SECTION F:  Release of Information Forms

The information obtained after receiving signed Authorization to Release Information forms is confidential and extremely sensitive (i.e. wages, unemployment compensation, interest and dividends). Both HUD and MSHDA employees and/or contractual agents may be subject to penalties for unauthorized disclosure or improper use of the income information that is obtained from using these forms.

The release of information forms or certification must be signed by the head of household, spouse, and by each additional adult (age 18 and older) household member at the time of the initial eligibility determination and at least annually thereafter as a part of each interim and annual re-examination process.  If a current household member turns 18 years of age prior to the next scheduled annual re-examination, execution of the certification forms can be postponed until the next interim or annual re-examination, whichever occurs first.

Failure of the applicant or participant to sign the consent forms constitutes grounds for denial of eligibility.

a)         Authorization for Release of Information/Privacy Act Notice (HUD 9886)

The HUD 9886 form is used to obtain the following information only: 

• Wage and unemployment compensation from state wage information collection agencies (SWICAs),
• Salary and wage information from current and former employers,
• Unearned income from financial institutions;

It also notifies the applicant/participant that Social Security Numbers (SSN's) are required and must be provided for all household members. 

This consent will expire 15 months from the date signed.

Box 1 must be completed (stamped) with the Housing Specialist/Agent name, address, and date.  Box 2 must be crossed out.

b)                 Applicant/Tenant Authorization, Certification, and Consent (MSHDA 158)

The MSHDA 158 form is used to meet HUD requirements and authorize release of Social Security Administration (SSA), Immigration and Naturalization Service (INS), FIA, and law enforcement agency information.  This consent will expire 15 months from the date signed.

Income/Asset/Expense Documentation

NOTE: Income/Expense verification requests may be combined with the Initial Request Verification if desired.

Review the Checklist (MSHDA 1792) and request income and expense verifications, based on the information provided, via the Original Request for Documents (MSHDA 53).

• Verifications cannot be dated more than 60 days prior to the voucher issuance date.
• Verifications cannot be dated more than 120 days prior to the effective date of the new contract.

c)         Applicable Forms List