Statutory declarations
Statutory Declaration of Income for Rent-Geared-to-Income Housing
Free template from Minute Notary, an Ontario notary office. A sworn statement of household income for a rent-geared-to-income housing provider, for when some income cannot be shown with documents.
No charge until a notary signs it
Word files are editable. Review any changes carefully before signing or uploading.
Also known as
- RGI income declaration
- Declaration of income for social housing
- Household income statutory declaration
+2 more names
- Community housing income declaration
- Subsidized housing income affidavit
The blanks fill themselves in as you type.
- Scope
- General template, not legal advice
- Formats
- PDF + editable Word downloads
- Builder
- Live preview as you type
Statutory Declaration of Income for Rent-Geared-to-Income Housing
A compact preview of this template
01You and your housing provider
Your full legal name
Household members, including you
Income sources
STATUTORY DECLARATION OF HOUSEHOLD INCOME
(Rent-geared-to-income housing)
I, ______, of ______, in the Province of Ontario, DO SOLEMNLY DECLARE THAT:
I make this declaration to ______ in connection with ______.
The members of my household, including me, are:
• ______, born ______ — ______
The income received by members of my household, and the monthly amount of each source, is:
• ______: ______, ______ per month, received since ______
No member of my household receives income from any other source, including employment, self-employment, a business, government benefits, support payments, pensions, rent, or regular gifts or help from others, except as listed above.
The assets owned by members of my household, with their approximate value, are: ______.
I cannot provide documents to prove all of this income because ______.
I will tell the housing provider of any change in my household's income or membership within the time it requires.
I understand that the housing provider relies on this declaration to set my household's rent.
AND 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 and by virtue of the Canada Evidence Act.
Signed and sworn (or affirmed/declared) before me by videoconference in Ottawa, Ontario, while the Affiant(s)/Declarant(s) were located in ______________________, on ______________________, pursuant to O. Reg. 431/20, and Electronic Commerce Act, 2000.
______________________________ | ______________________________ |
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How it works
Prepare your document, one step at a time.
Answer the questions, choose the download you need, then continue with signing or booking.
Overview
About this document
- 01
What is a statutory declaration of income for RGI housing?
It is a solemn declaration in which a member of the household lists everyone in the household, each source of income and its monthly amount, and the household's assets, and confirms there is no other income.
The housing provider uses it together with the documents you can supply to calculate your rent-geared-to-income assistance.
- 02
When you need one
You may need this declaration when:
- You are applying for rent-geared-to-income housing and cannot document one income source.
- Your provider's annual review asks about income you cannot prove with a slip or statement.
- Your household had no income, or very irregular income, for part of the year.
- A household member's income has changed and you are reporting it.
- 03
What to include
Have these ready:
- The housing provider's or service manager's name.
- Every household member, with date of birth and relationship to you.
- Each income source: who receives it, what type it is, the monthly amount and since when.
- Assets such as bank accounts, investments and vehicles, with approximate values.
- Why documents are not available for the income you declare.
- 04
Official source and who accepts it
Rent-geared-to-income assistance is governed by Ontario's Housing Services Act, 2011 and its regulations, and is run locally by service managers and the housing providers they fund. Under Ontario Regulation 367/11, the service manager reviews a household's eligibility at least once in every 12 months, and certain changes must be reported within 30 days or any longer period the service manager allows.
Each service manager decides what proof it accepts and may have its own declaration form; where it does, use that form. Ontario.ca lists the service manager for each municipality.
- 05
Common mistakes
Avoid these:
- Using this declaration when your provider has its own form.
- Leaving out a household member's income, including part-time work, support payments or family help.
- Mixing weekly, monthly and yearly figures. Convert each source to a monthly amount.
- Forgetting to report a later change within the time your provider sets.
- Signing before the appointment.
- 06
How to get it notarized in Ontario
Fill in the form on this page and download a clean, ready-to-sign PDF. Do not sign it yet: an affidavit or statutory declaration is signed in front of a notary public or commissioner for taking affidavits, after the oath or affirmation.
When you are ready, book an appointment with Minute Notary. You can swear or affirm it before a notary by video from anywhere in Ontario, or in person on a mobile visit. Bring government-issued photo ID; the notary administers the oath or affirmation and applies the seal.
Good to know
Before you fill it in.
Short notes on this template. Worth a minute before you start.
- 01
Prepared for use in Ontario. A general template, not legal advice.
- 02
Notarize online by video across Ontario, or in person anywhere in Ontario.
- 03
Sign in front of the notary, who administers your oath or affirmation and applies the seal.
Official sources
Frequently asked
Questions about the Statutory Declaration of Income for Rent-Geared-to-Income Housing
- Will my housing provider accept a sworn declaration?
- Many accept one for income that has no documents, but each provider decides. Ask your worker before your appointment, and use the provider's own form if it has one.
- How often will I need one?
- Your household's assistance is reviewed at least once every 12 months, so you may need a new declaration at each review while the undocumented income continues.
- Can I swear it by video?
- Yes. A statutory declaration can be commissioned by video from anywhere in Ontario, or in person on a mobile visit. Bring government-issued photo ID.
- Who in the household signs it?
- The person making the declaration, usually the applicant or tenant. If your provider wants another adult to declare their own income, that person can swear a separate declaration.
- Is this the same as a declaration of no income?
- No. This one lists every household member and every income source for RGI housing. If you only need to declare that you had no income for a period, use the declaration of no income.
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Fill it out
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