EXHIBIT H - Nevada



EXHIBIT NV-2c

Self-Employment Affidavit – Existing Business

|Project Name: |      | |       |Unit # |      |

|Initial Certification Recertification Other |

|Transfer? Yes No |If yes, from Unit # |      |

I       , hereby attach copies of my individual federal and state income tax returns for the immediately preceding calendar year for which such income tax returns could have been filed (or, if not filed, were not required to be filed) together with a current profit and loss statement. I anticipate that my net annual income for the next twelve (12) months will be $       .

I certify that the anticipated income indicated above and information shown in such income tax returns and profit and loss statement is true and complete to the best of my knowledge and that any income tax returns not filed were not required to be filed.

     

Signature of Applicant/Resident Date

     

Signature of Authorized Property Representative Date

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