SSA-L5061 MSSICS S Letter to Landlord Requesting Rental Information

Letter to Landlord Requesting Rental Information

MSSICS Screens

Letter to Landlord Requesting Rental Information

OMB: 0960-0454

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MSOM - MSSICS 010.016 Rental Data (LRNT)

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PolicyNetl MSOM/ MSSICS IIChapter 010

SENSITIVE - NOT TO BE SHARED \\lITH THE PUBLIC
02/07/97 (TN #202)

MSSICS 010.016 Rental Data (LRNT)
A.

INTRODUCTION

On this screen you record the rental information such as amount and frequency of the rental payment 

and if a parent or child relationship exists with the landlord or the landlord's spouse. 

If ANYONE IN HOUSEHOLD RELATED TO LANDLORD OR SPOUSE AS PARENT OR CHILD 

[6-M] is "Y", the system will display page 2. 


B.

FACSIMILE 1: LRNT-RENTALDATA

MSSICS

RENTAL DATA

PAGE 1 OF LRNT 


Jlc:l21 

SSS-SS-SSSS

SSSSS SSSSSSSSSS

PERIOD BEGAN: Ss/SS/SSSS

TRANSFER TO:

xxxx 


Q:!;!l
RENTAL PAYMENT: 9999999 


Ll:.fJ 

FREQUENCY OF RENTAL PAYMENT:

9 l=MONTHLY
2=WEEKLY

3;DAILY 

4=BI-WEEKLY 


J2~Cl

RENTAL LIABILITY VERIFIED(Y/N): X

Lf'N]
ANYONE IN HOUSEHOLD RELATED TO LANDLORD OR SPOUSE 

AS PARENT OR CHILD (y /N): x 


L?:..c:..L
CURRENT MARKET RENTAL VALUE: 9999999

I~. . . C:. L
VERIFIED (Y/N) : X 


j9-C] 


LANDLORD NAME: XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
..[..l .. ()<::J

ADDRESS: XXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXX 

.J.l.~•.. ·:.91. 

TELEPHONE: 999 999 9999 


I:l?[)I. 

RENTAL SUBSIDY: SSSSSSS 


.I.U:.91
REMARKS (Y): X

C.

FACSIMILE 2: LRNT - RENTAL DATA

MSSICS

RENTAL DATA

llDJ

PAGE 2 OF LRNT
[2

·oJ

SSS-SS-SSSS
sssss SSSSSSSSSS PERIOD BEGAN: Ss/ss/SSSS TRANSFER TO:
HOUSEHOLD MEMBER(S) RELATED TO LANDLORD AS
l=PARENT
2=CHILD

Ll..t:.tJ!J

llc~~l

RELATIONSHIP:
9
9

HOUSEHOLD MEMBER
SSSSSSSSSS S SSSSSSSSSSSSSSSSSSS
SSSSSSSSSS S SSSSSSSSSSSSSSSSSSS
SSSSSSSSSS S sssssssssssssssssss
ssssssssss S sssssssssssssssssss

9
9

http://policynet.ba.ssa.gov/msom.nsf/links/MSSICSO 100 16

XXXX

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MSOM - MSSICS 010.016 Rental Data (LRNT)
9
9
9
9
9
9
9
9
9
9
9

SSSSSSSSSS
SSSSSSSSSS
SSSSSSSSSS
SSSSSSSSSS
SSSSSSSSSS
SSSSSSSSSS
SSSSSSSSSS

S
S
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SSSSSSSSSS S
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sssssssssssssssssss
SSSSSSSSSSSSSSSSSSS
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L1.}=Ol
REMARKS 	 (Y): X

D. 	

HOW YOU GOT HERE

You entered "2" (this household member rents) for SELECT on Owned/Rental Data (LORD).

E. 	

COMMON FIELDS

[1-0] PERIOD BEGAN: SS/SS/SSSS
[2-0] TRANSFER TO: XXXX
[13-0] REMARKS (Y): X
Reference:

F. 	

Living Arrangements, MSOM MS..sICSJI1Q,i)01

FIELD DESCRIPTIONS
[3-M]

RENTAL PAYMENT: 9999999

Enter the amount of the required rental payment. 

Note:

[4-C]

Enter the amount required regardless of the amount paid for that period. 


FREQUENCY OF RENTAL PAYMENT: 9

Enter the appropriate value. 

This field is required if RENTAL PAYMENT [3-M] is greater than zero. 


[5-C]

RENTAL LIABILITY VERIFIED (YIN): X

Enter the appropriate value.
If claimant or claimant's spouse have rental liability and live with another adult household
member who is not a deemor, it is necessary to verify the rental liability. This field indicates if
rental liability is verified. If entry is "N", the system generates an issue on Development
Worksheet (DWOl) to obtain verification.
This field is conditional based upon whether it meets the requirement to verify the rental
liability.

http://policynet.ba.ssa.gov/msom.nsfllinksIMSSICSOI0016

11120/2008

MSOM - MSSICS 010.016 Rental Data (LRNT) 	
Reference:

Page 3 of4

Rental Liability As LA Basis, POMS S1 00835.120
Development Worksheet (DW01), MSOM MSSJCSJ)22,OOA

[6-M]
ANYONE IN HOUSEHOLD RELATED TO LANDLORD OR
SPOUSE AS PARENT OR CHILD (YIN): X
Enter the appropriate value.
If you enter "Y", the system displays page 2 to capture which household member is related and
the relationship.
Reference:

[7-C]

Rental Subsidies, POMS

.sL0083~!.-38Q

CURRENT MARKET RENTAL VALUE: 9999999

Enter the amount the provider of the residence would rent the residence for on the open market.
This field is required if ANYONE IN HOUSEHOLD RELATED TO LANDLORD OR
SPOUSE AS PARENT OR CHILD [6-M] is "Y".

[8-C]

VERIFIED (YIN): X

Enter the appropriate value.
This field is required when If ANYONE IN HOUSEHOLD RELATED TO LANDLORD OR
SPOUSE AS PARENT OR CHILD [6-M] is "Y".
Note: If VERIFIED is "N", then the system generates an issue to the Development Worksheet
(DW01) for verification to be obtained.
DeVelopment Worksheet (DWOl), MSOMMS]JCS 022.004.

[9-C]
XX 


LANDLORD NAME: XX[MAXIMUM OF 40 CHARACTERS]

LANDLORD NAME is only required if: 

•	

ANYONE IN HOUSEHOLD RELATED TO LANDLORD OR SPOUSE AS PARENT
OR CHILD [6-M] is "Y"; or

•	

claimant or spouse have rental liability and live with any other person who does not meet
the SSI definition of a child or a deemor.

[lO-C]
ADDRESS: XX[UP TO 4 LINES MAXIMUM 22
CHARACTERS EACH]XX
Enter the mailing address of the landlord.
This field is required if:

http://policynet.ba.ssa.gov/msom.nsfllinks/MSSICSOlOOI6

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MSOM - MSSICS 010.016 Rental Data (LRNT) 	

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•	

ANYONE IN HOUSEHOLD RELATED TO LANDLORD OR SPOUSE AS PARENT
OR CHILD [6-M] is "Y"; or

•	

claimant or spouse have rental liability and live with any other person who does not meet
the definition of child or a deemor.

[11-0]

TELEPHONE: 9999999999

Enter the telephone number of the landlord.

[12-D]

RENTAL SUBSIDY: SSSSSSS

The system computes and displays the amount of the rental subsidy after the screen is first
transmitted.
Note: This does include the comparison of the CMRV and the PMV for recipients residing in
CT, IL, IN, NY, VT and WI.
Caution:
For the states that rental subsidies must be compared to the PMV (NY, CT, IL,
IN, VT and WI), for January each year (because of the COLA change which changes the PMV
amount), you must indicate a change on LCHG of 12/31/(each year) which initiates a PERIOD
BEGAN [I-D] of III1(ofthat year) and walk through this new period in order that the
comparison will pick up the new PMV rates.
Reference:

[14-M]

Rental Subsidies, POMS SI 00835.379

RELATIONSHIP: 9

Enter the appropriate value for the relationship to the landlord or landlord's spouse.

[15-D]
SS

HOUSEHOLD MEMBER: SS[MAXIMUM 30 CHARACTERS]

This is a display of the household members for you to select the person related to the landlord or
landlord's spouse.

G.

RELATED REFERENCES

Name, Amount and Date Field Formats, MSSK~QQJJ.tQ1
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Link to this section:

http://policynet.ba.ssa.gov/msom.nsf/lnx/MSSJCSOl0016
Rev:

http://policynet.ba.ssa.gov/msom.nsf/links/MSSICSOl0016

11120/2008


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