parent)______

If yes, provide names and ages: ______

______

I am a graduate or professional student……………………………………….______

If yes, provide name and address of school______

______

I am married………………………………………………………………………______

I am at least 24 years old or will turn 24 years old this year………………______

If yes, provide your birth date: ______(mo/dy/yr)

4.Did your parents or legal guardians claim you as a dependent on their

most recent tax returns?………………………………………………………______

5.Are your parents receiving section 8 or USDA-RD rental assistance or

are they income eligible to receive rental assistance……………………… ______

6.Please provide the following information for your parents, legal guardians, or others who provide you financial support. We need this contact information even if your parents and guardians don’t provide support:

Name: ______Tel.#______

Address:______

Name: ______Tel.#______

Address:______

Name:______Tel.#______

Address:______

If you or another member of your household is determined to be an ineligible student now or in the future, you may not be eligible for rental assistance. If we determine at any time after move-in that you are ineligible for assistance, we will notify you by providing a 30-day written notice that your assistance will be terminated. Your household will then be required to pay the full market rate rent; or, your household would be changed to another housing program offered at the property, if any.

I certify that the above information and attachments, if any, are true and accurate to the best of my knowledge. I further understand that the above information will only be used to determine whether I am eligible as a non-student; or, a part-time or full-time student on my own or as part of a household. I also understand that there are additional screening and income criteria that I must meet to determine my final eligibility for housing and/or rental assistance.

Applicant/ResidentDate

Owner/Owner’s AgentDate

NOTE: This Apartment Community does not discriminate on the basis of handicapped status in the admission or access to, or treatment of employment in, its federally assisted programs and activities.

HUD Information for Students (12/09)Page 1 of 3RS-24hr