Asset Self-Certification Worksheet
This worksheet accompanies the Asset Self-Certification to be completed by property management. When total net family assets are less than or equal to the applicable Imputed Income Limitation, only the actual income as disclosed on the Asset Self-Certification is included on the Tenant Income Certification.
Household Name:      
Unit #:      
Determine Household Net Assets
Table 1: Determine Household Assets
Line	Item	Value	
1.	Enter the value of any Non-Necessary Personal Property disposed of for less than fair market value from Part I of the Asset Self-Certification.	$	     	
2.	Enter the total of all Non-Necessary Personal Property by adding all values in (A) Cash Value from Part III of the Asset Self-Certification.	$	     	
3.	Enter the total of all Real Property by adding the values in (C) Cash Value from Part IV of the Asset Self-Certification.	$	     	
4.	Add lines 1 through 3.	$	     	
5.	Enter the amount of a federal tax return or refundable federal tax credit in the last 12 months from Part II of the Asset Self-Certification.	$	     	
6.	Subtract line 5 from line 4.	$	     	
7.	Is the value in line 6 less than or equal to the current asset self-certification amount of $     ? (Yes/No)	     	
If the value of line 7 is yes, then proceed to Determine Income from Assets.
If the value of line 7 is no, the Asset Self Certification cannot be used.
Determine Income from Assets
Table 2: Determine Income from Assets
Line	Item	Value	
8.	Enter the total of all values in (B) Annual Income from Part III of the Asset Self-Certification.	$	     	
9.	Enter the total of all values in (D) Annual Income from Part IV of the Asset Self-Certification.	$	     	
10.	Add lines 8 and 9.	$	     	
Enter the value of line 10 to Part IV-A of the Tenant Income Certification.