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200109053
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200109053
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Last modified
10/14/2011 9:29:01 AM
Creation date
10/20/2005 10:07:15 PM
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DEEDS
Inst Number
200109053
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EXHIBIT B -9 200109053 <br />PENSION OR WORKERS COMPENSATION VERIFICATION <br />TO: Date: <br />II" <br />Client or Employee <br />TO WHOM IT MAY CONCERN: <br />The client listed above has indicated that he or she is receiving a payment from you. Information <br />provided will remain confidential and will be used solely for the purpose of determining eligibility for <br />occupancy. <br />Sincerely, <br />LIHTC Project Manager <br />You are hereby authorized to furnish all information requested on this inquiry. <br />Signed: <br />Weekly Monthly <br />Weeks or amount still to be paid <br />Effective Date Ending Date if known <br />Retirement Pension Number <br />Current Gross Monthly Retirement Income <br />Total Gross Pension Income expected for the next 12 months <br />Remarks: (Please indicate any anticipated changes.) <br />By — <br />Title <br />Date _ <br />Phone <br />PLEASE RETURN FORM TO: <br />01- 351904.01 B -15 <br />Date: <br />Payments to Employee $ <br />
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