YCHHSD 192B Self-Employment Income Affidavit rev 01-b2008bpdf - co yuba ca 2026

1. Click ‘Get Form’ to open the YCHHSD 192B Self-Employment Income Affidavit in the editor.
2. Begin by entering the month for which you are declaring your income and expenditures in the designated field.
3. In the 'Income From Sales OR Services Rendered' section, list each source of income. Fill in the date received, from whom you received it, and the amount. Ensure that all entries are accurate.
4. Next, move to the 'Expenditures' section. Document all business-related expenses, including rent, utilities, wages, and supplies. For each expense, provide the date paid, to whom it was paid, and a brief description of what it was for.
5. After filling out all fields, review your entries for accuracy. Remember that all expenses must be verified with receipts.
6. Finally, sign and date the affidavit at the bottom of the form. If applicable, indicate whether verification is attached.

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