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EXHIBIT "B" <br />INCOME VERIFICATION FORM <br />List the Current Value of All Assets of <br />If the Asset generates income, <br />Assets ** <br />All Household Members Living <br />that income must be specified <br />in the Inclusionary Unit <br />In Part 2 above <br />Head of <br />Household <br />Other Adult <br />Household <br />Members <br />Total Value of <br />Value <br />Value <br />Assets <br />1. <br />Bank and Savings accounts <br />$ <br />$ <br />$ <br />2. <br />Stocks and bonds <br />$ <br />$ <br />$ <br />3. <br />Real property (i.e. rental property) <br />$ <br />$ <br />$ <br />4. <br />Other (describe) <br />$ <br />$ <br />$ <br />Total Asset Value $ <br />**Note: Necessary items, such as furniture and automobiles, used for personal use are excluded from <br />household assets. Collections of items for hobby, investment or business purposes must be included in <br />household assets. If the total value of household assets exceeds $5,000, the calculation of the household's <br />annual income shall include the greater of the actual amount of income, if any, derived from all of the <br />household assets; or 10% of the total value of the assets. <br />Income Verification Form Page 4 <br />Santa Ana, California <br />