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CDBG Program Household Income Self Certification Form Information on annual household income and race is required to determine eligibility for public services funded with federal Community Development.

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How to fill out the Cdbg Self Certification Form online

Filling out the Cdbg Self Certification Form is an essential step for individuals seeking eligibility for public services funded by federal Community Development Block Grant funds. This guide will provide clear, step-by-step instructions to help users complete the form efficiently and accurately online.

Follow the steps to complete your form accurately and efficiently.

  1. Click ‘Get Form’ button to obtain the form and open it in your editor.
  2. Begin by indicating the number of people in your household. Select the appropriate income range that corresponds to your household size.
  3. Calculate your total assets, including checking and savings account balances, tax-assessed values of real estate, cash value of life insurance policies, and any other assets. Enter this total in the specified field.
  4. Check one option under the ethnicity section.
  5. Check one option under the race section from the provided choices.
  6. Indicate whether your household has a female head of household by selecting 'Yes' or 'No'.
  7. Read the applicant statement carefully. Confirm that the information provided is accurate, and then sign with your printed name. If you are a parent or guardian signing for a participant under 18 years old, be sure to include your signature and the date.

Complete your Cdbg Self Certification Form online today to ensure timely access to resources.

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