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Income Changes - What to Bring?

All sources of income you expect to receive for all household members. Any person 18 or older who has NO INCOME must verify that they are not receiving any income. Bring original documents, NOT COPIES.

Income generally includes, but is not limited to:

Type of Income

What to Bring to Your Appointment

Employment

Paycheck stubs for the last 3 months (if less than full time, you should bring stubs for the last 12 months) verifying your income.  Provide name, address, phone and fax number of employer.
 

Self Employment

Business License, copy of IRS 1040 with profit & Loss statement (include supporting documents), IRS Schedule C
 

Unemployment Benefits

Unemployment Benefits will be verified by SHA Staff.  Please DO NOT go to employment security for this information.
 

Public Assistance

(TANF or Welfare)

DSHS income will be verified by SHA staff.  Please, DO NOT go to the DSHS Office for this information.
 

Social Security or SSI

1-800-772-1213

A letter from SSA showing current benefit amount OR the original award  letter sent by the SSA for this year stating benefit amount and your current bank statement showing direct deposit.
 

V.A. Benefits

1-800-827-1000

Call and ask them to mail you a verification of your current gross monthly benefit. (Veteran's Administration)
 

Railroad Retirement 

553-5483

Call and ask them to mail you a verification of your current gross monthly benefit.  Provide name, address and phone number of retirement provider.
 

Civil Service 

Retirement 

(No Local Number)

Write to the U.S. Office of Personnel Management, Civil Service Retirement System, P.O. Box 440, Boyers, PA  16017-0440 and ask them to mail you the verification of your gross monthly benefit.
 

Worker's/Injury Compensation

A statement from the Department of Labor and Industries, insurance company, law firm, etc., which shows your awarded gross amount.
 

Alimony, Regular Contributions or Gifts

A copy of the court order in the case of alimony; or a statement from any charity, private relief organization, individual or family member who gives you any regular contributions or gifts.
 

Child Support

Child support paid through the Office of Support Enforcement (OSE) will be verified by SHA Staff.  Informal support payments, not administered through OSE, must be verified with copy of divorce decree; parenting plan, court order; or notarized statement from non-custodial parent.
 

Armed Forces (Military)

A statement of all regular pay, special payments and allowances received by a member of the Armed Forces (includes National Guard and Reserves).
 

Retirement, pensions, annuities, and other benefits.

A statement of income from source of annuities, insurance policies, retirement, pensions, disability or death benefits. (Annuities should show current balance and rate of interest, i.e. 5%, 5.3%, etc..  If you are drawing on an annuity, you need to show your gross monthly draw.)
 

NO INCOME

A statement from Social Security, for you and each member of your household, which states no benefits.  (Note:  SHA will verify with DSHS and Employment Security)
 

Bank Account Statements and Assets

You will need to bring three (3) consecutive months of your most current bank statements for all bank accounts.  These include, but is not limited to:  checking, savings, Certificate of deposits, etc.  If you have investment accounts, you will need to bring in a financial statement from the financial institute or stock broker that provides current information for all investments.  These include, but is not limited to:  IRA’s, trust funds, stock, bonds, mutual funds, capitol investment, etc.  If you have other assets, you will need to bring in a financial statement or other written documents that provides current information for all other assets.  These include, but is not limited to:  US Saving Bonds, real estate, etc.


Deductions and Allowances (if eligible)

If you or a member of your household is elderly (62+) or has a disability and you pay for medical insurance and/or other medical expenses, you may be eligible for a deduction.
 
Type of Deduction or Allowances What to bring to the appointment

Medial Insurance and Other Expenses

Bring payment stubs, canceled checks, or money order receipts from your provider (Blue Cross, Blue Shield, AARP, etc.), hospital or doctor bills for the last 12-months; and payment agreements for bills that have not been paid.

 

Medications

Bring receipts from the last 3-months and a letter or computer printout from your pharmacy that lists your current medications; how much you take; how many pills in a bottle and how much the prescription costs from the last 12-months.

 

Child Care

If you or a member of your household is employed and pay for child care, bring canceled checks or money order receipts and a statement from the provider of any child care subsidy (DSHS, City of Seattle, employer, etc.).  You will be asked to declare this expense in a signed statement, which will be verified by your childcare provider.

 

Student

Verification of current school registration for full-time students 18-years or older.  (It is no longer necessary to verify financial aid.)

  

Personal Declaration

Fill the form out completely.  Provide as much information as you can.  If you need assistance filling out the form, you can ask for assistance.  Failing to report accurate and complete information about your household is Fraud and can place your housing assistance in jeopardy.  You, and all members who are living in your household who are 18 years or older must sign and return this form.

Authorization For Release of Information

You, as head of household, and all members living in your household who are 18-years or older must sign and date this form.

Social Security Number Verification

Provide the SSN for all persons living in your household, even if you think SHA may already have this information.

Declaration of Citizenship or Eligible Immigration Status

Fill out both sides completely.  You, as head of household, and all members who are living in your household who are 18 years or older must sign and date this form.  The responsible adult must also claim status for all minors living in the household.

Note:  Household members who were on the lease as of April, 1998 and who have already declared status, do not need to fill this out again.  All household members who have not declared status will need to do this only once.

Emergency References

Fill in the form completely.  You are strongly encouraged to provide the name, address and phone number of the person(s) such as family, friends, etc. that you want contacted in case of an emergency.  Also, the name and phone number of your Doctor and the Hospital you would like contacted, if necessary.
 

Seattle Housing Authority • 120 Sixth Avenue N • P.O. BOX 19028 • Seattle, WA 98109-1028 • (206) 615-3300