Giving True and Complete Information: I certify that all the information provided on this application is accurate to the best of my knowledge. I have reviewed my application and certify that the information shown is true and correct.
Composition: I know I am required to cooperate in supplying all information needed to determine my eligibility, level of benefits, or verify my true circumstances. Cooperation includes, but is not limited to, attending pre-scheduled meetings and completing and signing needed forms. I understand failure or refusal to do so may result in delays, termination of assistance, or eviction.
Reasonable Accommodation: I understand that if I am disabled, I have the right to request a reasonable accommodation to make services and programs accessible.
Criminal and Administrative Actions for False Information: I understand that knowingly supplying false, incomplete or inaccurate information is punishable under Federal or State criminal law. I understand that knowingly supplying false, incomplete, or inaccurate information may be considered fraud and is grounds for denial of assistance, termination of housing assistance and/or eviction from public housing.
I certify under penalty of perjury, my answers are correct and complete to the best of my knowledge and ability.