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ANN ARBOR HOME ENERGY REBATESIncome Eligibility SelfAttestation Form Instructions Fill out all sections of the form accuratelyEnsure all sources of household income are declaration and date the form
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The household income self-certification form (Form 1 PDF) is a document used to declare an individual's or household's income for various purposes, such as eligibility for government assistance programs, housing applications, or financial aid.
Individuals or families applying for assistance programs, housing benefits, or financial aid that require proof of income are typically required to file the household income self-certification form.
To fill out the form, individuals need to provide accurate information regarding their income sources, including wages, benefits, and other earnings. They must also sign the form to certify that the information provided is true and accurate.
The purpose of the form is to collect necessary income information to determine eligibility for various assistance programs, ensure compliance with income-related requirements, and provide an accurate assessment of financial need.
The form requires reporting of total household income, details of income sources (such as employment, benefits, etc.), and personal information like name, address, and signature of the individual certifying the income.
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