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Tenant Income Certification (April 2021)7 <br />Part VIII – Program Type <br />Select the program(s) for which this household’s unit will be counted toward the property’s occupancy requirements. One response from the first <br />column must be selected. <br />SIGNATURE OF OWNER/REPRESENTATIVE <br />It is the responsibility of the owner or the owner’s representative to sign and date this document immediately following execution by the resident(s). <br />The responsibility of documenting and determining eligibility (including completing and signing the Tenant Income Certificati on form) and ensuring <br />such documentation is kept in the tenant file is extremely important and should be conducted by someone well trained in tax c redit compliance. <br />These instructions should not be considered a complete guide on tax credit compliance. The responsibility for compliance with federal program <br />regulations lies with the owner of the building(s) for which the credit is allowable. <br />PART IX. SUPPLEMENTAL INFORMATION <br />Complete this portion of the form at move-in and at recertification’s (only if household composition has changed from the previous <br />year’s certification). <br />Tenant Demographic Profile Complete for each member of the household, including minors. Use codes listed on <br />supplemental form for Race, Ethnicity, and Disability Status. <br />Resident/Applicant Initials All tenants who wish not to furnish supplemental information should initial this section. <br />Parent/Guardian may complete and initial for minor child(ren). <br />EXHIBIT 5