Mod Rehab Program
The U.S Department of Housing and Urban Development provides rent subsidy payments to private property owners for rental units rehabilitated under the Section 8 Moderate Rehabilitation program. This program is often called Mod Rehab.
These subsidies provide housing assistance for low-income persons at 30 percent of median income. Seattle Housing Authority administers this program, but the buildings are managed and leased out by the property owners. Some Mod Rehab communities serve populations with special needs.
The forms below are for use by property managers of buildings in the Mod Rehab Program. Forms are available in PDF format (download Adobe Reader).
Form packets
- Annual review packet (PDF, 498 KB)
- Intake packet (PDF, 775 KB)
- Intake packet cover sheet (PDF, 73 KB)
- Move out packet (PDF, 105 KB)
- New move-in with intake packet (PDF, 334 KB)
- New move-in without intake (PDF, 48 KB)
- New move-in without intake cover sheet (PDF, 61 KB)
- Special review packet (PDF, 124 KB)
- Special review cover sheet (PDF, 58 KB)
- Transfer packet (PDF, 396 KB)
- Transfer cover sheet (PDF, 58 KB)
Individual forms
General
- Citizenship, Mod Rehab Declaration (PDF, 97 KB)
- Citizenship, Verification Consent (PDF, 82 KB)
- Debts Owed to PHAs and Terminations (PDF, 463 KB)
- Drug-Damage-Lead Based Paint (PDF, 149 KB)
- HUD Authorization for the Release of Information (PDF, 44 KB)
- Inability to Document Social Security Number (PDF, 76 KB)
- Seattle Housing Authority Release of Information (PDF, 28 KB)
- Social Security Card and Immigration Forms Copy Template (PDF, 44 KB)
- SRO Personal Declaration (PDF, 94 KB)
- Statement of Family Responsibility (PDF, 40 KB)
- Tenant Verification of Disability (Tax Credit) (PDF, 64 KB)
Verification
- Assets (Tax Credit) (PDF, 82 KB)
- Employment (Tax Credit) (PDF, 112 KB)
- L & I (Seattle Housing Authority) (PDF, 33 KB)
- Medical Expenses Declaration (PDF, 427 KB)
- Military Pay (Tax Credit) (PDF, 194 KB)
- Pension (Tax Credit) (PDF, 84 KB)
- Public Assistance (Tax Credit) (PDF, 79 KB)
- Self Employment (Tax Credit) (PDF, 93 KB)
- SSI (Tax Credit) (PDF, 28 KB)
- Unemployment (Tax Credit) (PDF, 72 KB)
- VA (Seattle Housing Authority) (PDF, 33 KB)
- Verification/Clarification by Phone (Tax Credit) (PDF, 119 KB)
- Verification of Deposit (Tax Credit) (PDF, 83 KB)
- Zero Income (PDF, 81 KB)
Inspection
- Inspection Self-Certification (PDF, 25 KB)
Intake
- Eligibility Certification (Tax Credit) (PDF, 44 KB)
- HUD Lease Addendum (PDF, 20 KB)
- Mod Rehab Housing Application (PDF, 48 KB)
- Rental Eligibility Certification (Tax Credit) (PDF, 73 KB)
- Verification of Homelessness (PDF, 25 KB)
Move Out
- Move Out Notice (PDF, 105 KB)
Special review
- Request for Special Review (PDF, 88 KB)
- Special Review Requirements (PDF, 24 KB)
Transfer
- Transfer Checklist (PDF, 67 KB)
Fax cover sheets
- Arion (PDF, 57 KB)
- Broadway (PDF, 57 KB)
- Dorothy Day (PDF, 56 KB)
- Frye (PDF, 56 KB)
- Gatewood (PDF, 56 KB)
- The Glen (PDF, 56 KB)
- Greenwood (PDF, 56 KB)
- Lyon (PDF, 56 KB)
- Pacific (PDF, 56 KB)
- Santos (PDF, 56 KB)
- Scargo (PDF, 56 KB)
- Union (PDF, 56 KB)
- Westlake (PDF, 56 KB)
- Wintonia (PDF, 56 KB)
Contact this program
Andy Eide
Supervisor
206-239-1649
Mary Armstrong
Annual Reviews, Compliance, HAP Reconciliations
206-239-1716
Kavitha James
Applications & New Move-Ins
206-239-1782
