Anderson, IN · Madison County
CDBG and HOME Income Verification Application
This application collects household, income, asset, and demographic information from Anderson residents seeking assistance through the city’s Community Development Block Grant or HOME programs.
- licensed online notary
- ~15 min average
- Notarized PDF emailed
What you’ll need
- Government-issued photo ID
- Webcam-enabled device (laptop or phone)
- This form, ready to upload as a PDF
What this form is
Anderson’s Community Development Department uses this application to assess household income and document eligibility for assistance through its CDBG and HOME programs. Applicants provide information about household members, income sources, assets, and supporting documents; the packet also includes verification forms for matters such as self-employment, zero income, banking, and child support. The form asks applicants to allow 5–7 days for processing and says financial assistance depends on available resources.
Who needs it
Anderson residents applying for CDBG or HOME assistance should complete the application and provide income verification for all adults in their household.
Why it needs a notary
The self-employment affidavit has a sworn statement and notary commission-expiration block; the self-employed affiant signs and swears to the statement before the notary.
How to get this notarized
- 1
Download the Application
Get the CDBG and HOME Income Verification Application packet from the City of Anderson.
- 2
Complete the Application
Fill in household and income information, and gather the supporting documents relevant to your situation.
- 3
Book an Online Notary
If completing the self-employment affidavit, book a session with a commissioned online notary.
- 4
Sign on Video
Sign and swear to the self-employment affidavit during your online notary session.
- 5
Submit to the City
Return the completed application and supporting documents to Anderson Community Development as directed in the packet.
Preview the form
The blank PDF straight from Anderson. Look it over, then upload your filled copy to start the notary session.
You’ll need ID and a webcam.
A licensed online notary will join you on video, verify your government-issued ID, witness your signature, and apply their seal. You’ll receive the notarized PDF by email when the session ends.
Frequently asked questions
- How do I get the self-employment affidavit notarized?
- Complete the self-employment affidavit, then sign and swear to it before a commissioned online notary. The affidavit includes a notary commission-expiration block.
- Do I need to notarize the entire application?
- The packet identifies a notary block on its self-employment affidavit. It does not show a notary block on the main application signature section; confirm with the city or town if unsure.
- Can I use an online notary for this form in Indiana?
- Indiana provides for a remote notary public endorsement under IC 33-42-17. IC 33-42-9-8 recognizes notarial acts by a notary public or other authorized officer of another state.
- What should I submit with the application?
- The form requests income verification for all adults and lists documents such as recent pay stubs, tax returns, benefit letters, child support proof, and bank statements, depending on the applicant’s circumstances.