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73505919v2 <br /> <br /> <br /> B-1-6 <br /> <br />Part III – Annual Income <br /> <br />See HUD Handbook 4350.3 for complete instructions on verifying and calculating income, including acceptable <br />forms of verification. <br /> <br />From the third party verification forms obtained from each income source, enter the gross amount anticipated to <br />be received for the 12 months from the effective date of the (re)certification. Complete a separate line for each <br />income-earning member. List the respective household member number from Part II. <br /> <br />Column (A) Enter the annual amount of wages, salaries, tips, commissions, bonuses, and other income <br />from employment; distributed profits and/or net income from a business. <br /> <br />Column (B) Enter the annual amount of Social Security, Supplemental Security Income, pensions, <br />military retirement, etc. <br /> <br />Column (C) Enter the annual amount of income received from public assistance (i.e., TANF, general <br />assistance, disability, etc.) <br /> <br />Column (D) Enter the annual amount of alimony, child support, unemployment benefits, or any other <br />income regularly received by the household. <br /> <br />Row (E) Add the totals from columns (A) through (D) above. Enter this amount. <br /> <br />Part IV – Income from Assets <br /> <br />See HUD Handbook 4350.3 for complete instructions on verifying and calculating income from assets, including <br />acceptable forms of verification. <br /> <br />From the third party verification forms obtained from each asset source, list the gross amount anticipated to be <br />received during the 12 months from the effective date of the certification. List the respective household member <br />number from Part II and complete a separate line for each member. <br /> <br />Column (F) List the type of asset (i.e., checking account, savings account, etc.) <br /> <br />Column (G) Enter C (for current, if the family currently owns or holds the asset), or I (for imputed, if <br />the family has disposed of the asset for less than fair market value within two years of the <br />effective date of (re)certification). <br /> <br />Column (H) Enter the cash value of the respective asset. <br /> <br />Column (I) Enter the anticipated annual income from the asset (i.e., savings account balance multiplied <br />by the annual interest rate). <br /> <br />TOTALS Add the total of Column (H) and Column (I), respectively. <br /> <br />If the total in Column (H) is greater than $5,000, you must do an imputed calculation of asset income. Enter the <br />Total Cash Value, multiply by 2% and enter the amount in (J), Imputed Income.