The Employee Self Certification Form must be completed for all newly hired employees associated with the Community Development Block Grant job creation and job retention programs (e.g., ED and PFED). The Employee Self Certification Form is for collecting the family income and demographics of newly hired employees. It is recommended to have job applicants complete the form as part of the application process so their income status is known prior to hire, to help ensure the Business is hiring an adequate number of low- and moderate-income persons for the jobs being retained or created as a result of the CDBG funding assistance.
2019 Employee Self Certification Forms
2020 Employee Self Certification Forms
2021 Employee Self Certification Forms
2022 Employee Self Certification Forms
2023 Employee Self Certification Forms
2024 Employee Self Certification Forms
2025 Employee Self Certification Forms
