Pasadena, TX · Harris County
Certification of Zero Income
Adult household members with no income complete this certification for a Pasadena Community Development program to report their income status.
What this form is
This certification is for adult household members who have no income and are participating in a CDBG or ESG program. Each adult household member without income must complete a form stating that they have no income from listed sources and expect no imminent change in financial status during the next 12 months. It asks for household and personal details, a signature, printed name, and date.
Who needs it
Every adult household member without any income must complete this certification for the applicable program.
How to submit it
The form lists the City of Pasadena Community Development Department and P.O. Box 672, Pasadena, TX 77501. It does not provide a submission method beyond that department and mailing address.
About notarization
This certification is signed and dated without a notary; it includes a declaration under penalty of perjury but identifies no notarized attachment or related step.
How to submit this form
- 1
Download The Form
Download the Certification of Zero Income PDF.
- 2
Complete The Certification
Each adult household member without income completes the form with their household and personal details and income certification.
- 3
Review And Sign
Review the statements, then sign, print your name, and date the certification.
- 4
Submit To The City
Send the completed form to the City of Pasadena Community Development Department at the P.O. Box listed on the form.
Frequently asked questions
- Who completes the Certification of Zero Income?
- Every adult household member without any income completes a separate certification. The form asks for household and personal information and a statement about income.
- Do I need a notary for the Certification of Zero Income?
- No. The signer signs and dates the certification without a notary. It includes a declaration under penalty of perjury but names no notarized attachment or related step.
- How do I submit the Certification of Zero Income?
- The form lists the City of Pasadena Community Development Department at P.O. Box 672, Pasadena, TX 77501. It does not state a specific submission method.
Need something notarized?
This Certification of Zero Income doesn’t need a notary — but Texas residents can notarize other documents online with a commissioned online notary.