Return of HUD Housing Assistance Paid in Error
Repayment Agreement
This Agreement is entered into on this date, between (the resident(s)), hereafter referred to as “I/We or My/Our”and, hereafter referred to as “the owner/agent".
Address:
My/Our current email address is:
The owner/agent’s address is:
Because I/We failed to disclose accurate eligibility, employment and/or income information, HUD housing assistance was received by this household in error. I/We understand that failure to disclose any income, as described by the lease, is a material lease violation in accordance with paragraph(s):
Lease violations can result in termination of tenancy (eviction) in accordance with HUD regulations described in Chapter 8 of HUD Handbook 4350.3 Revision 1.
In accordance with HUD guidance, I/We must return any assistance paid in error to the owner/agent who will then return appropriate funds to HUD. I/We understand that, even if I/We move to another residence, I/We am still required to pay HUD any assistance received in error.
I/We understand that the owner/agent has recalculated my assistance and I/We must return to HUD the amount of $ and this amount is due immediately.
I/We am unableto pay the debt in a lump sum. In accordance with HUD Handbook 4350.3 Revision 1 and subsequent HUD Housing Notices, HUD and the owner/agent are willing to forego collection of the entire amount of the debt, at this time. The owner/agent will accept periodic paymentsof the amount I/We oweif I/We pay the debt in accordance with the conditions set forth below.
In consideration of my/our signing this Agreement, the owner/agent agrees to forbear the pursuing of legal and equitable remedies against me, but only for so long as I/We make timely payments under the terms of thisAgreement.
I/We shall have months to pay my debt, starting from the date of this Agreement.
No delay or omission by the owner/agent to exercise any right to which it might be entitled shall be construed to be a waiver of any such right, and everysuch right may be exercised from time to time and as often as may be deemed necessary by the owner/agent, the owner/agent’s legal counsel, HUD (or HUD’s agents) or the Office of the Inspector General (OIG).
Further, this Agreement is made knowingly, voluntarily and intelligently and not under any degree of duress or compulsion whatsoever.
I/We certify that I/We have disclosed any and all income received during my tenancy at. I/We understand that, if the owner/agent discovers additional undisclosed income, the owner/agent will begin the steps necessary to facilitate immediate termination of tenancy (eviction) for material lease violation.
I/We do hereby agree that I/We owe the amount of, as a result of my occupancy at Enter Property Name______. This debt is the result is the result of the following violation(s):
ENTER (Lease paragraph and description of each violation)
According to the agreement, I/Weagree to pay $ today. The remainder will be paid in monthly payments of $. This amount is due no later than the day of each month.
Total Amount Due:$
Total Paid: $ (initial payment)
Balance: $
This payment amount hasbeen determined based on my/our ability to pay and is in addition to the regular rent amount indicated on any current or future certifications. Ifmy/ourentire household income increases or decreases by a $200 or more per month ($2400 per year divided by 12), this agreement will be subject to modificationdepending on the circumstances at the time.
Any assistance paid in error is due to HUD even if I/we no longer reside at this property. If the household composition changes, the remaining adults agree to fulfill the terms of this agreement.
I/We understand that if I/We do not meet the terms of this agreement, the following action will be taken:
- Termination of HUD housing assistance beginning the first day of the month following non-payment
- Termination of tenancy (eviction) for material lease violation
- Denial of assistance in any other property owned or managed by
By signing this Repayment Agreement, I agree to the terms set forth. I have been given the opportunity to ask questions. I agree to the payment amount and understand that, this amount must be agreed upon by both the owner/agent and by me.
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Head of HouseholdDate
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ResidentDate
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ResidentDate
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Property ManagerDate
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Revised 11/2012______
Initials of Adult Household Members