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Column (H) Enter the cash value of the respective asset. <br />Column (I) Enter the anticipated annual income from the asset (i.e., savings account <br />balance multiplied by the annual interest rate).. <br />TOTALS Add the total of Column (H) and Column (I), respectively. <br />If the total in Column (H) is greater than $5,000, you must do an imputed calculation of asset <br />income. Enter the Total Cash Value, multiply by 2 % and enter the amount in (J), Imputed <br />Income. <br />Row {K) Enter the Greater of the total in Column (I) or (J) <br />Row (L) Total Annual Household Income from All Sources Add (E) and (K) and <br />enter the total <br />HOUSEHOLD CERTIFICATION AND SIGNATURES <br />After all verifications of income and/or assets have been received and calculated, each household <br />member age 18 or older must sign and date the Tenant Income Certification. For move-in, it is <br />recommended that the Tenant Income Certification be signed no earlier than five days prior to <br />the effective date of the certification. <br />Part V -Determination of Income Eligibility <br />Total Annual Household Enter the number from item (L). <br />Income from all sources <br />Current Income Limit per Enter the Current Move-in Income Limit for the household <br />size. <br />Family Size <br />Household income at move-in For recertifications only. Enter the household income from <br />the <br />Household size at move-in move-in certification. On the adjacent line, enter the <br />number of household members from the move-in <br />certification. <br />Household Meets Income Check the appropriate box for the income restriction that <br />the <br />Restriction household meets according to what is required by the set- <br />aside(s) for the project. <br />Current Income Limit x 140% For recertification only. Multiply the Current Maximum <br />Move-in Income Limit by 140% and enter the total.. <br />Below, indicate whether the household income exceeds that <br />2029975v1 B-3 <br />