NORTH BROADWAY HOUSING PARTNERS LP (C/O OF JAMBOREE AND WISEPLACE)

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INSTRUCTIONS FOR COMPLETING TENANT INCOME CERTIFICATION Thisforne is to be completed by the owner or an authorized representative. Part I - Development Data Enter the type of tenant certification: Initial Certification (move -in), Recertification (annual recertification), or Other. If other, designate the purpose of the recertification (i.e., a unit transfer, a change in household composition, or other state -required recertification). Effective Date Enter the effective date of the certification. For move -in, this should be the move -in date. For annual income recertification's, this effective date should be no later than one year from the effective date of the previous (re)certification. Move -In Date Enter the most recent date the household tax aedit qualified. This could be the move -in date or in an acquisition relish property, this is not the date the tenant moved into the unit, it is the most recent date the management company income qualified die unit for tax credit purposes. Property Name Enter the name of the development. County Enter the county (or equivalent) in which the building is located. TCAC# Enter the project number assigned to the property by TCAC. Please include hyphens between the state abbreviation, four digit allocating year, and project specific number. For example: CA-2010-123 BIN # Enter the building number assigned to the building (from IRS Form 8609). Address Enter the physical address of the building, including street number and name, city, state, and zip code. If applicable, CDLAC# If project is awarded 4% bonds please enter the project number assigned to the property by CDLAC. Please include hyphens between the state abbreviation, four digit allocating year, and project specific number. For example: I6-436 Unit Number Enter the unit number. # Bedrooms Enter the number of bedrooms in the unit. Square Footage Eater the square footage for the entire unit. Vacant Unit Check if unit was vacant on December 31 of requesting year. For example, for the collection of 2011 data, this would refer to December 31, 2011. Part II - Household Composition List all occupants of the unit. State each household member's relationship to the head of household by using one of the following definitions: H Head of Household S Spouse U Unborn Child/Anticipated A Adult Co -Tenant O Other Family Member Adoption or Foster C Child F Foster child(ren)/adult(s) L Live-in Caretaker N None of the above Date of Birth Enter each household member's date of birth. Student Status Check FT for Full-time student, PT for Part-time student, or N/A if household member is not a student and question does not apply. Last Four Digits of Social Security For each tenant 15 years of age or older, enter the last four digits of the social security Number number or the last four digits of the alien registration number. If the last four digits of SSN or alien registration is missing, enter 0000. For tenants under age 15, social security number not required, although please enter 0000. If there are more than 7 occupants, use an additional sheet of paper to list the remaining household members and attach it to the certification. Tenant Income Certification (April 2021)