Free Income Affidavit For Pension Template

Income Affidavit For Pension

I, [Your Name], being duly sworn, depose and state as follows:

  1. Personal Information:

  • Full Name: [Your Name]

  • Date of Birth: [Birthdate]

  • Social Security Number: [SSN]

  • Address: [Your Address]

  • Contact Information: [Your Email]

  1. Employment and Income:

  • Current Employer: [Your Company Name]

  • Occupation/Position: [Your Title]

  • Monthly Gross Income: [Your Income]

  1. Pension Benefits:

  • Pension Provider: [Pension Provider Name]

  • Type of Pension: [Pension Type]

  • Monthly Pension Benefit: [Amount]

  1. Additional Financial Information:

ASSETS:

  • Savings Account: [Amount]

  • Investment Portfolio: [Amount]

  • Real Estate: House valued at [Amount]

LIABILITIES:

Mortgage on Real Estate: [Amount]

I certify under penalty of perjury that the foregoing is true and correct to the best of my knowledge, information, and belief.

[Your Name]


Sworn to and subscribed before me on this [Date] day of [Month] [Year].

[Notary Public Name]

Notary Public, State of [Your State]

Commission Number: [Commission Number]

Date Commission Expires: [Date]

[Notary Seal, if applicable]

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