VERIFICATION OF COMPLIANCE
WITH CARES ACT
lex
et
justitia
C
O
M
M
O
N
W
E
A
L
T
H
O
F
K
E
N
T
U
C
K
Y
C
O
U
R
T
O
F
J
U
S
T
I
C
E
AOC-1027 Doc. Code: FDVOC
Rev. 8-20
Page 1 of 4
Commonwealth of Kentucky
Court of Justice
www.kycourts.gov
SCAO 2020-56
Case No. ____________________
Court ________________________
County ______________________
Division ______________________
_____________________________________________ PLAINTIFF
VS.
_____________________________________________ DEFENDANT
_____________________________________________
_____________________________________________
Address
Name
In support of the attached eviction filing related to the property located at: ____________________________________
______________________________________________________________________________________________,
and in compliance with Kentucky Supreme Court Administrative Order 2020-56, Plaintiff submits this Verification:
1. I certify that I am the Plaintiff in the above-referenced case and I have investigated whether the property identified
above is a “covered dwelling” under Section 4024 of the Coronavirus Aid, Relief and Economic Security (CARES) Act
or is a property for which the borrower of a federally backed multifamily mortgage loan has received a mortgage
forbearance under Section 4023 of the CARES Act.
My investigation included (Identify any database(s), websites, or any other information you have used, or specific contacts
you have made with, e.g., the owner or borrower, federal agencies, mortgage servicer(s), or any others):
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
2. Select Option A, B, C, D, or E below and complete all information under that Option. [Applicable definitions
are attached.]
A. The property is not a "covered dwelling" under Section 4024 of the CARES Act and is not a property for which a
multifamily borrower has received a mortgage forbearance under Section 4023 of the CARES Act.
B. The property is a "covered dwelling" under Section 4024 of the CARES Act; however, this eviction action is for
a reason(s) other than nonpayment of rent or fees, penalties, or other charges related to nonpayment of rent.
 C. The property is a "covered dwelling" under Section 4024 of the CARES Act and this eviction action is for
nonpayment of rent or fees, penalties, or other charges related to nonpayment of rent. (Complete the following.)
Tenant was provided 30 days' notice to vacate as required by Section 4024 of the CARES Act. See attached
notice, provided to Tenant on _________________________, 20____. (Attach notice.)
AND
Tenant is not being charged fees, penalties, or other charges related to nonpayment of rent that accrued during
the period between March 27, 2020, and July 25, 2020.
D. Mortgage forbearance was granted to the borrower of a federally backed multifamily mortgage loan on this
property under Section 4023 of the CARES Act; however, this eviction action is not solely for nonpayment of
rent or fees, penalties, or other charges related to nonpayment of rent.
Address
AOC-1027
Rev.
8-20
Page 2 of 4
E. Mortgage forbearance was granted to the borrower of a federally backed multifamily mortgage loan on this
property under Section 4023 of the CARES Act and this eviction action is solely for nonpayment of rent
or fees, penalties, or other charges related to nonpayment of rent. (Complete the following.)
Plainti led this case after the expiration of the forbearance period granted to the multifamily borrower
under Section 4023 of the CARES Act. Date of expiration: _________________________, 20____.
AND
Tenant was provided 30 days' notice to vacate as required by Section 4023 of the CARES Act. See attached
notice, provided to Tenant on _________________________, 20____. (Attach notice.)
AND
Tenant is not being charged fees, penalties, or other charges related to nonpayment of rent that accrued during
the period of forbearance.
I declare under the penalty of perjury that I have read or have had read to me the statements contained in this Verification
and that they are true, complete, and accurate to the best of my personal knowledge. Further, I understand that filing an
eviction action that does not meet the criteria of any one of the options above could result in sanctions, up to and including
dismissal, award of attorneys’ fees, and any other sanctions the court deems appropriate.
____________________________, 2______ ___________________________________________
Date Plaintiff’s / Attorney’s Signature
__________________________________ ___________________________________________
Printed Name Title / Position
________________________________________________________________________________________
Address
( ) ( ) ______________________________________
Phone no. Alternate phone no. Email address
CARES Act
Public Law 116-136
Explanation of Terms
SEC. 4024. TEMPORARY MORATORIUM ON EVICTION FILINGS.
(a) DEFINITIONS.—In this section:
(1) COVERED DWELLING.—The term ‘‘covered dwelling’ means a dwelling that—
(A) is occupied by a tenant—
(i) pursuant to a residential lease; or
(ii) without a lease or with a lease terminable under State law; and
(B) is on or in a covered property.
(2) COVERED PROPERTY.—The term ‘‘covered property’ means any property that—
(A) participates in—
(i) a covered housing program (as de ned in section 41411(a) of the Violence Against Women Act of
1994 (34 U.S.C. 12 12491(a))); or
(ii) the rural housing voucher program under section 542 of the Housing Act of 1949 (42 U.S.C.
1490r); or
(B) has a—
(i) Federally backed mortgage loan; or
(ii) Federally backed multifamily mortgage loan.
(3) DWELLING.—The term ‘‘dwelling’’—
(A) has the meaning given the term in section 802 of the Fair Housing Act (42 U.S.C. 3602); and
(B) includes houses and dwellings described in section 803(b) of such Act (42 U.S.C. 3603(b)).
(4) FEDERALLY BACKED MORTGAGE LOAN.—The term ‘‘Federally backed mortgage loan’ includes any loan
(other than temporary nancing such as a construction loan) that—
(A) is secured by a rst or subordinate lien on residential real property (including individual units of condo-
miniums and cooperatives) designed principally for the occupancy of from 1 to 4 families, including any
such secured loan, the proceeds of which are used to prepay or pay o an existing loan secured by the
same property; and
(B) is made in whole or in part, or insured, guaranteed, supplemented, or assisted in any way, by any o cer
or agency of the Federal Government or under or in connection with a housing or urban development
program administered by the Secretary of Housing and Urban Development or a housing or related
program administered by any other such o cer or agency, or is purchased or securitized by the Federal
Home Loan Mortgage Corporation or the Federal National Mortgage Association.
(5) FEDERALLY BACKED MULTIFAMILY MORTGAGE LOAN.—The term ‘‘Federally backed multifamily mortgage
loan’’ includes any loan (other than temporary nancing such as a construction loan) that—
(A) is secured by a rst or subordinate lien on residential multifamily real property designed principally for
the occupancy of 5 or more families, including any such secured loan, the proceeds of which are used to
prepay or pay o an existing loan secured by the same property; and
(B) is made in whole or in part, or insured, guaranteed, supplemented, or assisted in any way, by any o cer
or agency of the Federal Government or under or in connection with a housing or urban development
program administered by the Secretary of Housing and Urban Development or a housing or related
program administered by any other such o cer or agency, or is purchased or securitized by the Federal
Home Loan Mortgage Corporation or the Federal National Mortgage Association.
AOC-1027
Rev.
8-20
Page 3 of 4
Public housing (42 U.S.C. § 1437d)
Section 8 Housing Choice Voucher program (42 U.S.C. § 1437f)
Section 8 project-based housing (42 U.S.C. § 1437f)
Section 202 housing for the elderly (12 U.S.C. § 1701q)
Section 811 housing for people with disabilities (42 U.S.C. § 8013)
Section 236 multifamily rental housing (12 U.S.C. § 1715z-1)
Section 221(d)(3) Below Market Interest Rate (BMIR) housing (12 U.S.C. § 1715l (d))
HOME (42 U.S.C. § 12741, et seq.)
Housing Opportunities for Persons with AIDS (HOPWA) (42 U.S.C. § 12901, et seq.)
McKinney-Vento Act homelessness programs (42 U.S.C. § 11360, et seq.)
Department of Agriculture
Section 515 Rural Rental Housing (42 U.S.C. § 1485)
Sections 514 and 516 Farm Labor Housing (42 U.S.C. §§ 1484, 1486)
Section 533 Housing Preservation Grants (42 U.S.C. § 1490p-2)
Department of Treasury
Low-Income Housing Tax Credit (LIHTC) (26 U.S.C. § 42)
For purposes of Section 4024(a)(2), a “federally backed mortgage loan” is any loan that is secured by a rst or
subordinate lien on residential real property designed for the occupancy of one or more families and is made in whole or
in part, or insured, guaranteed, supplemented, or assisted in any way, by any o cer or agency of the Federal Government
or under or in connection with a housing or urban development program administered by the Secretary of Housing and
Urban Development or a housing or related program administered by any other such o cer or agency, or is purchased
or securitized by the Federal Home Loan Mortgage Corporation (“Freddie Mac”) or the Federal National Mortgage
Association (“Fannie Mae”).
SEC. 4023. FORBEARANCE OF RESIDENTIAL MORTGAGE LOAN PAYMENTS FOR MULTIFAMILY PROPERTIES
WITH FEDERALLY BACKED LOANS.
(F) DEFINITIONS.—In this section:
(2) FEDERALLY BACKED MULTIFAMILY MORTGAGE LOAN.—The term “Federally backed multifamily
mortgage loan” includes any loan (other than temporary nancing such as a construction loan) that—
(A) is secured by a rst or subordinate lien on residential multifamily real property designed principally for
the occupancy of 5 or more families, including any such secured loan, the proceeds of which are used to
prepay or pay o an existing loan secured by the same property; and
(B) is made in whole or in part, or insured, guaranteed, supplemented, or assisted in any way, by any o cer
or agency of the Federal Government or under or in connection with a housing or urban development
program administered by the Secretary of Housing and Urban Development or a housing or related
program administered by any such other o cer or agency, or is purchased or securitized by the Federal
Home Loan Mortgage Corporation or the Federal National Mortgage Association.
AOC-1027
Rev.
8-20
Page 4 of 4
For purposes of Section 4024(a)(2), a “covered property” includes any property that participates in any of the following
programs or receives funding from any of the following sources:
Rural Housing Voucher Program (42 U.S.C. 1490r)
VAWA Covered Housing Programs:
Department of Housing and Urban Development (HUD)
Print
Reset Form