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0 <br />COMMUNITIES <br />Income Verification for UNEMPLOYED Persons <br />I have submitted an application to rent an <br />apartment at <br />Init I and complete if applicable <br />_ (a) I am not presently employed and do not anticipate becoming employed within the next twelve <br />months. <br />(b) I am not presently employed but anticipate becoming employed within the next twelve <br />months. <br />Based on my past work experience, skills, and income history as reflected in my income tax <br />return for the most recent tax year (COPY ATTACHED) and with adjustment to reflect <br />circumstances anticipated within the next twelve months, <br />I expect to earn <br />per year when I become employed. <br />(c) I am receiving Unemployment Compensation benefits in the amount of <br />(Benefits statement attached). <br />(d) I will be living off my savings of $ <br />(e) I will be receiving support from (source) <br />employment Is found (Statement attached). <br />in the amount Of $ every (Letter of support attached or statement). <br />(f) Declaration of No Income <br />I , do hereby certify that I do NOT <br />receive income from ANY source. I understand source of Income Includes, but is not <br />limited to the following; <br />Employment <br />Unemployment <br />Compensation <br />Workers Compensation <br />Study <br />Self Employment <br />AFDC <br />SSI <br />Retirement Funds <br />Alimony <br />Income from Assets <br />Penslons <br />General Assistance <br />Dlsabllity <br />Union Benefits <br />Family Support <br />Annuities <br />I certify that the foregoing information is true, complete and correct to the best of my knowledge. <br />Inquiries may be made to verify statements herein. I also understand that false statements or omissions <br />are grounds for disqualification. <br />Applicant/Resident's Signature Date <br />12 -10 <br />