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Recertification Packet

P 864.877.5471
F 864.848.1331
TDD 864.877.5471

Office Hours:
Monday - Thursday
8:00am - 5:30pm

103 School Street • Greer, SC 29651

Fields marked with * must be completed or form will not submit.

Please complete all sections of this certification packet and ANSWER all questions. The answers provided on this document are utilized to determine your continued rental assistance benefits subsidized through the U.S. Department of Housing and Urban Development (HUD). DO NOT leave any questions blank, answer either Yes or No.

ALL adult members of the household must certify that the information relating to them listed in this certification is correct and must attend the recertification appointment AND if you are 18 or will be 18 by recertification appointment you must also bring state issued ID.

[{"type":"header","subtype":"h4","label":"Head of Household","className":"d-block"},{"type":"text","required":true,"label":"First Name","name":"First-Name","className":"col-md-6","subtype":"text"},{"type":"text","required":true,"label":"Last Name","name":"Last-Name","className":"col-md-6","subtype":"text"},{"type":"text","required":true,"label":"Street Address","name":"Street-Address","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","required":true,"label":"City","name":"City","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"select","required":true,"label":"State","name":"State","className":"col-md-6 col-lg-3","values":[{"label":"Alabama","value":"AL"},{"label":"Alaska","value":"AK"},{"label":"Arizona","value":"AZ"},{"label":"Arkansas","value":"AR"},{"label":"California","value":"CA"},{"label":"Colorado","value":"CO"},{"label":"Connecticut","value":"CT"},{"label":"Delaware","value":"DE"},{"label":"District of Columbia","value":"DC"},{"label":"Florida","value":"FL"},{"label":"Georgia","value":"GA"},{"label":"Hawaii","value":"HI"},{"label":"Idaho","value":"ID"},{"label":"Illinois","value":"IL"},{"label":"Indiana","value":"IN"},{"label":"Iowa","value":"IA"},{"label":"Kansas","value":"KS"},{"label":"Kentucky","value":"KY"},{"label":"Louisiana","value":"LA"},{"label":"Maine","value":"ME"},{"label":"Maryland","value":"MD"},{"label":"Massachusetts","value":"MA"},{"label":"Michigan","value":"MI"},{"label":"Minnesota","value":"MN"},{"label":"Mississippi","value":"MS"},{"label":"Missouri","value":"MO"},{"label":"Montana","value":"MT"},{"label":"Nebraska","value":"NE"},{"label":"Nevada","value":"NV"},{"label":"New Hampshire","value":"NH"},{"label":"New Jersey","value":"NJ"},{"label":"New Mexico","value":"NM"},{"label":"New York","value":"NY"},{"label":"North Carolina","value":"NC"},{"label":"North Dakota","value":"ND"},{"label":"Ohio","value":"OH"},{"label":"Oklahoma","value":"OK"},{"label":"Oregon","value":"OR"},{"label":"Pennsylvania","value":"PA"},{"label":"Rhode Island","value":"RI"},{"label":"South Carolina","value":"SC","selected":true},{"label":"South Dakota","value":"SD"},{"label":"Tennessee","value":"TN"},{"label":"Texas","value":"TX"},{"label":"Utah","value":"UT"},{"label":"Vermont","value":"VT"},{"label":"Virginia","value":"VA"},{"label":"Washington","value":"WA"},{"label":"West Virginia","value":"WV"},{"label":"Wisconsin","value":"WI"},{"label":"Wyoming","value":"WY"}]},{"type":"text","required":true,"label":"Zip Code","name":"Zip-Code","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","subtype":"email","required":true,"label":"Email","name":"email","className":"col-md-6"},{"type":"text","subtype":"email","required":true,"label":"Email Confirmation","name":"email-confirmed","className":"col-md-6"},{"type":"radio-group","required":true,"label":"Marital Status - Pick One:","inline":true,"name":"Marital-Status","className":"d-block","values":[{"label":" Single","value":"single"},{"label":" Married","value":"married"},{"label":" Divorced","value":"divorced"},{"label":" Widowed","value":"widowed"}]},{"type":"file","label":"<div>If divorced, must attach Divorce Decree from Family Court.<br><br></div>Please select one or more files for upload. You may upload up to 20 files (35 Mb max). Files can be PDF, JPG, JPEG format. To upload multiple files, please hold control while clicking on multiple files before clicking \"Open\".","name":"If-divorced-must-attach-Divorce-Decree-from-Family-Court","subtype":"file","multiple":true,"className":"d-block"},{"type":"header","subtype":"h4","label":"Family Composition","className":"d-block"},{"type":"paragraph","subtype":"p","label":"List all the people who live with you in your unit.<br>Adding Household Members requires prior GHA and Landlord Approval","className":"d-block"},{"type":"text","required":true,"label":"Member 1: First Name","name":"Member-1-First-Name","className":"col-md-6","subtype":"text"},{"type":"text","required":true,"label":"Member 1: Last Name","name":"Member-1-Last-Name","className":"col-md-6","subtype":"text"},{"type":"radio-group","required":true,"label":"Member 1: Relationship to Head","inline":true,"name":"Member-1-Relationship-to-Head","className":"col-md-6","values":[{"label":"Child","value":"child"},{"label":"Spouse","value":"spouse"},{"label":"Co-Head","value":"Co-Head"},{"label":"Adult","value":"adult"}]},{"type":"radio-group","required":true,"label":"Member 1: Full-Time Student?","inline":true,"name":"Member-1-Full-Time-Student","className":"col-md-6","values":[{"label":"Yes","value":"yes"},{"label":"No","value":"no"}]},{"type":"radio-group","required":true,"label":"Member 1: Disabled?","inline":true,"name":"Member-1-Disabled","className":"col-md-6","values":[{"label":"Yes","value":"yes"},{"label":"No","value":"no"}]},{"type":"radio-group","required":true,"label":"Member 1: Sex?","inline":true,"name":"Member-1-Sex","className":"col-md-6","values":[{"label":"Male","value":"male"},{"label":"Female","value":"female"}]},{"type":"text","label":"Member 2: First Name","name":"Member-2-First-Name","className":"col-md-6","subtype":"text"},{"type":"text","label":"Member 2: Last Name","name":"Member-2-Last-Name","className":"col-md-6","subtype":"text"},{"type":"radio-group","label":"Member 2: Relationship to Head","inline":true,"name":"Member-2-Relationship-to-Head","className":"col-md-6","values":[{"label":"Child","value":"child"},{"label":"Spouse","value":"spouse"},{"label":"Co-Head","value":"Co-Head"},{"label":"Adult","value":"adult"}]},{"type":"radio-group","label":"Member 2: Full-Time Student?","inline":true,"name":"Member-2-Full-Time-Student","className":"col-md-6","values":[{"label":"Yes","value":"yes"},{"label":"No","value":"no"}]},{"type":"radio-group","label":"Member 2: Disabled?","inline":true,"name":"Member-2-Disabled","className":"col-md-6","values":[{"label":"Yes","value":"yes"},{"label":"No","value":"no"}]},{"type":"radio-group","label":"Member 2: Sex?","inline":true,"name":"Member-2-Sex","className":"col-md-6","values":[{"label":"Male","value":"male"},{"label":"Female","value":"female"}]},{"type":"text","label":"Member 3: First Name","name":"Member-3-First-Name","className":"col-md-6","subtype":"text"},{"type":"text","label":"Member 3: Last Name","name":"Member-3-Last-Name","className":"col-md-6","subtype":"text"},{"type":"radio-group","label":"Member 3: Relationship to Head","inline":true,"name":"Member-3-Relationship-to-Head","className":"col-md-6","values":[{"label":"Child","value":"child"},{"label":"Spouse","value":"spouse"},{"label":"Co-Head","value":"Co-Head"},{"label":"Adult","value":"adult"}]},{"type":"radio-group","label":"Member 3: Full-Time Student?","inline":true,"name":"Member-3-Full-Time-Student","className":"col-md-6","values":[{"label":"Yes","value":"yes"},{"label":"No","value":"no"}]},{"type":"radio-group","label":"Member 3: Disabled?","inline":true,"name":"Member-3-Disabled","className":"col-md-6","values":[{"label":"Yes","value":"yes"},{"label":"No","value":"no"}]},{"type":"radio-group","label":"Member 3: Sex?","inline":true,"name":"Member-3-Sex","className":"col-md-6","values":[{"label":"Male","value":"male"},{"label":"Female","value":"female"}]},{"type":"textarea","label":"List Additional Household Members Below:","placeholder":"4. First Name, Last Name, Relationship to Head, Full-Time Student, Disabled, Sex","name":"List-Additional-Household-Members-Below","subtype":"textarea","className":"d-block"},{"type":"header","subtype":"h4","label":"Income - Any and all monies coming into household for any household member(s) from any and all sources.","className":"d-block"},{"type":"radio-group","required":true,"label":"1. Income from Social Security / Social Security Disability Income / Death Benefits. <br>Do you or any family members receive income from either of the above sources?","inline":true,"name":"1-Income-from-Social-Security--Social-Security-Disability-Income--Death-Benefits--Do-you-or-any-family-members-receive-income-from-either-of-the-above-sources","className":"d-block","values":[{"label":" Yes","value":"yes"},{"label":" No","value":"no"}]},{"type":"paragraph","subtype":"p","label":"If yes, you are required to bring the Social Security Verification Letter for the current year.<br><br>You may request a letter from SSA by calling 1.800.772.1213. (TTY 1.800.325.0778) or at https://www.ssa.gov/onlineservices/.","className":"d-block"},{"type":"radio-group","required":true,"label":"2. Income from retirement/pension/workers compensation/payments in lieu of earnings/unemployment/veterans benefits/military pay.<br>Do you or any family member receive income from the above sources?","inline":true,"name":"2-Income-from-retirementpensionworkers-compensationpayments-in-lieu-of-earningsunemploymentveterans-benefitsmilitary-pay-Do-you-or-any-family-member-receive-income-from-the-above-sources","className":"d-block","values":[{"label":" Yes","value":"yes"},{"label":" No","value":"no"}]},{"type":"paragraph","subtype":"p","label":"If yes, please bring paper document stating name, address, amount received and how often that amount is received. ","className":"d-block"},{"type":"radio-group","required":true,"label":"3. Income from Employment (Job)<br>Do you or any member of your family receive income from employment (job)?","inline":true,"name":"3-Income-from-Employment-Job-Do-you-or-any-member-of-your-family-receive-income-from-employment-job","className":"d-block","values":[{"label":" Yes","value":"yes"},{"label":" No","value":"no"}]},{"type":"paragraph","subtype":"p","label":"If yes, complete the information requested below and bring three most current and consecutive pay stubs.","className":"d-block"},{"type":"text","label":"Family Member 1: Name","name":"Family-Member-1-Name","className":"col-md-6","subtype":"text"},{"type":"text","label":"Family Member 1: Employer","name":"Family-Member-1-Employer","className":"col-md-6","subtype":"text"},{"type":"text","label":"Family Member 2: Name","name":"Family-Member-2-Name","className":"col-md-6","subtype":"text"},{"type":"text","label":"Family Member 2: Employer","name":"Family-Member-2-Employer","className":"col-md-6","subtype":"text"},{"type":"textarea","label":"List Additional Family Member Names and Employers Below:","placeholder":"3. Family Member Name, Employer","name":"List-Additional-Family-Member-Names-and-Employers-Below","subtype":"textarea","className":"d-block"},{"type":"paragraph","subtype":"p","label":"Any family member 18 years or older that goes to school AND receives income from employment must ALSO bring in a student status statement from the school (high school or college) stating their name, address, and their student status.","className":"d-block"},{"type":"radio-group","required":true,"label":"4. A. Income from alimony/court ordered child support<br>Do you or any member of your family receive income from alimony/court ordered child support?","inline":true,"name":"4-A-Income-from-alimonycourt-ordered-child-support-Do-you-or-any-member-of-your-family-receive-income-from-alimonycourt-ordered-child-support","className":"d-block","values":[{"label":" Yes","value":"yes"},{"label":" No","value":"no"}]},{"type":"paragraph","subtype":"p","label":"If yes, complete the information requested below AND bring a 12-month payment history from the family court. ","className":"d-block"},{"type":"text","label":"Family Member Name:","name":"Family-Member-Name","className":"col-lg-4","subtype":"text"},{"type":"text","label":"Absent Parent Name and Phone Number","name":"Absent-Parent-Name-and-Phone-Number","className":"col-lg-4","subtype":"text"},{"type":"text","label":"Amount/How Often Received","name":"AmountHow-Often-Received","className":"col-lg-4","subtype":"text"},{"type":"textarea","label":"List Additional Information Below:","placeholder":"2. Family Member Name, Absent Parent Name and Phone Number, Amount/How Often Received","name":"List-Additional-Information-Below","subtype":"textarea","className":"d-block"},{"type":"radio-group","required":true,"label":"4. B. Voluntary Child Support or no Court Order for Child Support?","inline":true,"name":"4-B-Voluntary-Child-Support-or-no-Court-Order-for-Child-Support","className":"d-block","values":[{"label":" Yes","value":"yes"},{"label":" No","value":"no"}]},{"type":"paragraph","subtype":"p","label":"If yes, please bring a written statement with child's name, amount received and how often paid. You can create an online account with DSS and print the child support court order payments. ","className":"d-block"},{"type":"radio-group","required":true,"label":"5. Income from lottery winnings/insurance settlements annuities/IRA's<br>Do you or any member of your family receive income from any of the above sources?","inline":true,"name":"5-Income-from-lottery-winningsinsurance-settlements-annuitiesIRAs-Do-you-or-any-member-of-your-family-receive-income-from-any-of-the-above-sources","className":"d-block","values":[{"label":" Yes","value":"yes"},{"label":" No","value":"no"}]},{"type":"paragraph","subtype":"p","label":"If yes, please bring the supporting documentation stating name, address, amount received and how often payment is received.","className":"d-block"},{"type":"radio-group","required":true,"label":"6. Income from self-employment (Uber, Lyft, Uber Eats or any similar services)<br>Do you or any member of your family receive income from self-employment?","inline":true,"name":"6-Income-from-self-employment-Uber-Lyft-Uber-Eats-or-any-similar-services-Do-you-or-any-member-of-your-family-receive-income-from-self-employment","className":"d-block","values":[{"label":" Yes","value":"yes"},{"label":" No","value":"no"}]},{"type":"paragraph","subtype":"p","label":"If yes, please bring current tax returns.","className":"d-block"},{"type":"radio-group","required":true,"label":"7. Income from gifts/contributions and scholarships<br>Do you or any member of your family receive monies on a regular basis from the same source that are directly deposited into your account(s)? This ALSO includes but not limited to monies to payments for services.","inline":true,"name":"7-Income-from-giftscontributions-and-scholarships-Do-you-or-any-member-of-your-family-receive-monies-on-a-regular-basis-from-the-same-source-that-are-directly-deposited-into-your-accounts-This-ALSO-includes-but-not-limited-to-monies-to-payments-for-services","className":"d-block","values":[{"label":" Yes","value":"yes"},{"label":" No","value":"no"}]},{"type":"paragraph","subtype":"p","label":"If yes, please bring 30 day current statements or transaction history.","className":"d-block"},{"type":"radio-group","required":true,"label":"8. Income from Trusts or Inheritance<br>Does any family member receive regular income from a trust, inheritance or an estate?","inline":true,"name":"8-Income-from-Trusts-or-Inheritance-Does-any-family-member-receive-regular-income-from-a-trust-inheritance-or-an-estate","className":"d-block","values":[{"label":" Yes","value":"yes"},{"label":" No","value":"no"}]},{"type":"paragraph","subtype":"p","label":"If yes, please bring your most current statement showing income and proof of payment.","className":"d-block"},{"type":"radio-group","required":true,"label":"9. Income from TANF (Formerly known as Family Independence or FI Assistance)<br>Does any family member receive income from above agency?","inline":true,"name":"9-Income-from-TANF-Formerly-known-as-Family-Independence-or-FI-Assistance-Does-any-family-member-receive-income-from-above-agency","className":"d-block","values":[{"label":" Yes","value":"yes"},{"label":" No","value":"no"}]},{"type":"paragraph","subtype":"p","label":"If yes, please bring the case inquiry from DSS.<br><br>You may request DSS to mail you the case inquiry by calling 1.800.616.1309 or by visiting the local DSS office in Spartanburg or Greenville (No longer located in Greer).","className":"d-block"},{"type":"header","subtype":"h4","label":"Bank Accounts (Deposit Account)","className":"d-block"},{"type":"radio-group","required":true,"label":"Do you or any household member have a depository account?","inline":true,"name":"Do-you-or-any-household-member-have-a-depository-account","className":"d-block","values":[{"label":" Yes","value":"yes"},{"label":" No","value":"no"}]},{"type":"paragraph","subtype":"p","label":"A depository account is any place where you can deposit monies into.<br>Example: Bank, Apply Pay, Cash App, Zelle, Vimo Accounts and other similar accounts.","className":"d-block"},{"type":"radio-group","required":true,"label":"Does the account have a balance of $50,000 or more?","inline":true,"name":"Does-the-account-have-a-balance-of-50000-or-more","className":"d-block","values":[{"label":" Yes","value":"yes"},{"label":" No","value":"no"}]},{"type":"paragraph","subtype":"p","label":"If yes, you are required to bring 30 days current statement. If you do not receive statements, you will need to bring your 30-day current transaction history.","className":"d-block"},{"type":"header","subtype":"h4","label":"Expenses","className":"d-block"},{"type":"radio-group","required":true,"label":"1. Medical Expenses (for families with members 62 and older or disabled)<br>Are you or any household member at least 62 years old or disabled and pay out of pocket for medical expenses? This includes health insurance premium, co-pays, co-insurance, medical bills not covered by health insurance or prescription cost?","inline":true,"name":"1-Medical-Expenses-for-families-with-members-62-and-older-or-disabled-Are-you-or-any-household-member-at-least-62-years-old-or-disabled-and-pay-out-of-pocket-for-medical-expenses-This-includes-health-insurance-premium-co-pays-co-insurance-medical-bills-not-covered-by-health-insurance-or-prescription-cost","className":"d-block","values":[{"label":" Yes","value":"yes"},{"label":" No","value":"no"}]},{"type":"paragraph","subtype":"p","label":"If yes, please bring paper statement showing the amount deducted from your check and/or amount you pay each month to your medical insurance company.","className":"d-block"},{"type":"radio-group","required":true,"label":"Do you pay for prescription medication?","inline":true,"name":"Do-you-pay-for-prescription-medication","className":"d-block","values":[{"label":" Yes","value":"yes"},{"label":" No","value":"no"}]},{"type":"paragraph","subtype":"p","label":"If yes, please bring your 12-month printout from pharmacy showing the amount paid out of pocket.","className":"d-block"},{"type":"radio-group","required":true,"label":"Do you have outstanding medical bills on which you are paying?","inline":true,"name":"Do-you-have-outstanding-medical-bills-on-which-you-are-paying","className":"d-block","values":[{"label":" Yes","value":"yes"},{"label":" No","value":"no"}]},{"type":"paragraph","subtype":"p","label":"If yes, please bring the bill and the statements showing the amount of the payments being made.","className":"d-block"},{"type":"radio-group","required":true,"label":"2. Childcare expenses or care of a disabled family member<br>Do you have childcare expenses for a child(ren) under the age of 13 or expenses for care of a disabled family member in order for you to work, or in order for you to attend school?","inline":true,"name":"2-Childcare-expenses-or-care-of-a-disabled-family-member-Do-you-have-childcare-expenses-for-a-children-under-the-age-of-13-or-expenses-for-care-of-a-disabled-family-member-in-order-for-you-to-work-or-in-order-for-you-to-attend-school","className":"d-block","values":[{"label":" Yes","value":"yes"},{"label":" No","value":"no"}]},{"type":"paragraph","subtype":"p","label":"If yes, please bring a statement on the provider's letterhead with the child's (or children's) names, ages, hours and days care is provided with the amount paid.","className":"d-block"},{"type":"header","subtype":"h4","label":"Background Check","className":"d-block"},{"type":"checkbox-group","required":true,"label":"I/We do hereby understand and agree to a background check being run on all members of my household 18 years of older now and on an as-needed basis. The background check includes but is not limited to criminal, sex offender, address verification, job status, etc. by signing this form, I/we am giving Greer Housing Authority permission to run these checks as needed and retain any retain information needed.","inline":true,"name":"IWe-do-hereby-understand-and-agree-to-a-background-check-being-run-on-all-members-of-my-household-18-years-of-older-now-and-on-an-as-needed-basis-The-background-check-includes-but-is-not-limited-to-criminal-sex-offender-address-verification-job-status-etc-by-signing-this-form-Iwe-am-giving-Greer-Housing-Authority-permission-to-run-these-checks-as-needed-and-retain-any-retain-information-needed","className":"d-block","values":[{"label":"I/we understand.","value":"I/we understand."}]},{"type":"header","subtype":"h4","label":"Warning","className":"d-block"},{"type":"paragraph","subtype":"p","label":"WARNING Title 18, Section 1001 of the United States Code states that a person is GUILTY OF A FELONY FOR KNOWINGLY AND WILLINGLY MAKING FALSE OR FRAUDULENT STATEMENTS to any department or agency of the United States. MAKING FALSE STATEMENTS IS ALSO A FLEONY UNDER THE LAWS OF THE STATE OF SOUTH CAROLINA. I/We hereby certify under penalty of perjury that all the information contained in the certification is true and correct. I/We understand and acknowledge that making false statements on this certification is a crime under federal and South Carolina state laws, which may result in termination from the program and criminal prosecution.","className":"d-block"},{"type":"text","required":true,"label":"Signature of Head of Household","name":"Signature-of-Head-of-Household","className":"col-md-6","subtype":"text"},{"type":"date","required":true,"label":"Date of Head of Household","name":"Date-of-Head-of-Household","className":"col-md-6"},{"type":"text","label":"Signature of Spouse/Co-Head/Other Adult","name":"Signature-of-SpouseCo-HeadOther-Adult","className":"col-md-6","subtype":"text"},{"type":"date","label":"Date of Spouse/Co-Head/Other Adult Signature","name":"Date-of-SpouseCo-HeadOther-Adult-Signature","className":"col-md-6"},{"type":"text","label":"Signature of Other Adult","name":"Signature-of-Other-Adult","className":"col-md-6","subtype":"text"},{"type":"date","label":"Date of Signature of Other Adult","name":"Date-of-Signature-of-Other-Adult","className":"col-md-6"},{"type":"paragraph","subtype":"p","label":"<div>Privacy Advisory. Authority: The Department of Housing and Urban Development (HUD) is authorized to collect this information by the U.S. Housing Act of 1937 (42 U.S.C. 1437 et. seq.), Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d), and by the Fair Housing Act (42 U.S.C. 3601-19). Purpose: This form authorizes HUD and the above-named HA to request income information to verify your household’s income in order to ensure that you are eligible for assisted housing benefits and that these benefits are set at the correct level. Failure to provide any of the requested information may result in a delay or rejection of your eligibility approval.  </div><div><br></div><div>HRDE, Inc./Unity Housing, Inc./Unity Housing Apartments, LP, does not discriminate on the basis of handicapped/disability status in the admission or access to, or treatment or employment in, its federally assisted programs and activities.</div><div><br></div><div>The Housing Authority will provide reasonable accommodation upon request.</div>","className":"d-block"}]