I (WE) HEREBY CERTIFY THAT THE STATEMENTS MADE ON THIS APPLICATION ARE TRUE AND CORRECT TO THE BEST OF MY (OUR) KNOWLEDGE.
I (WE) AUTHORIZE THE CITY TO OBTAIN THE NECESSARY VERIFICATIONS AND DOCUMENTATION REQUIRED FOR THE PURPOSE OF VERIFICATION OF EMPLOYMENT, ASSETS, LIABILITIES, OR OTHER DATA FOR THEIR CONFIDENTIAL USE IN CONSIDERING MY (OUR) APPLICATION.
I (WE) HEREBY CERTIFY THAT I(WE) UNDERSTAND THAT FALSE STATEMENTS OR INFORMATION ARE FRAUD AND ARE IMMEDIATE GROUNDS FOR DENIAL OF ASSISTANCE.
I (WE) HEREBY CERTIFY THAT I(WE) UNDERSTAND BY VOLUNTARILY APPLYING FOR THIS CDBG GRANT, I(WE) ACKNOWLEDGE THAT ALL ADMINISTRATIVE GUIDELINES, AND ALL APPLICABLE HUD AND SECTION 8 REGULATIONS APPLY, AND THAT ALL OF THIS MATERIAL IS AVAILABLE FOR MY(OUR) REVIEW AT THE CITY OF LONGVIEW HOUSING AND COMMUNITY DEVELOPMENT OFFICE, 1202 N. 6TH STREET, LONGVIEW, TEXAS.
APPLICANT AND ALL RELATED HOUSEHOLD MEMBERS 18 YEARS OF AGE AND OLDER MUST SIGN THE APPLICATION. IF PERSON OTHER THAN APPLICANT(S) SIGNS THE APPLICATION, POWER OF ATTORNEY DOCUMENTATION MUST BE ATTACHED.
I (WE) UNDERSTAND THAT COMPLETING THIS APPLICATION DOES NOT GUARANTEE THAT I (WE) WILL BE ELIGIBLE FOR THE CHILDCARE ASSISTANCE PROGRAM. I (WE) MUST COMPLETE THE APPLICATION PROCESS AND BE CERTIFIED ELIGIBLE BEFORE A SCHOLARSHIP GRANT CAN BE AWARDED. I (WE) UNDERSTAND THAT I(WE) AM SUBJECT TO ALL PROGRAM GUIDELINE CHANGES.
I(WE) UNDERSTAND THAT THE INFORMATION I (WE) PROVIDED, INCLUDING ALL FINANCIAL INFORMATION, IS SUBJECT TO VERTIFICATION BY THE CITY OF LONGVIEW AND/OR THE U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT.
PENALTY FOR FALSE OR FRAUDULENT STATEMENT: U. S. C. Title 18, Sec. 1001, Provides: “Whoever, in any matter within the jurisdiction of any department or agency of the United States knowingly and willingly falsifies…or makes any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry shall be fined not more than $10,000 or imprisoned not more than five years, or both.”
Incomplete applications will be returned with the noted deficiencies and will not be eligible for review during the current funding cycle.