AHSC-DC SPECIAL CLAIMS CHECKSHEET AND SPECIAL CLAIMS REQUIREMENTS
Tenant: ______Unit: ______
Project Name: ______Contract Number: ______
Unpaid Rent and Tenant Damages (Special Claims Processing Guide ch. 5 & 4350.3 ch.9-14)
1. ____Form HUD-52670-A Part2
2. ____Form HUD-52671-ASchedule of Special Claims(Includes Certification of Compliance)
3. ____Copy of the resident’s signedfirst 50059 at move-in to show the security deposit required.
4. ____Documentation that the appropriate security deposits were collected from the tenant: for example, a copy of the original lease, a copy of the tenant’s ledger card, or a copy of the receipt(s) for security deposit.
5. ____ Copy of the certified letter sent to the tenant detailing the unpaid rent and other charges due under the lease, the disposition of the security deposit, demanding payment, and advising the tenant that failure to pay the sums due will result in the owner/agent hiring a collection agency to collect the debt. The letter must include a notice to the tenant that they have a right to discuss the charges with the owner/agent. (See Security Deposit Disposition Notice 3-3.C 4).
6. ____Documentation that the matter was turned over to a collection agency for collection and that the collection agency has attempted to collect the debt (i.e., copy of the agency’s first demand letter).
7. ____Documentation for other charges that were due under the lease that demonstrates the charges were approved by HUD.
In addition, submit the following for Tenant Damages:
8. ____Copy of the move-in inspection form (signed by both the resident and management on or before the resident’s move-in date annotating condition of the unit).
9. ____Copy of move-out inspection form signed by management and resident (if available)--clearly describing all above normal wear and tear damages charged to the resident, indicating the extent of damage due to the tenant’s abuse and/or neglect.
10. ____Itemized list of damages
11. ____Breakdown of costs to repair the damages, which may include invoices, receipts, copies of work orders or maintenance records supporting dates work was completed.
12. ____The O/A must certify the submitted claim is not the result of normal wear and tear or routine maintenance.
13. ____For painting and/or carpet cleaning, provide maintenance schedule for unit (showing when unit was last painted and/or carpet cleaned and extent of damage caused by the resident).
14. ____“Life Expectancy” for major replacement/repair items (e.g., carpet, appliances, etc.) - provide age of the item & schedule for replacement, description of damage caused by the tenant and method of pro-ration (if applicable)
- Damaged items submitted for special claims may not also be submitted for reimbursement under the reserve for replacement account.
- Tenants may not be required to pay for professional carpet cleaning when vacating a unit as a prerequisite for reimbursement of the security deposit.
Regular Vacancy – (Vacancy After Rent-up)
(Special Claims Processing Guide ch. 3 & 4350.3 Paragraph 9-14.B)
1. ____Form HUD-52670-A Part2
2. ____Form HUD-52671-C Schedule for Special Claims (Includes Certification of Compliance)
3. ____The Move-out tenant’s original move-in 50059 (verifying TTP supporting that the appropriate amount of security deposit was collected).
4. ____Documentation that the appropriate security deposit was collected from the tenant: for example, a copy of the original lease, a copy of the tenant’s ledger card, or a copy of the receipts(s) for security deposit.
5. ____A copy of the security deposit disposition notice provided to the tenant which indicates the move-out date, amount security deposit collected, amount of security returned and any charges withheld from the deposit for unpaid rent, tenant damages or other charges due under the lease.
6. ____Copy of reconditioning log or maintenance record (showing move-out date & date of death (if applicable); start and finish dates of each process; date unit is ready for occupancy; and date unit is re-rented. In addition, written explanation of reasons for vacancies over 30 days.
7. ____Copy of Waiting List (by bedroom size--showing outcome of applicant contacts)—after the Initial submission, should be updated every 6-months.
8. ____If the unit was not filled from the waiting list(s), documentation of marketing efforts must be included such as copies of advertising or invoices for advertising expenses that substantiate the date marketing occurred in accordance with the AFHMP.
9. ____For Unit Transfers, documentation of reason for transfer & evidence the security deposit was either transferred to the new unit or a new security deposit was collected.
- Vacancy claims may not be submitted until after 60 days have passed or after the unit has been re-rented-- but no later than 180 days after the unit is ready for occupancy.
Debt Service(Special Claims Processing Guide ch. 4 & 4350.3 Paragraph 9-14.E.5)
(These claims are submitted to the respective HUD office in DC, to the attention of the MF Project Manager-Special Claims not to the contract administrator.)
1. ____Form HUD-52670-A Part 2
2. ____HUD Form 52671-D - Schedule for Special Claims (Includes Certification of Compliance)
3. ____Un-audited financial statements--covering 6 months for which claims are being made.
4. ____Written narratives for (a) cause of vacancies; (b) cause of financial problems; (c) actions
taken to correct the financial condition and to prevent re-occurrence; (d) time frame for paying
delinquent mortgage and excessive accounts.
5._____ Efforts to market the vacant units (if applicable)
- Only owners of Sec. 8 (except LMSA) and 202/PAC projects may bill HUD for Debt Service Claims.
Claims must be submitted on semi-annual basis. (See Handbook for further instructions).
Vacancy During Rent-Up(202/811 and PRAC projects ONLY)
1_____ Completed form HUD-52670-A, Part 2
2._____ Completed form HUD-52671-B.
3.____A list of all units leased and available for lease as of the effective date of the Permission to Occupy (form HUD-92485 signed by the HUD Architect or Engineer) or the effective date of the contract, whichever is later. Also include justification for all un-leased units explaining why they remain vacant.
4.____Evidence that marketing began not less than 90 days prior to initial occupancy, including copies of advertisements, or invoices for advertising expenses substantiating the date marketing began and a copy of the waiting list.
5.____Waiting-list documentation. Documentation should include the outcome of applicant contacts, (i.e. date applicant was contacted, response of applicant and the status of applicant’s move-in).
6.____ Copies of letters to rejected applicants demonstrating rejection for good cause.
If an owner is opting out of the Section 8 contract they should refer to Section 1-4, page2; paragraph (B) found in the HUD Special Claims Processing Guide for submission requirements.
Submission must include the appropriate checklist. All claims are then to be listed individually on Form HUD-52670-A, Part 2 by unit number order and the above claim forms (as applicable) placed in the order listed directly behind the HUD-52670-A, Part 2. Two original owner signed/certified copies of each form are required along with one copy of the supporting documentation for HUD/CA’s use. The residents’ MI and MO 50059’s must show in TRACS to be approved for Special Claims. APPROVED CLAIMS MUST BE SUBMITTED FOR PAYMENT WITHIN 90 DAYS OF APPROVAL OR THE PAYMENT WILL BE DENIED.
(FINAL Revised: September 2008)p. 1