Verification of Non Employment

VERIFICATION OF NON EMPLOYMENT

(RD/HUD/LIHTC)

I, ______________________________, do hereby certify that I am not presently employed, nor am I expecting to work in the next twelve months. If I should become employed or begin to receive income, I will report it immediately to the manager (and sign a “Request for Verification of Employment” form to be completed by employer; if applicable) so that I may be recertified.

I realize that failure to report a change in employment status would be a direct violation of my Lease Agreement.

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Signature Date

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Social Security Number

Sworn to before me and subscribed in my presence this _____day of ________________, in the year_______.

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Signature of Notary Public

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Name of Notary Public

My commissions expires:____________________________________________

1/04