Zero income affidavit

Dear All,

My cousin id suffering from Cancer and we had applied to Cancer aid and research foundation for financial help. 

However, they are asking for some affidavit which states that the patient has no fixed income and that the patiet earns zero money and they do not have a format of the same.

Request you to please help me with the said format of affidavit at the earliest. Please. 

Thank you.

Regards,
Riddhi Thakkar