Skip To Content

COVID-19 Self Employment Certification Form

 

COVID-19 Self Employment Certification Form

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Attach supporting bank statements.
  • Under penalty of perjury, I certify that the information presented in this certification is true and accurate to the best of my knowledge. The undersigned further understand(s) that providing false representations herein constitutes an act of fraud. False, misleading or incomplete information may result in the termination of housing assistance.

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY

We don't support Internet Explorer

Please use Chrome, Safari, Firefox, or Edge to view this site.