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201109462 Column(I): Enter the anticipated annual income from the asset(i.e.,savings account balance multiplied by the annual interest rate). TOTALS: Add the total of Columns(H)and(I),respectively. If the total in Column(H)is greater than$5,000,you must do an imputed calculation of asset income. Enter the Total Cash Value, multiply by 2%and enter the amount in Column(J),Imputed Income. Box(K): Enter the greater of the total in Column(I)or(J). Box(L): Total Annual Household Income From all Sources. Add(E)and(K),and enter the total. Effective Date of Enter the effective date of the income certification corresponding to the totai annual household income Certification: entered in Box L. If annual income certification is not required,this may be different from the effective date listed in Part I. Household Size at Enter the number of tenants corresnonding to the total annual household income entered in Box L. If annual Certification: income certification is not reqnired,this may be different from the number of tenants listed in Part II. HOUSEHOLD CERTIFICATION AND SIGNATURES After all verifications of income and/or assets have been received and calculated, each household member age 18 or older must sign and date the Tenant Income Certification. For move-in, it is recommended that the Tenant Income Certification be signed no earlier than 5 days prior to the effective date of the certification. Part V—Determination of Income Eligibility Total Annual Household Income Enter the number from item(L). from all Sources: Current Income Limit per Family Enter the Current Maximum Move-in Income Limit for the household size. Size: Household income at move-in: For recertifications only. Enter the household income from the move-in certification. On the Household size at move-in: adjacent line,enter the number of household members from the move-in certification. Household Meets Income Check the appropriate box for the income restriction that the household meets according to what Restriction at: is required by the set-aside(s)for the project. Current Income Limit x 140%: For recertifications only. Multiply the Current Maximum Move-in Income Limit by 140%and enter the total. Below,indicate whether the household income exceeds that totaL If the Gross Annual Income at recertification is greater than 140%of the current income limit,then the available unit rule must be followed. Part VI—Rent Tenant Paid Rent: Enter the amount the tenant pays toward rent(not including rent assistance payments such as Section 8). Rent Assistance: Enter the amount of rent assistance,if any. Utility Allowance: Enter the utility allowance. If the owner pays all utilities,enter zero. Other non-optional charges: Enter the amount of non-optional charges,such as mandatory garage rent,storage lockers,charges for services provided by the development,etc. Gross Rent for Unit: Enter the total of Tenant Paid Rent plus Utility Allowance and other non-optional charges. Maximum Rent Limit for this Enter the maximum allowable gross rent for the unit. unit: