Pasadena, TX · Harris County
Zero Income Certification
This certification is completed by each adult household member with no income for the City of Pasadena’s CDBG or ESG program.
What this form is
Each adult household member with no income completes this certification for the City of Pasadena’s CDBG or ESG program. It records household and personal details, confirms that the signer has no income from listed sources, and states that no financial changes are expected during the next 12 months. The signer certifies the information under penalty of perjury; program staff have a section to record their review.
Who needs it
Each adult household member with no income must complete a separate certification for the household’s CDBG or ESG program.
How to submit it
Submit it to the City of Pasadena Community Development Department at P.O. Box 672, Pasadena, TX 77501.
About notarization
This document is signed without a notary; the signer certifies the information under penalty of perjury and signs and dates the form.
How to submit this form
- 1
Download the Form
Download the City of Pasadena Zero Income Certification.
- 2
Complete the Certification
Each adult household member with no income completes a form with their household and personal details and certifies their income information.
- 3
Sign and Date
Sign and date the certification; the form states that the information is certified under penalty of perjury.
- 4
Submit to the City
Submit the completed form to the Community Development Department at P.O. Box 672, Pasadena, TX 77501.
Frequently asked questions
- Who completes the Zero Income Certification?
- Each adult household member with no income must complete this certification. It is for the City of Pasadena’s CDBG or ESG program.
- What information does the certification ask for?
- It asks for household and personal details and a certification that the signer has no income from the listed sources and expects no financial changes over the next 12 months.
- Do I need a notary for the Zero Income Certification?
- No. The form has no notary block. The signer certifies the information under penalty of perjury, then signs and dates it.
- How do I submit the Zero Income Certification?
- Submit it to the City of Pasadena Community Development Department at P.O. Box 672, Pasadena, TX 77501.
Need something notarized?
This Zero Income Certification doesn’t need a notary — but Texas residents can notarize other documents online with a commissioned online notary.