Self-Employment Attestation
I, ___________________________________________, confirm that I have been
self-employed for _________ years as a ________________________________,
under the business name of __________________________________________.
The nature of my business is as follows:-
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
I operate my business out of the following address:
________________________________________________________
My gross income for _______ was $_________.
(Year)
My expected gross income for _______ will be $_________.
(Year)
Signed,
________________________________ ______________________
(Signature) (Date