• Tools and Templates

CDBG Self-Certification of Annual Income Form


Date Published: October 2015


A verifiable self-certification is where the beneficiary states and signs-off on their income at the time of assistance.  In some cases, such as the national objective of limited clientele, community development grantees may choose to use a verifiable self-certification to document the annual income of beneficiaries for the community development block grant program (CDBG) program.  This form can be completed and included in beneficiary files.  Please note that using a self-certification approach to income documentation can put the activity at possible risk if a beneficiary is later audited and determined to be over the applicable income limit.

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Tags: CDBG Colonias CDBG Entitlement CDBG HUD Administered CDBG Insular Areas CDBG State
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