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CC_Minutes_2008_0908
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CC_Minutes_2008_0908
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10/20/2008 2:02:29 PM
Creation date
10/20/2008 1:56:54 PM
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Roseville City Council
Document Type
Council Minutes
Meeting Date
9/8/2008
Meeting Type
Regular
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INSTRUCTIONS FOR COMPLETING <br />TENANT INCOME CERTIFICATION <br />This form is to be completed by the owner or an authorized representative. <br />Part I -Development Data <br />Cheek the appropriate box for Initial Certification (move-in), Recertification (annual <br />recertification), or Other. If Other, designate the purpose of the recertification (i.e., a unit <br />transfer, a change in household composition, or other state-required recertification). <br />Move-in Date Enter the date the tenant has or will take occupancy of the unit. <br />Effective Date Enter the effective date of the certification. For move-in, this should be <br />the move-in date. For annual recertifcation, this effective date should be <br />no later than one year from the effective date of the previous <br />(re)certification. <br />Property Name Enter the name of the development. <br />County Enter the county (or equivalent) in which the building is located. <br />BIN # Enter the Building Identification Number (BIN) assigned to the building <br />(from 1125 Form 8609). <br />Address Enter the unit number. <br />Unit Number Enter the unit number. <br /># Bedrooms Enter the number of bedrooms in the unit. <br />Part II -Household Composition <br />List all occupants of the unit. State each household member's relationship to the head of the <br />household by using one of the following coded definitions: <br />H Head of household <br />A Adult co-tenant <br />C Child <br />L Live-in caretaker <br />S Spouse <br />O Other family member <br />F >?oster child <br />N None of the above <br />2029975x1 B-1 <br />
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