10-22-2001 Council Packet - Laserfiche WebLink

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on the date of this ccrtincate« including income described in (a) below, but excluding all income described in (b) below, is $_______________. (a) Tlie amount set forth above includes all of the following income (unless such income is described in (b) below; (i) all wages and salaries, overtime pay, commissions, fees, tips and bonuses before payroll deductions; (ii) net income from the operation of a business or profession or from the rental of real or personal properly (without deducting expenditures for business expansion or amortization of capital indebtedness or any allowance for depreciation of capital assets); (iii) interest and dividends (including income from assets os set forth in item 7(b) below); (iv) the full amount of periodic payments received from social security, annuities, insurance policies, retirement funds, pensions, disability or death benefits and other similar types of periodic receipts; (v) payments in lieu of earnings, such as unemployment and disability compensation, workmen’s compensation and sevenmee pay; (vi) the maximum amount of public assistance available to the above persons; (vii) periodic and determinable allowances, such os alimony and child support pa>Tnents and regular contributions and gifts received from persons not residing in the dwelling; (viii) all regular pay, special pay and allowances of a member of the Armed Forces (whether or not living in the dwelling) who is the head of the household or spouse; and (ix) any earned income tax credit to the extent it exceeds income tax liability. The follow ing income is excluded from the amount set lorth above: (i) casual, sporadic or irregular gifts; (ii) amounts that arc specifically for or in reimbursement of medical expenses; (iii) lump sum additions to family assets, such as inheritances, insurance pavments (including pavments under health and accident insurance and workmen’s compensation), capital gains and settlement