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S <br />10. The total anticipated income, calculated in accordance with the provisions of this Certification including <br />assets, of all persons over the age of 18 years listed above for the 12-month period beginning the date that <br />I/we plan to move into a unit is $ <br />11. This certificate is made with the knowledge that it will be relied upon by the Developer to determine <br />maximum income for eligibility to purchase the unit, and I/we declare that all information set forth herein is <br />true, correct and complete and based upon information I/we deem reliable and that the statement of total <br />anticipated income contained in section 10 is reasonable and based upon such investigation as the <br />undersigned deemed necessary. <br />12. I/we will assist the Developer in obtaining any information or documents required to verify the <br />statements made herein, including either an income verification from my/our present employer(s) or copies <br />of federal tax returns for the immediately preceding calendar year. <br />13. I/we acknowledge that I/we have been advised that the making of any misrepresentation or <br />misstatement in this declaration will constitute a material breach of my/our agreement with the Developer <br />to purchase the unit. <br />14. Housing Statistical Information (Optional -will be used for reporting purposes only) <br />Race (Head of Household) <br />White 81ack Asian <br />Hispanic Native American Other <br />Physical Disability <br />Yes No <br />Signature of all persons over the age of 18 years listed in number 2 above required <br />I/we declare under penalty of perjury that the foregoing is true and correct. <br />Executed this day of in the County of ,California. <br />Applicant <br />Applicant <br />Applicant <br />Applicant <br />