MAC Pt. 28, R. 5.11
Affidavits
Cite as Miss. Admin. Code Pt. 28, R. 5.11
Affidavits
Affidavits are written declarations made under oath before a notary public or other authorized
officer. Agencies should have a staff member who is a notary, and clients should not be charged.
Affidavits are valid for thirty (30) days. An affidavit is not needed if there is a court order.
Affidavits are to be obtained for the following reasons:
A. Authorized Representative applying for services on behalf of an applicant: The
representative must have an affidavit giving authority to act on behalf of the applicant.
Original copies of documents required for eligibility must be presented. If the
representative has a Power of Attorney, an affidavit is not required. The Power of
Attorney must be scanned into Virtual ROMA.
B. Separation: The State of Mississippi does not recognize legal separation. Applicants must
obtain an affidavit which declares separation from the spouse.
C. Zero income household: Applicant must obtain an affidavit when declaring zero income
for the entire household.
D. Unemployed: For each adult (18 years of age and older) that lives in the household, has
no income and is not a student, an affidavit must be obtained confirming unemployment
status for thirty (30) days.
E. Guardianship: If the applicant reports having guardianship over any minors
(grandchildren, nieces, nephews, etc.) in the home, an affidavit MUST be completed
AND the applicant must obtain official documentation from a verifiable
agency/source (CPS, attorney offices, school records, etc.) to confirm residency
status of the child.
F. Other: This option should be used if there are any circumstances where the subgrantee
feels an affidavit is required. This must be utilized only in Emergency Situations.