Self employed status declaration form 2025

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I declare that my household income is $ per ☐ week ☐ every other week ☐ month ☐ year. ☐ I certify, under penalty of perjury, that I do not have any income from any source at this time. I declare, under penalty of perjury, that the information I have given on this form is true, correct, and complete.
This form is to be completed by self-employed individuals who have not filed taxes and who cannot provide paystubs to establish annual household income (e.g., an individual who works for cash or contracts with organizations but does not have an employer).
in the (name of field or industry, i.e., marketing, finance, construction, etc.). I confirm that I have been self-employed since (date) and operating under the business name of (business name or personal name). This business is a (sole proprietorship or partnership), and I own XX% of it.
I,, declare that I have been working and receiving payment in the form of in the amount of $per (circle one) day, week, two weeks, month. I have no pay stubs or other documentation to prove my earnings.
My name is (Employer name) and this letter is to verify the employment of (your name). (Your name) works at (company name) as a (Job title). (He/she) has worked with this company since (Hire date) and works (hours per week). (Your name) earns (Salary) on a (Pay period) basis.
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Some ways to prove self-employment income include: Annual Tax Return (Form 1040) 1099 Forms. Bank Statements. Profit/Loss Statements. Self-Employed Pay Stubs.
I hereby declare that all the information given above is true and correct to the best of my knowledge. All the information shared in the resume is correct, and I take full responsibility for its correctness. I solemnly declare that the information in this resume is true to the best of my knowledge and belief.

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