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<br />200809274 <br /> <br />2'dOJB968 <br /> <br />CERTIFICA TION OF NO CHILD SUPPORT <br /> <br />Household Name: <br /> <br />Date: <br /> <br />Property Name: <br /> <br />Unit # (if assigned): <br /> <br />Child's Name: <br /> <br />Child's Name: <br /> <br />Child's Name: <br /> <br />Child's Name: <br /> <br />I, <br /> <br />certify, <br /> <br />o I am not entitled to receive child support or other compensation pursuant to any court order <br /> <br />o I am not recciving child support or other compensation pursuant to any non-court agreement. <br /> <br />Do you anticipate receiving any child support in the upcoming 12 months? <br /> <br />DYes <br /> <br />o No <br /> <br />If yes, please explain: <br /> <br />Reason as to why you are not pursuing child support: <br /> <br />Under penalty of perj ury, I certify that the information presented in this certification is true and accurate <br />to the best of my knowledge. The undersigned further understands that providing false representations <br />herein constitutes an act of fraud. False, misleading or incomplete information may result in the <br />termination of a lease agreement. <br /> <br />Signature of Applicant/Tenant <br /> <br />Date <br /> <br />(Updated 11107) <br />