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Annual Recertification: Housing Choice Voucher Program

Each year as a participant in the Housing Choice Voucher program you are required to submit documentation to recertify your eligibility for receipt of program benefits.  You will receive notification from Loudoun County Department of Family Services that will inform you when these forms are due.  In the following sections, you will be guided through the process of recertification and provided with links to the documents that you must either sign or initial before submitting for review.  Linked forms are highlighted and underscored

Please be sure to read all instructions carefully and complete all
3 STEPS before submitting any documents.

Click here to print these instructions.

Steps for Annual Recertification

Step 1:
Complete the
Personal Declaration and Affidavit Form.  Once completed, click the "certify" button found at the bottom of the page.  Each member of the household, age 18 or older, must then enter their initials, their preferred language and the last four (4) digits of their social security number.  After completion,click "done with certifications."

Step 2: 
Information provided in your Personal Declaration and Affidavit may require additional documentation to support your claims.  Please review the list below, noting the page and section numbers to determine what documentation you will need. If you answer “Yes” to any question, please provide the name of the household member for which the information applies. 
  • Page 4, Section II A. Household Income- If you answered "yes" to income obtained through social security, pension, unemployment or disability, please enclose a copy of the most recent statement showing the amount of your benefit.    
  • Page 5, Section II B. Employment- Please provide (2) months-worth of the most recent
    paystubs showing wages earned from employment for each household member earning income. If self-employed, please submit a copy of the previous income tax return filed. 
  • Page 5, Section II C. Public Assistance Benefits- Please provide the most    
    recent statement showing receipt of public assistance benefits received for each household member. Examples: TANF, VIEW, etc. 
  • Page 5, Section II D. Child Support- Please provide the most recent statement showing funds received through child support payments for each household member. 
  • Page 5, Section II D. Alimony - Please provide the most recent statement showing funds received through alimony payments for each household member.  
  • Page 6, Section III A. Account Information- For each type of financial account, please submit a copy of your most recent monthly statement. For life insurance policies, please provide a statement showing the policy's cash value.
  • Page 7, Section V A. Child Care Expenses- For each child or disabled family member for whose care you are financially responsible, please provide verification of care. Verification of child care
  • Page 7, Section V B. Medical Expenses - If the Head of Household or Spouse is 62years of age or older and/or disabled, please provide copies of medical bills including the cost of health insurance premiums. 

Step 3: 
Please note that some forms require the signature and/or initials of each household member, age 18 and older.  Please read each form carefully to determine if they contain any special instructions.

Forms that MUST be completed, signed, and returned to your housing counselor.

1. Affidavit of Understanding:  Print form.  The head of household must print their full name, sign and date.  This form should only be completed by the head of household.

2. HUD-9886:  Print form.  The head of household must sign, date and enter their social security number.  Each household member, age 18 or older, must also sign this form.

3. Loudoun County Release of Information FormPrint one form for each member of the household, ages 18 or older. Enter the name of the person signing, initial the boxes indicating the agencies from which you receive services, sign and date the form. 

4. Family Obligations Form: Print form.  Head of Household must sign, date, initial the language of preference and the acknowledgement that you have read and understood the Family Obligations Form.  Each household member, ages 18 or older, must also sign the form.

Forms to be read and initialed

Please print each form listed below.  The head of household must initial each form indicating it has been read and understood.  Send these forms back to your housing counselor.

1.  Denial for Alcohol Abuse or Crime by Family Members 
2.  Grounds of Denial of Assistance

Step 4:
Once all forms are printed, signed and/or initialed, please email them to your assigned Housing Counselor (see list below):

Housing Counselor:
  • Meg Asaro:  email
  • Ursula Brinkley: email
  • Christine Hillock:  email    
  • Tandi Hoffmann: email
  • Yasmina Turner: email
  • Cyndy Wyrick: email    
  • HCV Division Manager Antwaun Jackson: email

You can also mail them to:

Loudoun County Department of Family Services
Att: (Your Counselor's Name)
Loudoun County Department of Family Services
102 Heritage Way
Suite 103
P.O. Box 7400
Leesburg VA 20177-7400

When all household members have certified the Personal Declaration form, and you have successfully submitted all required documents your paperwork will be processed. 

Should you receive a message requiring additional information, you will have 10 business days to submit the requested information.

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