FULL AGENDA PACKET_2021-07-20 - Laserfiche WebLink

Home Browse Search

EXHIBIT 2 TENANT INFORMATION FORM Part 3: Income Information Did you file a Federal Income Tax Return last year? ` Yes ` No Does anyone living outside your household pay for or provide money for any of your household bills or yes ` No living expenses? Review and update the following income information for all family members 18 or older, including income received on behalf of household members under the age of 18. Check "Fixed" for income that changes annually based on a COLA or Interest Rate. Add new income sources in the space provided below. An income is any one of the following types without limitation: Alimony Payments Food Stamps Self Employment Wages/Salaries Child Support Military Pay Social Security Benefits Welfare Benefits Disability Benefits Periodic Gifts SSI Worker's Compensation Financial assistance to attend school Retirement Payments Unemployment Benefits DOCUMENTATION REQUIRED: Provide 4 current and consecutive original pay stubs, payroll summary reports, SSA benefit verification letters, child support payment stubs, welfare benefit letters and/or printouts, self employment tax statements, or unemployment benefit notices, and check the Documentation Attached box for each income. Member Name Income Type Fixed Monthly Income Current Income Documentation Attached ❑ $ L] Yes No Yes No Verification Source Name and Address Member Name Income Type Fixed Monthly Income Current Income Documentation Attached ❑ $ I� yes i-1 No Yes No Verification Source Name and Address Member Name Income Type Fixed Monthly Income Current Income Documentation Attached ❑ $ L:]Ves L] No Yes No Verification Source Name and Address Member Name Income Type Fixed Monthly Income Current Income Documentation Attached $ u Yes L-1 No Yes No Verification Source Name and Address Member Name Income Type Fixed Monthly Income Current Income Documentation Attached $ D Yes L No Yes Na Verification Source Name and Address Member Name Income Type Fixed Monthly Income Current Income Documentation Attached $ u Yes L-1 No Yes Na Verification Source Name and Address Member Name Income Type Fixed Monthly Income Current Income Documentation Attached $ L] Yes No Yes No Verification Source Name and Address Member Name Income Type Fixed Monthly Income Current Income Documentation Attached $ —]Yes I-1 No Yes No Verification Source Name and Address Attach Additional Sheets If Necessary City Council 31 — 17 7/20/1 Page 10 of 29