4-1 SUBMISSION ANNUAL ADMIN PLAN_EXHIBIT 3

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Third-party verification form signed by the provider, if family-provided documents are not available. In addition, the PHA must verify that: The family member for whom the expense is incurred is a person with disabilities (as described in 7-II.F above). The expense permits a family member, or members, to work (as described in 6-II.E.). The expense is not reimbursed from another source (as described in 6-II.E.). Family Member is a Person with Disabilities To be eligible for the disability assistance expense deduction, the costs must be incurred for attendant care or auxiliary apparatus expense associated with a person with disabilities. The PHA will verify that the expense is incurred for a person with disabilities (See 7-II.F.). Family Member(s) Permitted to Work The PHA must verify that the expenses claimed actually enable a family member, or members, (including the person with disabilities) to work. SAHA Policy SAHA will request third-party verification from a rehabilitation agency or knowledgeable medical professional indicating that the person with disabilities requires attendant care or an auxiliary apparatus to be employed, or that the attendant care or auxiliary apparatus enables another family member, or members, to work (See 6-II.E.). This documentation may be provided by the family. If third-party verification has been attempted and is either unavailable or proves unsuccessful, the family must certify that the disability assistance expense frees a family member, or members (possibly including the family member receiving the assistance), to work. Unreimbursed Expenses To be eligible for the disability expenses deduction, the costs must not be reimbursed by another source. SAHA Policy The family will be required to certify that attendant care or auxiliary apparatus expenses are not paid by or reimbursed to the family from any source. 04/01/14 Page 7-25