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AFFIDAVIT <br />This Affidavit is made with the knowledge that it will be relied upon by the City of <br />Santa Ana, our landlord and the owner of our apartment building, to determine maximum income for <br />eligibility. (1/we) warrant that all information set forth in this document is true, correct and complete <br />and based upon information (1/we) deem reliable and based upon such investigation as (1/we) deemed <br />necessary. <br />(I/We) acknowledge that (1/we) have been advised that the making of any misrepresentation or <br />misstatement in this affidavit will constitute a material breach of (my/our) rental agreement with the <br />property owner to rent the unit and will additionally enable the property owner to initiate and pursue <br />all applicable legal and equitable remedies with respect to the unit and to me/us, <br />(I/We) do hereby swear under penalty of perjury that the foregoing statements are true and correct <br />and that this affidavit has been executed as of the date specified below by each adult member of the <br />household which intends to occupy an Inclusionary Unit located at <br />Ana, California. <br />Signature <br />Printed Name <br />Executed at <br />Date <br />Santa Ana, California <br />Signature Date <br />Printed Name <br />Executed at , Santa Ana, California <br />,Santa <br />Tenant Income Verification Form Page 1 <br />Administrative Procedures Manual: Rental Housing Development April 27, 2023 <br />