HB-1-3550
Attachment 12-E
Page 2 of 2
For each non-retired applicant, a written explanation of employment history of less than two
years or employment gaps in excess of 30 days within the last two years.
ASSETS, CREDIT, OTHER DOCUMENTATION:
For each applicant, a copy of their two most recent asset/bank statements. (Note that if you
are obtaining this information through online banking, you should print your bank statement,
as opposed to printing the online transaction history.)
For each applicant, a written explanation for late payments, collections, judgments, or other
derogatory items in their credit history of which they may be aware. If applicants are unsure
what their credit history looks like, they can obtain a free credit report by calling 1-877-322-
8228 or logging into http://www.annualcreditreport.com. By law, individuals are entitled to
receive one free credit file disclosure every 12 months from each of the nationwide consumer
credit reporting companies – Equifax, Experian and TransUnion. This free report cannot
replace the credit report that the Agency will obtain to determine eligibility.
For each applicant, verification of their identity. A copy of a Government-issued photo
identification, evidence of date of birth (only required if not listed on the photo
identification).
For a household member who is a full-time student and 18 years of age or older, a copy of
their school transcript.
If applicable, provide written evidence of child care expenses for dependents 12 years of age
or younger.
If applicable, evidence of out of pocket annual medical expenses (for applicants 62 years of
age and older, or individuals with a disability) who wish to be considered for a deduction to
household income.
PROPERTY INFORMATION:
Evidence of Ownership: Copy of Deed, or other documentation.
Tax Statement: Most recent property tax assessment and annual statement, if applicable.
Insurance: Evidence of homeowner’s hazard or flood coverage, if applicable.
Repair Bid(s) including an itemized description of repairs, material, labor, and a copy of
Contractor’s license, if applicable.
Mortgage Statement: Most recent copy of mortgage statement, if applicable.
Photos of repair(s) and the front and back of property.
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