Self Certifcation Income Form
We are required to verify income information and income changes for ALL residents in Public Housing / HCV Program. However, during this COVID-19 / Coronavirus pandemic, we are able to provide TEMPORARY self-certification.
All adult household members must certify their change of income during this crisis.
However, this is TEMPORARY, and must also RE-CERTIFY in the normal manner once the crisis has passed, and business returns to normal.
WARNING: The information provided on this form is subject to verification by HUD at any time, and Title 18, Section 1001 of the U.S. Code states that a person is guilty of a felony and assistance can be terminated for knowingly and willingly making a false or fraudulent statement to a department of the United States Government.