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i <br /> EXHIBIT 2 <br /> TENANT INCOME VERIFICATION FORM <br /> Monthly Gross Income <br /> List All Sources of Income of All Household Members Living in the Incluslonary unit <br /> Part 1: Earned Income <br /> Other Adult <br /> i <br /> Head of Household <br /> Household Members Total <br /> 1. Gross amount, before payroll deductions of wages, $ $ $ <br /> salaries, overtime pay, commissions, fees, tips and <br /> bonuses. <br /> i <br /> a <br /> 2. Net income from business. $ $ $ <br /> i <br /> i <br /> 3. Social security, annuities, insurance policies, $ $ $ <br /> pensionlretirement funds, disability or death <br /> benefits received periodically. <br /> 4. Payment in lieu of earnings, such as $ $ $ <br /> unemployment, disability compensation, worker's j <br /> compensation and severance pay. � <br /> 5. Public assistance,welfare payments $ $ $ <br /> f <br /> B. Alimony, child support, other periodic allowances $ $ $ <br /> 7. Regular pay, special pay and allowances of $ $ $ i <br /> members of the Armed Forces <br /> l <br /> 8. Other $ $ $ <br /> Subtotal: Monthly Earned income $ <br /> Total Monthly Earned income x 12 = $ __ _ Total Annual Household Gross Earned Income <br /> i <br /> i <br /> i <br /> i <br /> i <br /> Tenant Income Verification Form Page 2 <br /> Santa Ana. California _ August A.2014 <br /> City Council 16 — 83 5/19/2026 <br /> i <br />