Mr./Mrs. Tenant Name has applied for residency at Street Address Address Line 2 City State ZipAs part of our processing, we must obtain an affidavit from you, the designated live-in care attendant. Please complete the section below and return it in the enclosed self-addressed envelope. Thank you for your cooperation and prompt response.
pI, First Name Last Name , hereby certify that: I am the live-in care attendant of the above-named applicant/tenant. I am not responsible for the financial support of said applicant/tenant. Applicant/tenant is not responsible for my financial support. I would not otherwise be living in the unit except to provide the necessary support and care to allow said applicant/tenant to live independently. I understand that I have no survivorship rights to the apartment and that if said aplicant/tenant moves out for any reason, I must immediately vacate the apartment as well. I understand the unit is governed by the requirements of the LIHTC Program and that occupants of such unit must meet all eligibility requirements of the Program. I understand that I have not been certified as such and that my only reason for living in the unit is to provide supportive care to said applicant/tenant.
I certify that the above information is true and correct.
WARNING: Sectionl00l ofTitle 18 U.S. Code makes it a criminal offense to willfully falsify a material fact or make a false statement in any matter within the jurisdiction of a federal agency.