Updated HOME Sample Self-Certification of Income Form to Implement COVID-19 Waivers Now Available

HUD’s Office of Affordable Housing Programs (OAHP) has updated the sample self-certification of income form originally published in June 2020. The revised form supersedes previous form and is valid for use through September 30, 2021, the extended HOME COVID-19 waiver period.

View the Updated HOME Sample Self-Certification of Income Form.

Participating Jurisdictions (PJs) can use the sample self-certification of income form to document the annual income of:

• New applicants of HOME-assisted rental units
• New applicants of HOME Tenant-Based Rental Assistance (TBRA) programs, including emergency and short-term TBRA
• Existing TBRA tenants requiring assistance under an emergency TBRA program
• Existing tenants of HOME rental units up for income re-examination (annual and 6th year redeterminations)
• Prior applicants denied assistance due to the inclusion of excludable unemployment benefits

Visit the HUD Exchange HOME COVID-19 Guidance page for additional information and resources.