Introduction

As required in Section 2-811, paragraph 4 of the ADU ordinance, the owner of a development containing rental affordable dwelling units must provide the FCRHA with a monthly report on the status of the rental ADU's (other than any units leased to the FCRHA).

Attached is a copy of the format to be used for this report as well as instructions explaining each of the categories of information needed. Owners may utilize the form attached or may generate a report from their tenant computer data base which follows the same format.

A sample cover letter and owner certification form transmitting the report to the Department of Housing and Community Development is shown below. It contains the certification required monthly of each owner.

Cover Letter and Owner Certification Form

To: Fairfax County Department of Housing and Community Development
Attn: Special Projects
3700 Pender Drive, Suite 300
Fairfax, Virginia 22030

Re: Property Name
Property Address

The Owner hereby certifies the following under oath:

The information contained in the attached Rental ADU Monthly Report is true, accurate and correct as of the date hereof. That to the best of the Owner's information and belief, the tenants who lease ADUs meet eligibility criteria established by the Fairfax County Redevelopment and Housing Authority.

In Witness Whereof, the undersigned has signed this Report as of _____________, _____.

Name of Ownership Entity:

By: ___________________________________________________
Authorized Representative

NOTE: The Rental ADU Monthly Report must be an attachment to the cover letter and owner certification form to fulfill all of the Owner certification requirements pursuant to the ADU Regulations. The Rental ADU Monthly Report must also include copies of new or revised Rental ADU Income Certification forms and Rental ADU Annual Occupancy Affidavits

RENTAL ADU MONTHLY REPORT INSTRUCTION GUIDE

The following instructions are provided to clarify how the Rental ADU Monthly Report is to be filled out on a column by column basis.

UNIT ADDRESS - Indicate the mailing street address with building and unit number.

BEDROOM SIZE - Use guidelines to determine the household size appropriate for various size units, (see Regulations Concerning the Sale and Rental of ADUs, Section 4, Procedures for Rental of ADUs, C.3, General Provision for Rental ADUs, for further details).

50% HUD MSA 1/3 - Place a check mark in this column to represent the applicable income limit of the tenant. Note: Either this column or the 70% HUD MSA 2/3 column must be checked. (See ADU Ordinance, Section 2-811, Administration of Rental ADU, Paragraph 1, for further details).

70% HUD MSA 2/3 - Place a check mark in this column to represent the applicable income limit of the tenant. Note: Either this column or the 50% HUD MSA 1/3 column must be checked. (See ADU Ordinance, Section 2-801, Purpose and Intent, for further details).

NAME OF FAMILY - Indicate last name first with initial of first name following in the column. If the signers of the lease have different last names they must be listed.

ADULT - Indicate total number of adults living in the unit. Definition of an adult is anyone 18 years of age and older.

DEPENDENT - Indicate total number of dependents living in the unit. Definition of a dependent is anyone 17 years of age and younger.

DATE OF LEASE - Indicate the start date of the initial lease by day, month and year.

EFFECTIVE DATE OF RECERTIFICATION - If applicable, indicate the date when recertification was effective by day, month, and year.

INITIAL & RECERTIFIED HOUSEHOLD INCOME - Indicate the total income calculation from the current ADU Income Certification Form in this column.

PROGRAM INCOME LIMIT - Indicate the current program income limit pertaining to the 50% HUD MSA or the 70% HUD MSA calculation adjusted by size, (see the most recent ADU Program Income Eligibility Limits, Section I, Maximum Income Limits, for further details).

CURRENT RENT - Indicate the current rent for the unit. Rent may not exceed the limit set for the applicable unit size in the most recent ADU Program Rental Income Limits. Note there are separate limits for the one-third of the units rented to households whose income does not exceed 50% of MSA median income and for the two-thirds of the units rented to households whose income does not exceed 70% of MSA median income.

MOVE-INS - Indicate any move-ins that have occurred within the monthly reporting period. Thereafter the tenant will be listed in the section titled "Existing" in the following month.

EXISTING - All tenants listed within the section titled "Existing" will continue to be indicated on the monthly report until their status changes. In the event of a transfer, the unit being vacated will be listed in the section titled "Move-outs" and the unit being transferred to will be listed in the section titled "Move-ins".

MOVE-OUTS - Indicate any move-outs that have occurred within the monthly reporting period. Thereafter, the move-out units will be listed in the section titled "Vacant" in the following month. A move-out will be listed at the point in time management takes legal possession of the unit. (Columns shaded between Adult and Current Rent do not need to be filled in.)

VACANT - Indicate all vacant ADU units for the monthly reporting period. Move-outs that have occurred within the reporting period prior to the last day of the month will be restated in the section titled "Vacant" if the unit will continue to be a designated ADU Rental unit. (Columns shaded between Name of Family and Current Rent do not need to be filled in.)