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    Affidavit Marital Separation Status

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    imclaimingmydream
    This document is an affidavit of marital separation status. It requires the applicant to choose one of three statements regarding their marital status: 1) they are legally separated and must provide separation documents, 2) they are separated but not legally and have begun legal proceedings and anticipate the separation being permanent, or 3) they are separated but not legally and have not begun legal proceedings, providing a reason. The applicant must then state if they do or do not anticipate receiving compensation from their spouse in the next 12 months. The applicant signs to certify the information is accurate under penalty of perjury.

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    Affidavit Marital Separation Status

    Uploaded by

    imclaimingmydream
    1K views1 page
    This document is an affidavit of marital separation status. It requires the applicant to choose one of three statements regarding their marital status: 1) they are legally separated and must provide separation documents, 2) they are separated but not legally and have begun legal proceedings and anticipate the separation being permanent, or 3) they are separated but not legally and have not begun legal proceedings, providing a reason. The applicant must then state if they do or do not anticipate receiving compensation from their spouse in the next 12 months. The applicant signs to certify the information is accurate under penalty of perjury.

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    Affidavit

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    This document is an affidavit of marital separation status. It requires the applicant to choose one of three statements regarding their marital status: 1) they are legally separated and must provide separation documents, 2) they are separated but not legally and have begun legal proceedings and anticipate the separation being permanent, or 3) they are separated but not legally and have not begun legal proceedings, providing a reason. The applicant must then state if they do or do not anticipate receiving compensation from their spouse in the next 12 months. The applicant signs to certify the information is accurate under penalty of perjury.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    1K views1 page

    Affidavit Marital Separation Status

    Uploaded by

    imclaimingmydream
    This document is an affidavit of marital separation status. It requires the applicant to choose one of three statements regarding their marital status: 1) they are legally separated and must provide separation documents, 2) they are separated but not legally and have begun legal proceedings and anticipate the separation being permanent, or 3) they are separated but not legally and have not begun legal proceedings, providing a reason. The applicant must then state if they do or do not anticipate receiving compensation from their spouse in the next 12 months. The applicant signs to certify the information is accurate under penalty of perjury.

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    © All Rights Reserved
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    of 1

    AFFIDAVIT OF MARITAL SEPARATION STATUS

    DATE: __________________________________ PROPERTY NAME: _________________________________

    APPLICANT/RESIDENT NAME:_______________________________________ UNIT #:______________________

    If you are currently separated from your spouse this form must be completed.
    Choose and complete the appropriate statement below:

    I am currently legally separated from my spouse.


    (A copy of legal separation agreement must be attached)

    I am currently, but not legally, separated from my spouse. I began the legal process on
    ___________________(insert date) and I anticipate this separation to be permanent.
    (A copy of the legal documents in process must be attached)

    I am currently, but not legally, separated from my spouse and I have not begun the legal process
    for the following reason (s): _______________________________________________________
    ______________________________________________________________________________

    If statement 2 or 3 above is checked, choose and complete the following appropriate statement:

    I am currently receiving or anticipate receiving $ _______________________ per


    _______________(state frequency) from my spouse during the next 12 months.

    I am not currently and do not anticipate receiving any compensation from my spouse
    during the next 12 months.

    I hereby certify that the information provided above is accurate and complete to the best of my knowledge. I consent to release such
    information in order to comply with government regulations regarding allocation of Section 42 or Section 515 housing. I understand
    that providing false or misleading information under oath may subject me to criminal penalties. I fully understand the information
    requested and the ramifications of my breach of this agreement.

    _________________________________________________ _____________________
    SIGNATURE OF APPLICANT/TENANT DATE

    NOTARY

    State of North Carolina

    County of ________________

    Sworn to before me and subscribed in my presence this _________ day of _____________, 20 ______.

    ______________________________________ __________________________
    SIGNATURE OF NOTARY PUBLIC DATE

    My commission expires:______________________
    WARNING: Section 1001 of Title 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.
    AFFIDAVIT OF MARITAL SEPARATION STATUS

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