Affidavit of Self-Employment Income

AFFIDAVIT OF SELF-EMPLOYMENT INCOME

I, ______, of ______, in the Province of Ontario, MAKE OATH AND SAY that:

1. I am self-employed, carrying on business as ______. The nature of my work is: ______.

2. For the period ______, my gross income from this self-employment was ______.

3. For the same period, my net income (after business expenses) was ______.

4. The figures stated above are true and are supported by my business records.

I make this solemn declaration conscientiously believing it to be true and knowing that it is of the same force and effect as if made under oath.

SWORN / DECLARED before me at the ______________________ of ______________________, in the Province of Ontario, this ______ day of ______________, 20______.

_______________________________ _______________________________

A Commissioner for taking Affidavits Signature of Declarant