3-Section 3 and Targeted Section 3 Worker Self-Certification Form.pdf

Wilmington Housing Authority

Section 3 Worker and Targeted Section 3 Worker Self-Certification

The purpose of HUD’s Section 3 program is to provide employment, training, and contracting opportunities to low-income individuals, particularly those who are recipients of government assistance for housing or other public assistance programs. Your response is voluntary, confidential, and has no effect on your employment.

ELIGIBILITY FOR SECTION 3 WORKER OR TARGETED SECTION 3 WORKER STATUS

A Section 3 worker seeking certification shall self-certify and submit this form to the recipient contractor or subcontractor, that the person is a Section 3 worker or Targeted Section 3 Worker as defined in 24 CFR Part 75.

Instructions: Enter/select the appropriate information to confirm your Section 3 worker or Targeted Section 3 Worker status.

Employee Name:

1. Are you a resident of public housing or a Housing Choice ☐ YES ☐ NO Voucher Holder (Section 8)?

2. Are you a resident of the City of Wilmington ☐ YES ☐ NO

3. In the field below, select the amount of individual income you believe you earn on an annual basis. *The grantee should confirm that their state and local laws do not prohibit this question.

☐ Less than $10,000 ☐ $30,001 - $40,000 ☐ More than $60,000 ☐ $10,001 - $20,000 ☐ $40,001 - $50,000 ☐ $20,001 - $30,000 ☐ $50,001 - $60,000

Select from ONE of the following two options below:

I qualify as a:

☐ Section 3 Worker (as defined on page 3 of Section 3 Worker Certification Form)

☐ Targeted Section 3 Worker (as defined on page 3 of Section 3 Worker Certification Form)

Employee Affirmation

I affirm that the above statements (on frontside of this form) are true, complete, and correct to the best of my knowledge and belief. I hereby certify, under penalty of law, that the following information is correct to the best of my knowledge.

Employee Address:

Print Name: Date Hired:

Signature: Date:

FOR ADMINISTRATIVE USE ONLY

Is the employee a Section 3 worker based upon their self-certification? □YES □NO

Is the employee a Targeted Section 3 worker based upon their self-certification? □YES □NO

Was this an applicant who was hired as a result of the Section 3 project? □YES □NO

If Yes, what is the name of the company? _ ______________________

What was the date of hire? _ ________________

EMPLOYERS MUST RETAIN THIS FORM IN THEIR SECTION 3 COMPLIANCE FILE

FOR FIVE YEARS.

The Wilmington Housing Authority

Section 3 Income Limits

Eligibility Guidelines

The worker’s income must be at or below the amount provided below for an individual (household of 1) regardless of actual household size.

Individual Income Limits for City of Wilmington

FY 2022

Income Limits Category

FY 2022

Income Limits

Extremely Low-Income Limits (30%)

$22,150

Very Low-Income Limits (50%)

$36,900

Low Income Limits (80%)

$59,050

See https://www.huduser.gov/portal/datasets/il.html for most recent income limits.

Section 3 Worker Definition:

• A low or very low-income resident (the worker’s income for the previous or annualized calendar year is below the income limit established by HUD); or

• Employed by a Section 3 business concern; or

• A YouthBuild participant.

Targeted Section 3 Worker Definition (for public housing or Section 8)

• Employed by a Section 3 business concern or

• Currently meets or when hired met at least one of the following categories as documented within the past five years:

• A resident of public housing; or

• A resident of other public housing projects or Section 8-assisted housing; or

• A YouthBuild participant.

Targeted Section 3 Worker Definition (for housing and community development)

• Employed by a Section 3 business concern or

• Currently meets or when hired met at least one of the following categories as documented within the past five years:

• Living within the service area or the neighborhood of the project, as defined in 24 CFR 75.5

• A YouthBuild participant.