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, 396 KB)
- Intake packet (PDF, 312 KB)
- Intake packet cover sheet (PDF, 20 KB)
- Move out packet (PDF, 32 KB)
- New move-in with intake packet (PDF, 200 KB)
- New move-in without intake (PDF, 48 KB)
- New move-in without intake cover sheet (PDF, 20 KB)
- Special review packet (PDF, 75 KB)
- Special review cover sheet (PDF, 20 KB)
- Transfer packet (PDF, 296 KB)
- Transfer cover sheet (PDF, 20 KB)
Individual forms
General
- Drug-Damage-Lead Based Paint (PDF, 28 KB)
- HUD Authorization for the Release of Information (PDF, 44 KB)
- Citizenship, Mod Rehab Declaration (PDF, 48 KB)
- Citizenship, Verification Consent (PDF, 32 KB)
- Inability to Document Social Security Number (PDF, 32 KB)
- Seattle Housing Authority Release of Information (PDF, 44 KB)
- Social Security Card and Immigration Forms Copy Template (PDF, 44 KB)
- SRO Personal Declaration (PDF, 56 KB)
- Statement of Family Responsibility (PDF, 40 KB)
- Tenant Verification of Disability (Tax Credit) (PDF, 36 KB)
Verification
- Medical Expenses (PDF, 60 KB)
- Assets (Tax Credit) (PDF, 52 KB)
- Verification/Clarification by Phone (Tax Credit) (PDF, 64 KB)
- Employment (Tax Credit) (PDF, 76 KB)
- L & I (Seattle Housing Authority) (PDF, 36 KB)
- Military Pay (Tax Credit) (PDF, 156 KB)
- Pension (Tax Credit) (PDF, 48 KB)
- Public Assistance (Tax Credit) (PDF, 52 KB)
- Self Employment (Tax Credit) (PDF, 60 KB)
- SSI (Tax Credit) (PDF, 28 KB)
- Unemployment (Tax Credit) (PDF, 40 KB)
- VA (Seattle Housing Authority) (PDF, 36 KB)
- Verification of Deposit (Tax Credit) (PDF, 52 KB)
- Zero Income (PDF, 44 KB)
Inspection
- Inspection Self-Certification (PDF, 28 KB)
Intake
- Verification of Homelessness (PDF, 36 KB)
- Eligibility Certification (Tax Credit) (PDF, 40 KB)
- Mod Rehab Housing Application (PDF, 64 KB)
- Rental Eligibility Certification (Tax Credit) (PDF, 48 KB)
- HUD Lease Addendum (PDF, 20 KB)
Move Out
- Move Out Notice (PDF, 32 KB)
Special review
- Special Review Requirements (PDF, 24 KB)
- Request for Special Review (PDF, 75 KB)
Transfer
- Transfer Checklist (PDF, 80 KB)
Fax cover sheets
- Arion (PDF, 28 KB)
- Broadway (PDF, 28 KB)
- Dorothy Day (PDF, 28 KB)
- Frye (PDF, 28 KB)
- Gatewood (PDF, 28 KB)
- The Glen (PDF, 20 KB)
- Greenwood (PDF, 28 KB)
- Lyon (PDF, 28 KB)
- Pacific (PDF, 28 KB)
- Santos (PDF, 28 KB)
- Scargo (PDF, 28 KB)
- Union (PDF, 28 KB)
- Westlake (PDF, 28 KB)
- Wintonia (PDF, 28 KB)
Contact this program
Andy Eide
Supervisor
206-239-1649
Mary Armstrong
Annual Reviews, Compliance, HAP Reconciliations
206-239-1716
Emma Meinig
Applications & New Move-Ins
206-239-1782
