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John R. Kasich, Governor David Goodman, Director ENERGY ASSISTANCE PROGRAM – ZERO INCOME SELF-DECLARATION FORM Please complete and sign this form if you have ...
Mobile Housing Board Housing Choice Voucher Program Zero Income Statement ... Ø Complete and sign a Zero Income Certification Form
Certification of Zero Income (March 2009) CERTIFICATION OF ZERO INCOME (To be completed by . adult. household members who are claiming zero income from any source, if ...
ZERO INCOME STATEMENT Date Last/First Name Date of Birth 1. I am signing this letter to declare that I currently do not have any income from any
south shore community action council, inc. 71 obery street plymouth, ma 02360 fy2017 low income home energy assistance program (liheap) no income (zero income) statement
a statement on the amount ... The person signing below declares that the information provided on this form is correct and complete ... CERTIFICATION OF ZERO INCOME
Contact your local participating agency for the recertification form if you do not receive one. ... Zero Income Statement for other member of household (Not Notarized)
STATEMENT OF NO EMPLOYMENT INCOME. ... Debtor was not employed and had no income from an employer within ... FLNB Local Form 16 (Rev. 07/11) DIVISION
DEFICIT STATEMENT (ZERO INCOME) ... through documentary evidence in the form of a to be the person whose name is signed to the preceding document, ...
this form may disqualify me from participation in the HOPWA program, and may be grounds for termination of assistance. ... Zero Income Affadavit Keywords: