Fillable Checklist for Vacancy Special Claim

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Checklist for Vacancy Special Claim

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Checklist for Vacancy Special Claim
KHRC Form
Project Name:___________________________________________________ Contract Number:______________________________
Vacated Resident’s Name: __________________________________________Vacated Unit Number:__________________________
Move-out date:__________________________ Transfer Date:_______________________Date of Death:______________________
HUD-52670-A, Part 2 – completed, signed and dated
HUD-52671-C - completed, signed and dated
Owner/Agent completed checklist (KHRC form available on website)
TRACS Move-In/Move-Out Query or Certification Query showing the date the former tenant moved out AND the date the new
tenant moved in. If the unit is still vacant, a current TRACS report must be included to show the vacancy.
Original HUD-50059 for the tenant who vacated the unit showing the TTP and security deposit required at time of move-in
Unit Transfers or N/A
If the former tenant transferred, the TRACS Certification Query must be provided showing as an IR-O or UT-O
UT 50059 for the former tenant who transferred out
Tenant Ledger for former tenant showing the transfer of security deposit
If the new tenant transferred into the unit, a reason for the transfer & the transfer waiting list MUST be provided
One of the following documents showing the amount of security deposit collected from the former tenant when they moved in:
original lease or
tenant ledger or
security deposit receipt
Security deposit disposition
If security deposit was forfeited due to lack of 30 day notice a reason must be provided and the amount entered on line 11 of
HUD 52671C
If the former tenant’s assistance was terminated prior to move out due to failure to comply with recertification requirements, a
reason for the termination, reminder notices and final notification letter must be provided.
Vacancy reconditioning log (Sample Reconditioning Log available through KHRC website)
If the turnover functions took longer than 10 days, an explanation must be provided
If the vacancy is due to death, documentation showing the date of death of the former tenant must be provided
Waiting list showing the tenant who moved into the unit. If a waiting list is not available, documentation of advertising efforts
must be provided.
PL
EASE NOTE: KHRC and HUD reserve the right to request additional supporting documentation as needed to complete the special
claim. Failure to submit ALL of the listed and/or requested documentation could result in the denial of the special claim.
Checklist for Damage and/or Unpaid Rent Special Claim
P
roject Name:___________________________________________________ Contract Number:______________________________
Vacated Resident’s Name: __________________________________________Vacated Unit Number:__________________________
Move-out date:__________________________ Date of Death:______________________
HUD-52670-A, Part 2 – completed, signed and dated
HUD-52671-A - completed, signed and dated
Owner/Agent completed checklist (KHRC form available on website)
Original HUD-50059 for the tenant who vacated the unit showing the TTP and security deposit required at time of move-in
One of the following documents showing the amount of security deposit collected from the former tenant when they moved in:
original lease or
tenant ledger or
security deposit receipt
TRACS Move-In/Move-Out Query or Certification Query showing the date the former tenant moved out.
If the vacancy is due to death, documentation showing the date of death of the former tenant must be provided
Security deposit disposition
Vacancy reconditioning log (KHRC form available on website)
If the former tenant’s assistance was terminated prior to move out due to failure to comply with recertification requirements, a
reason for the termination, reminder notices and final notification letter must be provided.
MI/MO inspection report
Copy of the certified letter provided to the tenant at move-out. The letter must include an itemized list of damages and charges
to the tenant and/or the amount of unpaid rent due, and demand payment and explain other attempts to collect will be pursued.
Proof the letter was mailed certified to the tenant
Documentation from the collection agency
DAMAGE CLAIM ONLY: Completed Life Expectancy Calculation Chart (KHRC form available on website).
DAMAGE CLAIM ONLY: Documents to support damage claim (pictures, invoices, receipts, etc)
P
LEASE NOTE: KHRC and HUD reserve the right to request additional supporting documentation as needed to complete the special
claim. Failure to submit ALL of the listed and/or requested documentation could result in the denial of the special claim.
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Checklist for Vacancy Special Claim

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Completed 10 February 2022

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