Verification of Eligibility

(a) Any applicant seeking eligibility based on financial need pursuant to section 17b-802-2(a)(2) of the Regulations of Connecticut State Agencies shall verify his or her household's income in a manner that is acceptable to the department. Forms of verification include, but are not limited to: (1) Current wage stubs; (2) Federal or state income tax filing forms; (3) A department form W-35 for disclosure of gross wages, salary or commission paid; (4) A copy of a Social Security check or any other benefit check; (5) A statement from an employer or other sources of documentation which clearly establish gross income; or (6) An IRS Form W-2 or W-2p. (b) The applicant shall provide the following documentation as it is relevant to the applicant: (1) Evidence that the applicant holds a federal Section 8 housing choice voucher or holds a certificate from the Rental Assistance Program, the Transitionary Rental Assistance Program or any other rental assistance program operated by the department, in conformance with section 17b-802-2 of the Regulations of Connecticut State Agencies; (2) Documentation or other evidence that the applicant is staying at an emergency shelter, which may include verbal or written verification from an appropriate official of an emergency shelter; (3) Documentation that the applicant occupies emergency housing; or (4) Documentation of the reason why the applicant cannot remain in permanent housing. Such documentation may include, but is not limited to: (A) Notice to quit and any other summary process paperwork addressed either to the applicant or the primary tenant with whom he or she lives. A copy of a judgment entered against the applicant in a summary process action instituted pursuant to chapter 846 of the Connecticut General Statutes; (B) Confirmation of domestic violence, which may include a sworn statement by the victim or any evidence of such violence available to the applicant, which may include: police, government agency or court records; documentation from a shelter worker, legal, medical, clerical or other professionals from whom the applicant has sought assistance in dealing with domestic violence; or a statement from an individual with knowledge of the circumstances which provide the basis for the claim of domestic violence. For purposes of this section, allegations of domestic violence by a victim may be sufficient to establish domestic violence where the department has no independent reasonable basis to find the applicant not credible; (C) Confirmation, whether verbal or written, from appropriate authorities such as state officials, police, fire or local code enforcement officials regarding a catastrophic event; (D) Evidence that the applicant was issued a federal Section 8 housing choice voucher or a certificate from the Rental Assistance Program, the Transitionary Rental Assistance Program or any other rental assistance program operated by the department when the applicant resided in a unit assisted under any of the aforementioned rental assistance programs, and that unit failed a housing quality standards inspection when that failure was the responsibility of the owner and the owner refused to correct the conditions causing the failure; (E) A sworn statement by the applicant that the primary tenant with whom he or she resides engages in criminal activity; (F) A sworn statement by the applicant that he or she has been illegally locked out of his or her dwelling unit; or (G) Evidence that a child in the applicant's family resides with the applicant and has a level of lead in the blood equal to or greater than twenty micrograms per deciliter of blood or any other abnormal body of lead and the local director of health has determined, after an epidemiological investigation pursuant to section 19a-111 of the Connecticut General Statutes, that the source of the lead poisoning was the dwelling unit in which the child resided with the applicant.