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TBRA LANDLORD AGREEMENT TO PARTICIPATE (Completed by PHA and Landlord) DATE : NAME of PHA : I. Landlord Information Name : Social Security # or Tax ID # Mailing Address : Telephone Number: E-Mail Address : II. Rental Unit Information Address : # of Bedrooms: Monthly FHFC Rent : Monthly Tenant Rent: Move In Date : Security Deposit Paid by PHA : Prorated First Months Rent Paid by PHA : III. Method of Payment Direct Deposit (attach authorization) Mail Check (delivery date of the check is beyond the control of FHFC) IV. Landlord Certification I hereby certify that I have read and agree to participate in and comply with the Florida Housing Finance Corporation Tenant Based Rental Assistance Program. I further certify that I agree to the following: 1 . I must attach a fully executed copy of the HOME Lease Addendum to the Lease of each Tenant participating in this program . 2 . (Grantee) will make rental assistance payments to me for a period of twelve months from the date of initial occupancy provided the tenant remains in the unit and the unit meets HUD Housing Quality Standards (HQS). I agree to notify the Grantee within ten days if the tenant moves out. I understand that if a tenant moves out before the end of the lease term, the Grantee will only pay rent through the remainder of the month in which the tenant moves. I further agree to hold harmless the Grantee for any breach of the lease, including but not limited to, tenant's failure to make monthly rental payments . 3 . I am obligated to repay any amounts that I receive to which I am not entitled without demand from the Grantee. Further, I agree to make no false claims for rental assistance payments . Date : Signature of Landlord Attachments : Copy of Lease and signed HOME Lease Addendum, Direct Deposit Form Florida Housing Finance Corporation Page 1 Attachment A, Exhibit 3 (Rev. 09/06)