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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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EXHIBIT I: Income Certification Form <br />For Cornerstone Villa e, City Of Santa Ana <br />Apartment Address <br />Apartment # <br />Date <br />MEMBERS OF HOUSEHOLD <br />Head of Household (Select one of <br />tenants if multiple tenants) (1) <br />Date of <br />Birth <br />Relationship to. <br />`tenant #1 (1) <br />Social Security # <br />(If available) <br />income .(2) <br />(Indlcate WKIMONR) <br />:Source- Income <br />Verification (3) <br />1. <br />SAME' <br />Names of All other Occupants in <br />Household (Include all children)) <br />2. <br />3. <br />4. <br />5. <br />Maximum for 1 bedroom apartment} <br />6. <br />7. <br />(Maximum for 2 bedroom apartment) <br />Only tenants in residence before 112000 <br />Income Qualification Summary for City of Santa Ana <br />Household Size (Total number of persons living in apartment) <br />Monthly Rent: <br />Maximum Rent Allowed <br />(Maximum rent from Chart provided by Association based on family size <br />Number of Bedrooms in Apartment (Circle One) <br />ONE TWO THREE <br />Household Income (Total income of all persons living in apartment) <br />(Sum of Incomes listed above. All income of all occupants must be included. See OPA Exhibit H for instructions on how to calculate.) <br />Maximum Housing Income for Household Size <br />(Use 80% of Medium Household Income for Household Size from most recent Chart provided to Association by City of Santa Ana) <br />Exbibit 1: 1 of 11 <br />
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