Affidavit of No Income (Zero Income)
Declare under oath that you currently receive no income from employment, self-employment, or any other source. Medicaid offices, housing authorities, and courts commonly require a zero income affidavit before approving benefits, subsidized housing, or fee waivers for applicants who report no earnings.
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Download a blank PDF template to print and complete manually.
Download Blank TemplateAffidavit of No Income (Zero Income) Affidavit — Frequently Asked Questions
What is a zero income affidavit and who needs one?
A zero income affidavit is a notarized sworn statement declaring that you currently have no income from any source. Housing authorities, Medicaid offices, and courts require it from applicants who report no earnings, because agencies cannot verify income that does not exist through pay stubs or tax records.
How do I prove I have no income?
Since there are no pay stubs to show, agencies typically accept a notarized affidavit of no income, sometimes with supporting evidence such as a letter from the person who houses or feeds you, recent bank statements, or your most recent tax return. Each agency sets its own documentation requirements.
How do I make a affidavit of no income (zero income) affidavit legally valid?
Fill in the affidavit of no income (zero income) affidavit, print it, and sign it in front of a Notary Public — do not sign beforehand. Bring a valid government-issued photo ID. Notaries are available at UPS Stores, banks, law offices, courthouses, and through online notarization services, and fees typically range from $2 to $25 per signature depending on your state.
Is this affidavit of no income (zero income) affidavit template free?
Yes. You can generate a completed affidavit of no income (zero income) affidavit PDF or download a blank printable template completely free, with no sign-up required. Your information is used only to generate the document and is not stored after the PDF is created.