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Self Verification of No Income

I, , hereby certify, under potential penalty of perjury, as of April 24, 2024 that I am not receiving any amount of steady income from any source whatsoever.

I also acknowledge that by signing this document I am aware that any false reporting of income will result in the immediate termination of Temporary Financial Assistance and may cause punitive legal action against me.

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April 27, 2020 9:34 am EDT

Self Verification of No Income Uploaded by Clinton Johnson - [email protected] IP 206.195.76.113

May 1, 2020 9:28 pm EDT

Front Desk - [email protected] added by Clinton Johnson - [email protected] as a CC'd Recipient Ip: 24.168.226.194