Child and Spousal Support
Affidavit
Applicant / Resident Name:
Development Name:
Unit Number / Identification:
Yes No
A. Do you receive child support and/or spousal support?
Go to B Go to C.1
B.
I receive:
1. Payment Amount $
2. Frequency
3. Name(s) of Recipient(s)
4. Name of Source(s)
5. Go to C.1
C. Yes No
1. Have you been awarded child or spousal support
by court order? Go to C.2 Sign Form
2. Provide copy of court order
Enter amount of award:
Frequency of award:
Go to C. 3
3. Yes No
Is payment being received as awarded?
Go to 3.a Go to 3.b
a. Indicate the manner by which payment is received and sign form.
i.
Enforcement Agency
Name of Agency:
Provide Agency Printout
Child support and/or spousal support payments that are received shall be included as
income whether or not there is yet a court order awarding payment.
Child/Spousal support amounts awarded by the courts but not received can be
excluded only when third party documentation verifies that payments are not being
made and that all reasonable legal actions to collect amounts due, including filing
with the appropriate courts or agencies responsible for enforcing payment, have been
taken.
As part of the qualification process required by federal and/or state housing
programs with jurisdiction over this development the following information is needed:
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CA Tax Credit Allocation Committee
Child / Spousal Support Affidavit (Updated July 2022)
Child and Spousal Support
Affidavit
ii.
Court of Law Name of Court:
iii. Direct from responsible party Name Source
iv. Other Explain:
b.
Applicant/Resident Signature
Date
If payment is not received or if amount received is less than amount awarded,
provide details and documentation of collection efforts.
Under penalty of perjury, I certify that the information presented in this affidavit is
true and accurate to the best of my knowledge. The undersigned further
understands that providing false representations herein constitutes an act of
fraud. False, misleading or incomplete information may result in the termination of
a lease agreement.
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CA Tax Credit Allocation Committee
Child / Spousal Support Affidavit (Updated July 2022)
