HUD 52578-b Section 8 Project-Based Voucher Program Statement of Fam

U.S. Department of Housing and Urban Development

Office of Public and Indian Housing

OMB approval No. 2577-0169

exp. (4/30/2014)

Section 8 Project-Based Voucher Program
Statement of Family Responsibility
Privacy Act Statement. The Department of Housing and Urban Development (HUD) is authorized
to collect the information required on this form by Section 8 of the U.S. Housing Act of 1937 (42
U.S.C. 1437f). Collection of family members’ name and address is mandatory. The information is
used to certify the members of the family participating in the Section 8 project-based voucher
program and the family’s awareness of their family responsibilities under the program. HUD may
disclose this information to Federal, State and local agencies when relevant to civil, criminal, or
regulatory investigations and prosecutions. It will not be otherwise disclosed or released outside
of HUD, except as permitted or required by law. Failure to provide any of the information may
result in delay or rejection of family eligibility approval.
1. Certification. The undersigned public housing agency (PHA) hereby certifies that
the family consisting of the following members:

__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
is eligible to participate in the Section 8 project-based voucher program of this
PHA and is approved to occupy a unit at:

__________________________________________________________________
__________________________________________________________________
Under this program, the PHA makes housing assistance payments to owners for units
leased and occupied by participating families.
2. Tenant Rent. The tenant rent is the portion of the monthly rent to owner paid by
the family, and is based on the family's income, composition, and expenses. The PHA
determines the tenant rent in accordance with HUD requirements.
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3. Changes i n T enant Rent. A f amily’s t enant rent may change because of changes in
program requirements or changes in family income, composition, or expenses.
Any change in a family's tenant rent will be effective on the date stated in a notice by
the PHA to the family and owner.
4. PHA Housing Assistance Payment. The monthly housing assistance payment by the
PHA to the owner for a unit leased by a family is the rent to owner minus the tenant rent
(total tenant payment minus any applicable utility allowance). The family is not
responsible for payment of the portion of the rent to owner covered by the housing
assistance payment.

5. Family Right to Move.

(A) The family may terminate its lease at any time after the first year of occupancy. The
family must give the owner advance written notice of intent to vacate (with a copy to the
PHA) in accordance with the lease. If the family elects to terminate the lease in this manner,
the PHA must offer the family the opportunity for continued tenant-based rental assistance
in accordance with HUD requirements.

(B) Before providing notice to terminate the lease under paragraph (A), the family must
first contact the PHA to request tenant-based rental assistance if the family wishes to
move with continued assistance. If tenant-based rental assistance is not immediately
available upon lease termination, the PHA must give the family priority to receive the
next available opportunity for continued tenant-based rental assistance.
6. Family Obligations. (A) Any family participating in the project-based voucher
program of the undersigned PHA must follow the rules listed below in order to continue
to receive housing assistance under the program. Any information the family supplies
must be true and complete.

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form HUD-(52578b)

(B) Each family member must:
1. Supply any information that the PHA or HUD determines to be necessary for
administration of the program, including submission of required evidence of
citizenship or eligible immigration status.

2. Supply any information requested by the PHA or HUD for use in a regularly
scheduled reexamination or interim reexamination of family income and
composition.
3. Disclose and verify social security numbers and sign and submit consent forms
for obtaining information.
4. Supply any information requested by the PHA to verify that the family is
living in the unit or information related to family absence from the unit.
5. Promptly notify the PHA in writing when the family is away from the unit for
an extended period of time in accordance with PHA policies.
6. Allow the PHA to inspect the unit at reasonable times and after reasonable
notice.
7. Notify the PHA and the owner in writing before moving out of the unit or
terminating the lease.
8. Use the assisted unit for residence by eligible family members. The unit must
be the family’s only residence.
9. Promptly notify the PHA in writing of the birth, adoption, or court-awarded
custody of a child.
10. Request P HA w ritten a pproval t o a dd a ny ot her f amily member as
an occupant of the unit.

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11. Promptly notify the PHA in writing if any family member no longer lives in
the unit.
12. Give the PHA a copy of any owner eviction notice.
13. Pay utility bills and provide and maintain any appliances that the owner is not
required to provide under the lease.
(C) The family (including each family member) must not:
1. Own or have any interest in the unit.
2. Commit any serious or repeated violation of the lease.
3. Commit fraud, bribery or any other corrupt or criminal act in connection
with the program.

4. Engage in drug-related criminal activity or violent criminal activity or other
criminal activity that threatens the health, safety or right to peaceful enjoyment
of other residents and persons residing in the immediate vicinity of the premises.
5. Sublease or let the unit or assign the lease or transfer the unit.
6. Receive project-based voucher assistance while receiving another housing
subsidy for the same unit or a different unit under any other Federal, State or local
housing assistance program.

7. Damage the unit or premises ( other t han da mage f rom or dinary w ear and
tear) or permit any guest to damage the unit or premises.

8. Receive project-based voucher assistance while residing in a unit owned by a
parent, child, grandparent, grandchild, sister or brother of any member of the family,
unless the PHA has determined (and has notified the owner and the family of such
determination) that approving rental of the unit, notwithstanding such

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relationship, would provide reasonable accommodation for a family member who
is a person with disabilities.
9. Engage in abuse of alcohol in a way that threatens the health, safety or right of
peaceful enjoyment of the other residents and persons residing in the immediate
vicinity of the premises.
 7HUPLQDWLRQRI$VVLVWDQFHThe PHA may terminate housing assistance for any
grounds authorized in accordance with HUD requirements, including family violation
of any obligation under Section 6 of this Statement of Family Responsibility. In
addition, if a family resides in a project-based voucher unit excepted from the 25
percent per-project cap on project-basing because of the family's participation in a
Family Self-Sufficiency (FSS) or other supportive services program, and the family
fails without good cause to complete its FSS contract of participation or supportive
service requirement, the PHA shall terminate assistance in accordance with HUD
requirements. 



 ,OOHJDO'LVFULPLQDWLRQIf the family has reason to believe that it has been
discriminated against on the basis of age, race, color, religion, sex, disability, national
origin, or familial status, the family may file a housing discrimination complaint with
any HUD office in person, by mail, or by telephone. The PHA will give the family
information on how to fill out and file a complaint. 

 +8'5HTXLUHPHQWV. HUD requirements for the Section 8 project-based voucher
program are issued by Headquarters as regulations, Federal Register notices, or other
binding directives. The Statement of Family Responsibility shall be interpreted and
implemented in accordance with HUD requirements. 

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form HUD-(52578b)

KEEP

THIS

DOCUMENT

FOR

YOUR

RECORDS

Family
Name of Family Representative:
________________________________________________________________________
Address, Telephone Number:
________________________________________________________________________
________________________________________________________________________
Signature of Family Representative, Date:
________________________________________________________________________
________________________________________________________________________
Public Housing Agency
Name of PHA:
________________________________________________________________________
Address, Telephone Number:
________________________________________________________________________
________________________________________________________________________
Signature of PHA Representative, Title, Date:
________________________________________________________________________
________________________________________________________________________
___________________________________________

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form HUD-(52578b)