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2ULJLQDOLVUHWDLQHGE\WKHUHTXHVWLQJRUJDQL]DWLRQIRUPHUD-9886 07/14 UHI+DQGERRNV  <br />6LJQDWXUHV <br />BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBBBBBBBBBBBBB <br />+HDGRI+RXVHKROG 'DWH <br />BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB <br />6RFLDO6HFXULW\1XPEHU LIDQ\ RI+HDGRI+RXVHKROG <br />BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBB <br />6SRXVH 'DWH <br />BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBB <br />2WKHU)DPLO\0HPEHURYHUDJH'DWH <br />BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBB <br />2WKHU)DPLO\0HPEHURYHUDJH'DWH <br />Consent: I consent to allow HUD or the HA to request and obtain income information from the sources listed on this form for <br />the purpose of verifying my eligibility and level of benefits under HUD’s assisted housing programs. I understand that HAs that <br />receive income information under this consent form cannot use it to deny, reduce or terminate assistance without first <br />independently verifying what the amount was, whether I actually had access to the funds and when the funds were received. In <br />addition, I must be given an opportunity to contest those determinations. <br />This consent form expires 15 months after signed. <br />BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBB <br />2WKHU)DPLO\0HPEHURYHUDJH 'DWH <br />BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBB <br />2WKHU)DPLO\0HPEHURYHUDJH 'DWH <br />BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBB <br />2WKHU)DPLO\0HPEHURYHUDJH'DWH <br />BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBB <br />2WKHU)DPLO\0HPEHURYHUDJH'DWH <br />Penalties for Misusing this Consent: <br />+8'WKH+$DQGDQ\RZQHU RUDQ\HPSOR\HHRI+8'WKH+$RUWKHRZQHU PD\EHVXEMHFWWRSHQDOWLHVIRUXQDXWKRUL]HGGLVFORVXUHVRULPSURSHUXVHVRI <br />LQIRUPDWLRQFROOHFWHGEDVHGRQWKHFRQVHQWIRUP <br />8VHRIWKHLQIRUPDWLRQFROOHFWHGEDVHGRQWKHIRUP+8'LVUHVWULFWHGWRWKHSXUSRVHVFLWHGRQWKHIRUP+8'$Q\SHUVRQZKRNQRZLQJO\RUZLOOIXOO\ <br />UHTXHVWVREWDLQVRUGLVFORVHVDQ\LQIRUPDWLRQXQGHUIDOVHSUHWHQVHVFRQFHUQLQJDQDSSOLFDQWRUSDUWLFLSDQWPD\EHVXEMHFWWRDPLVGHPHDQRUDQGILQHGQRWPRUH <br />WKDQ <br />$Q\DSSOLFDQWRUSDUWLFLSDQWDIIHFWHGE\QHJOLJHQWGLVFORVXUHRILQIRUPDWLRQPD\EULQJFLYLODFWLRQIRUGDPDJHVDQGVHHNRWKHUUHOLHIDVPD\EHDSSURSULDWHDJDLQVW <br />WKHRIILFHURUHPSOR\HHRI+8'WKH+$RUWKHRZQHUUHVSRQVLEOHIRUWKHXQDXWKRUL]HGGLVFORVXUHRULPSURSHUXVH <br />Privacy Act Notice.Authority: The Department of Housing and Urban Development (HUD) is authorized to collect this information <br />by the U.S. Housing Act of 1937 (42 U.S.C. 1437 et. seq.), Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d), and by the Fair <br />Housing Act (42 U.S.C. 3601-19). The Housing and Community Development Act of 1987 (42 U.S.C. 3543) requires applicants and <br />participants to submit the Social Security Number of each household member who is six years old or older. Purpose: Your income and <br />other information are being collected by HUD to determine your eligibility, the appropriate bedroom size, and the amount your family <br />will pay toward rent and utilities. Other Uses: HUD uses your family income and other information to assist in managing and monitoring <br />HUD-assisted housing programs, to protect the Government’s financial interest, and to verify the accuracy of the information you provide. <br />This information may be released to appropriate Federal, State, and local agencies, when relevant, and to civil, criminal, or regulatory <br />investigators and prosecutors. However, the information will not be otherwise disclosed or released outside of HUD, except as permitted <br />or required by law. Penalty: You must provide all of the information requested by the HA, including all Social Security Numbers you, <br />and all other household members age six years and older, have and use. Giving the Social Security Numbers of all household members <br />six years of age and older is mandatory, and not providing the Social Security Numbers will affect your eligibility. Failure to provide <br />any of the requested information may result in a delay or rejection of your eligibility approval. <br />Page 19 of 29 <br />EXHIBIT 2