• Springfield Metro Income Verification

    For business owners residing in Agawam, Amherst, Belchertown, Brimfield, Chicopee, Easthampton, East Longmeadow, Granby, Hadley, Hampden, Holland, Holyoke, Longmeadow, Ludlow, Monson, Northampton, Palmer, Pelham, South Hadley, Springfield, Wales, Ware, Westfield, West Springfield, Wilbraham
  • Community Development Block Grant Program (CDBG)

    Small Business Assistance Microenterprise Verification Form

  • Please be assured that this information will remain confidential and will be used only to meet the record keeping requirements of the U.S. Department of Housing and Urban Development, which is providing the CDBG funds. As soon as you have completed the information listed below, please return it to the Quaboag Valley Community Development Corporation, 23 West Main St, Ware, MA 01082, Melissa @qvcdc.org. Thank you for your cooperation.

  • We will ask you to provide documentation of your income via your latest tax return or quarterly tax.

  • Please provide your adjusted gross income from your most recent tax return (On your 1040: line 8b on 2019 or line 7 on 2018 Year) field. Year of return: If you are reporting income from a tax return that is more than a year old, we may request additional information.

  • I hereby certify that the information contained on this form is accurate and complete to the best of my knowledge, under penalty of law and verifiable by federal government representatives. field.

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