CITY OF NORTH LAS VEGAS NEIGHBORHOOD AND LEISURE SERVICES PROGRAM YEAR 17/18 CLIENT CERTIFICATION OF HOUSEHOLD SIZE AND INCOME LIMITS FORM

*The Program under which you are receiving assistance utilizes Housing and Urban Development (HUD) funds. In accordance with the federal regulations governing these funds, please supply the information requested below. This information is confidential and is only for use by the public agencies providing these funds.

Exhibit “C” DIRECT SERVICE INCOME ELIGIBILITY CRITERIA U.S. Department of Housing and Urban Development (HUD) 2017 Income Limits Clark County Median Family Income is $61,900 Annual Income Not to Exceed Extremely Low Low Income Moderate Family Size Income (30%)* (50%) Income (80%)

1 $13,200 $22,050 $35,250 2 $16,240 $25,200 $40,250 3 $20,420 $28,350 $45,300 4 $24,600 $31,450 $50,300 5 $28,780 $34,000 $54,350 6 $32,960 $36,500 $58,350 7 $37,140 $39,000 $62,400 8 $41,320 $41,500 $66,400

*Under ESG, for Homeless Prevention Activities beneficiaries must have income that is less than 30% of median income. Tenant-Based Rental Assistance Payment Standard Based on 2017 Fair Market Rents for Existing Housing U. S. Department of Housing and Urban Development (HUD)

UNIT SIZE *PAYMENT STANDARD Efficiency $630 1 - Bedroom $769 2 - Bedroom $954 3 - Bedroom $1,389 4 - Bedroom $1,6723

The Program Payment Standard includes rent payment and utility allowance. The maximum rent payment is calculated by deducting the utility allowance from the Program Payment Standard.

Reference: The U.S. Department of Housing and Urban Development, at https://www.huduser.gov/portal/datasets/il/il16/index.html

*Based on HUD median income guidelines of Fiscal Year 2017.

I hereby certify that my household size and income are as stated above. I consent to verification of this information by the organization, the City of North Las Vegas, Clark County, or HUD officials, as requested. * The FY 2014 Consolidated Appropriations Act changed the definition of extremely low-income to be the greater of 30/50ths (60 percent) of the Section 8 very low-income limit or the poverty guideline as established by the Department of Health and Human Services (HHS), provided that this amount is not greater than the Section 8 50% very low-income limit. Consequently, the extremely low income limits may equal the very low (50%) income limits.