Penalty for False or Fraudulent Statements: US. C. Title 18, Sec. 1001, provides: "whoever, in any matter, within the jurisdiction of any department or agency of the United States knowingly falsifies ... or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statements or entry, shall be fined not more than $10,000 or imprisoned not more than five years, or both.”
As the landlord, you are acknowledging that your tenant is applying for rental assistance through the Bay County Household Assistance Program. You are acknowledging that the funds provided are to go only toward the rent payments for your tenant and any monies provided to you through this program beyond what is owed must be used toward future rent payments for your tenant. Payment cannot be used towards administrative or penalty charges. I also acknowledge I will not commence eviction proceedings against the applicant/tenant(s) for the next 90 days.