The information obtained after receiving signed Authorization to Release Information forms is confidential and extremely sensitive (i.e. wages, unemployment compensation, interest and dividends). Both HUD and MSHDA employees and/or contractual agents may be subject to penalties for unauthorized disclosure or improper use of the income information that is obtained from using these forms.
The release of information forms or certification must be signed by the head of household, spouse, and by each additional adult (age 18 and older) household member at the time of the initial eligibility determination and at least annually thereafter as a part of each interim and annual re-examination process. If a current household member turns 18 years of age prior to the next scheduled annual re-examination, execution of the certification forms can be postponed until the next interim or annual re-examination, whichever occurs first.
Failure of the applicant or participant to sign the consent forms constitutes grounds for denial of eligibility.
The MSHDA 158 form is used to meet HUD requirements and authorize release of Social Security Administration (SSA), Immigration and Naturalization Service (INS), FIA, and law enforcement agency information. This consent will expire 15 months from the date signed.
Note: Income/Expense verification requests may be combined with the Initial Request Verification if desired.
Review the Checklist (MSHDA 1792) and request income and expense verifications, based on the information provided, via the Original Request for Documents (MSHDA 53).
Form Number |
Name of Form |
| HUD 9886 | Authorization for Release of Information/Privacy Act Notice |
| MSHDA 53 | Original Request for Documents |
| MSHDA 158 | Applicant/Tenant Authorization, Certification, and Consent |
| MSHDA 1792 | Checklist |
(Effective April 1, 2004)