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Signed affidavits verifying your self employment 2026

The document is a Self-Employment Affidavit that requires individuals to provide information about their business, including the name, address, type of business, and financial details such as tax returns and anticipated income and expenses. It consists of two parts: one for established businesses with filed tax returns and another for newly formed businesses without tax returns. The affidavit must be signed by the applicant, certifying the accuracy of the information provided under penalty of perjury.

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Send self affidavit stating last date of employment via email, link, or fax. You can also download it, export it or print it out.

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Click ‘Get Form’ to open the signed affidavit in the editor.
Begin by entering your Household Name and Unit Number at the top of the form. This personal information is essential for identification.
Fill in the Name of Business, Business Address, Type of Business, and City, State, and Zip. Ensure accuracy as this information verifies your self-employment status.
Indicate your Position Held and Start Date to provide context about your role within the business.
For Part A, if you have an established business, enter the number of self-employment federal tax returns filed in the last two years along with average net business income and anticipated annual net business income.
In Part B, if you are a newly formed business without tax returns, provide anticipated gross annual income and detail all anticipated expenses listed. Calculate total expenses accurately.
Finally, review all entries for accuracy before signing. Attach any required support documentation as specified in the notes section.

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