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HUMPHRIES, VALERIE R.
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HUMPHRIES, VALERIE R.
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Last modified
4/17/2025 2:02:21 PM
Creation date
3/27/2025 9:50:08 AM
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Contracts
Company Name
HUMPHRIES, VALERIE R.
Contract #
a-2002-200
Agency
Community Development
Expiration Date
1/1/1999
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INCOME VERIFICATION <br />(for employed persons) <br />The undersigned employee has applied for a rental unit located in a project with <br />improvements financed by the City of Santa Ana for persons of low income. Please <br />indicate below the employee's current annual income from wages, overtime, bonuses, <br />commissions or any other form of compensation received on a regular basis. <br />Annual wages $ <br />Overtime $ <br />Bonuses $ <br />Commissions $ <br />Total current income $ <br />I hereby certify that the statements above are true and complete to the best of my <br />knowledge. <br />Date: <br />Signature: <br />Title: <br />I hereby grant you permission to disclose my income to in order <br />that they may determine my income eligibility for rental of an apartment located in their <br />project which has benefited from improvements financed by the City of Santa Ana. <br />Date: <br />Please send form to: <br />Exhibit t: 8 - of l I <br />
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