Fillable Documentation of No Family Income (Choctaw Nation)

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Documentation of No Family Income (Choctaw Nation)

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The Documentation of No Family Income (Choctaw Nation) form is 1 page long and contains:

2 signatures
7 check-boxes
7 other fields

Country of origin: US
File type: PDF

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Documentation of No Family Income

I, __________________________________ being aware of the financial situation of ________________________________

(Full name of person providing information) (Parent/Guardian Name of Child Applying)

Do hereby attest that this family does not have any source of income known to me at this point and time.

In addition, I provide the following for the family due to their inadequate economic status:

 I do not provide any type of support, I just am aware of their financial situation.

 I provide room and board for this family

 I only provide housing for this family

 I provide financial support for this family in the amount of $ ______________

 daily

 weekly

 monthly

Printed name of person providing information: ________________________________________________________________

Mailing Address ________________________________________________________________________________________

Phone Number __________________________________ Date Signed __________________________________

Signature: ____________________________________________________________________________________________

I agree that the above information is correct.

Signature of Parent applying child: ________________________________________________________________________

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