Owner Household Income Information: Estimate the annual income of the household by projecting the total gross amount of income for all persons (related or not) living in the household at the time the assistance was requested. Estimated annual income shall include income from all sources of household members including social security and retirement. Income derived from the CDBG-assisted job shall not be considered in calculating estimated annual income.
The applicant is a Veteran under the following criteria: "Any former member of the armed forces who was discharged or released from duty under any conditions other than dishonorable, as well as active and former members of the Reserve, National Guard, and active duty military members preparing to transition to civilian life."
City of Austin Owner Disclaimer *
Evidenced by checking below, Owner certifies his or her annual household income. Owner certifies that the information herein provided is true and accurate. Owner further acknowledges that any inaccuracy and/or misrepresentation provided herein may constitute fraud, which is punishable by law. Owner certifies that all information herein and any attachments hereto, are true and correct as of the date set forth opposite signature. Owner acknowledges that Title 18, Section 1001 of the US Code states that any person that makes intentional or negligent statements to any department of the United States Government is guilty of a felony that could result in but not be limited to a fine, imprisonment, or both.
This activity is funded with federal Community Development Block Grant (CDBG) funds and is designed to primarily benefit low to moderate-income households (LMI) through the provision of assistance to micro-enterprises under 24 CFR 570.201(o). A micro-enterprise is a business that has no more than 5 employees, of which, one is the owner. The microenterprise business owner must also be an income eligible household in order to meet the federal micro-enterprise definition and participate in the program. Owner should not provide his/her signature unless he/she has read and understands the income information they are certifying under penalty of law. At the discretion of the program, Owner may be required to provide documentation to the Program to confirm the self-declaration of income.