Income Verification Forms

We want to make our programs as accessible as possible, yet still obtain the required documentation some of our funders require. We have created an online self-declaration for those who have no income or are missing required documentation. This page will provide you with common questions and answers on the form. You can fill it out, sign it from your phone, and hit submit.

Q: What if a household member who is 18 or older does not have any income?  

A: On the application, it will ask if household members age 18 and older have the income me to report, if the answer is checked “no,” they will be required to complete a self-declaration of zero income, explaining how they are getting by, and an electronic signature is required.

Q: How often does my income have to be verified? 

A: For ongoing CSBG clients with no income, this self-declaration form must be dated within one month from the date of application and monthly after that if there is no change in the client’s income.  

Q: What if I am missing required documentation? 

A: If you are missing required documentation due to a natural disaster, stranded, COVID-19, fleeing an abusive household you can complete the self-declaration.

If you are missing paystubs your employer can complete the employer income verification at the bottom of the page.

Self Declaration Form

Employer Income Verification Form

If you are employed but do not have paystubs your employer can complete this form for your proof of employment income. When the verification is obtained from an employer, complete information concerning the amount and source must be documented. In addition to recording the income amount and the source, documentation must include the name and title of the person who gave the verification.

90 Day Income Verification Update

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