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I received the above noted citation(s) and hereby request an advance deposit hardship waiver. I declare that I am financially unable to make the advance deposit.
Current proof of income is required. You must include documentation of ALL household income for the requestor. Please provide verification copies of all that apply: • Federal Income Tax Return (Form 1040, 1040A) for the previous year • Current Letter 1722 from the IRS for non-income adults (1-800-829-1040) • Current verification of Social Security Benefits (1-800-772-1213) • Current Welfare of General Assistance eligibility Notice of Action/Income Verification • Current Documentation of Unemployment from Employment Development Department (1-800- 300-5616
By typing your name above you declare under penalty and perjury that you are the cited individual and the foregoing statement and information provided are true and correct.
City of Morgan Hill Finance Department (408) 779-7237; 17575 Peak Avenue Morgan Hill, CA 95037
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