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9 <br /> Supplement Program applicants must present evidence of disabling condition <br /> diagnosis with one or more of the following conditions: substance use disorder, <br /> serious mental illness, developmental disability as defined by the Department of <br /> Housing and Urban Development (HUD). <br /> A disabling condition is defined by HUD as: <br /> 1. A physical, mental, or emotional impairment which is expected to be of <br /> long-continued and indefinite duration, substantially impedes an <br /> individual's ability to live independently, and of such a nature that the <br /> disability could be improved by more suitable conditions; <br /> 2. A developmental disability as defined in section 102 of the <br /> Developmental Disabilities Assistance and Bill of Rights Act; <br /> 3. The disease of acquired immunodeficiency syndrome or any conditions <br /> arising from the etiological agency for acquired immunodeficiency <br /> syndrome; or <br /> 4. A diagnosable substance abuse disorder. <br /> Evidence of this criterion must include one of the following: <br /> a. Written verification of the condition from a professional licensed by <br /> the state to diagnose and treat the condition; <br /> b. Written verification from the Social Security Administration; <br /> c. Copies of a disability check (e.g., Social Security Disability Insurance <br /> check or Veterans Disability Compensation); <br /> d. Intake staff (or referral staff) observation that is confirmed by written <br /> verification of the condition from a professional licensed by the state <br /> to diagnose and treat the condition that is confirmed no later than <br /> fourteen (14) days of the application for assistance and accompanied <br /> with one of the types of evidence above; or other documentation <br /> approved by HUD. <br /> Victim of Domestic Violence <br /> The Local Rent Supplement Program applicants, who qualify under the definition <br /> of Victim of Domestic Violence, must provide the following documentation at the <br /> time of application to establish that they meet the required criteria: <br /> 1. The individual may satisfy the PHA's request by providing any one of the <br /> following three forms of documentation [24 CFR 5.2007(b)]: <br /> a. A completed and signed HUD-approved certification form (HUD- <br /> 50066, Certification of Domestic Violence, Dating Violence, <br /> Sexual Assault, or Stalking),which must include the name of the <br /> perpetrator only if the name of the perpetrator is safe to provide <br /> and is known to the victim; <br /> b. A federal, state,tribal,territorial, or local police report, or court <br /> record, or an administrative record; or <br /> c. Documentation signed by a person who has assisted the victim in <br />