Are you a first time homebuyer? If so, you may be wondering what Form HUD 52665 is. This form is known as the Homebuyers’ Eligibility Checklist and it is used to determine your eligibility for certain mortgage programs. In this blog post, we will discuss what the Homebuyers’ Eligibility Checklist is and how to fill it out. We will also provide some tips on how to improve your chances of being approved for a mortgage.
Here is the details concerning the form you were in search of to complete. It will show you how much time it takes to complete form hud 52665, exactly what fields you will need to fill in, etc.
Question | Answer |
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Form Name | Form Hud 52665 |
Form Length | 4 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 1 min |
Other names | hud 52665 portability form, 52665 form print, hud 52665, portability housing form |
Family Portability Information
U.S. Department of Housing |
OMB Approval No. |
and Urban Development |
(exp. 04/30/2018) |
Housing Choice Voucher Program |
Office of Public and Indian Housing |
Public reporting burden for this collection of information is estimated to average .50 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. This agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless that collection displays a valid OMB control number.
This collection of information is authorized under Section 8 of the U.S. Housing Act of 1937 (42 U.S.C. 1437f). The information is used to standardize the information submitted to the receiving Public Housing Agency (PHA) by the initial PHA. In addition, the information is used for monthly billing by the receiving PHA.
Sensitive Information. The information collected on this form is considered sensitive and is protected by the Privacy Act. The Privacy Act requires that these records be maintained with appropriate administrative, technical, and physical safeguards to ensure their security and confidentiality. In addition, these records should be protected against any anticipated threats or hazards to their security or integrity which could result in substantial harm, embarrassment, inconvenience, or unfairness to any individual on whom the information is maintained.
Privacy Act Statement. The Department of Housing and Urban Development (HUD) is authorized to collect the information required on this form by Section 8 of the U.S. Housing Act of 1937 (42 U.S.C. 1437f) and by the Housing and Community Development Act of 1987 (42 U.S.C. 3534(a)). Collection of this information, including SSN and annual income, is mandatory. The information is used to standardize the information submitted to the receiving Public Housing Agency (PHA) by the initial PHA. In addition, the information is used for monthly billing by the receiving PHA. The SSN is used as a unique identifier. HUD may disclose this information to Federal, State and local agencies when relevant to civil, criminal, or regulatory investigations and prosecutions. It will not be otherwise disclosed or released outside of HUD, except as permitted or required by law. Failure to provide any of the information may result in delay or rejection of a family port.
Part I Initial PHA Information and Certification
Instructions: ThisportionoftheformistobecompletedbytheinitialPHAforafamilythatismovingoutoftheinitialPHA’sjurisdictionundertheportabilityprocedures.
1. HeadofHouseholdName
2. HeadofHouseholdSocialSecurityNumber
3. Voucher Number (ifapplicable)
4.BedroomSize
5.IssuanceDate (mm/dd/yyyy)
6.ExpirationDate (mm/dd/yyyy)
7.DateofLastIncomeExamination (mm/dd/yyyy)
8. |
Annualincomeif newadmission(notcurrentlyavoucherparticipant) |
$ ___________________________ |
9. |
Datebywhichinitialbillingmustbereceived(90daysfollowingtheexpirationdateoftheinitialPHAvoucher)(mm/dd/yyyy) |
__________________________ |
10. |
InitialPHAadministrativefeerate |
$ ____________________________ |
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(Note:includeproration,ifapplicable. Forexample,iftheprorationfactorfortheyearis79%andyourcolumnBrateis$60,enter$47.4) |
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11. |
80%ofinitialPHAongoingadministrativefee(line10x0.8) |
$_____________________________ |
12. |
ReceivingPHAtowhichfamilyhasbeenreferred: ___________________________________________________. |
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Attachments:
a.A copy of the voucher issued by the initial PHA.
b.The most recent form
Certification Statement:
The family is a current program participant or is not a current program participant but is
Name of Certifying PHA Official __________________________________________ |
Type Full Name and Address of Initial PHA below |
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Signature |
___________________________________________ |
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Initial PHA Contact Name |
___________________________________________ |
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Phone Number |
_________________ |
Email _______________________ |
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Form Submission Date (mm/dd/yyyy) ____________________ |
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Part
1. HeadofHouseholdName
2. HeadofHouseholdSocialSecurityNumber
3. VoucherBedroomSize(per receivingPHA’spolicies)
4. HAPContractNumber(ifapplicable)
5. Receiving PHA administrative fee rate |
$ ____________________________ |
(Note: include proration, if applicable. For example, if the proration factor for the year is 79% and your column B rate is $60, enter $47.4)
Certification Statement:
I certify that the information contained on Part II of this form and, if applicable, the attached form
Name of Certifying PHA Official _____________________________________________ |
Type full Name and Address of Receiving PHA below |
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Signature |
_____________________________________________ |
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Receiving PHA Contact Name |
_____________________________________________ |
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Phone Number |
_________________ |
Email _______________________ |
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Form Submission Date (mm/dd/yyyy) _____________________
Part
Instructions: for initial billings, Part
PHAs agree to a different billing schedule that requires a more frequent billing submittal.
Check all statements below that apply:
1. The above family has failed to submit a request for tenancy approval for an eligible unit within the allotted time period. You may therefore reissue your voucher to another family and, if applicable, modify any records concerning local preference usage and income targeting requirements.
STOP. Do not complete remainder of form.
2. We have executed a HAP contract on behalf of the family and are absorbing the family into our own program effective
_________________(mm/dd/yyyy). You may reissue your voucher to another family. STOP. Do not complete remainder of form.
3. We executed a HAP contract on __________________ (mm/dd/yyyy) with an effective date of ________________ (mm/dd/yyyy) and are
billing your agency. The effective date of the family’s annual reexamination will be _________________ (mm/dd/yyyy). A copy of the new
form
4. The HAP amount has changed effective ________________ (mm/dd/yyyy) for the family because of: (Check all applicable items. Complete
line 10 below).
annual recertification
interim/special recertification
change in payment standard
the family moved to another unit in the receiving PHA jurisdiction.
other: (specify)
Comments continued on separate page Yes
No
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5. The HAP payments have been abated effective _______________ (mm/dd/yyyy). Please suspend the HAP to owner portion from your payment
effective _______________ (mm/dd/yyyy) until further notice. STOP. Do not complete remainder of form.
6. The HAP payments that were abated beginning ________________ (mm/dd/yyyy) have resumed effective ________________ (mm/dd/yyyy).
Please resume payment of HAP effective ___________________ (mm/dd/yyyy). (Note: do not complete remainder of form unless line 4 above
also apply. In such cases, complete line 10 below.)
7. We will no longer bill your agency because we are terminating the family's participation in the program or the family is voluntarily leaving the program.
Billing arrangement termination effective date:________________________ (mm/dd/yyyy).
Reason for termination: (specify)
STOP. Do not complete remainder of form.
8. We are absorbing the family into our program and terminating the billing arrangement effective: ____________________ (mm/dd/yyyy).
STOP. Do not complete remainder of form.
9. The HAP contract has been terminated effective ___________________ (mm/dd/yyyy) and no new HAP contract has yet been executed on
behalf of the family.
The family:
will not be remaining in our jurisdiction and has been referred to your agency.
intends to remain in our jurisdiction. The family’s voucher expires _________________ (mm/dd/yyyy). (Note: submit this form again once
you know the outcome of the family’s search).
STOP. Do not complete remainder of form. |
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10. Billing Information |
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Regular Billing Amount: |
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a. Monthly HAP amount due |
_____________________ |
(line 12s or 12af of form |
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b. Ongoing admin fee |
_____________________ |
((1) lesser of: Part I, line 10 or Part II, line 5, or (2) amount otherwise agreed upon) |
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c. Total regular monthly billing amount |
_____________________ |
(sum of lines a and b) |
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Additional Amount Due, If Applicable: |
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d. Prorated HAP to owner from ____________to _____________ |
_____________________ |
e. |
_____________________ |
f. Other (explain) |
_____________________ |
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g. Total additional amount (sum of lines d, e and f) |
____________________ |
Total Billing Amount: |
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h. Payment Due This Billing Submission (sum of lines c and g) |
_____________________ |
(After this submission, billing amount is amount recorded on line c, unless otherwise notified by the receiving PHA.)
Comments:
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