ADDITIONAL SENTENCES WERE USED IN PREVIOUS LANDLORD STATMENT FORMS:
Upon completion and approval, CAPECO will authorize a one-time payment towards the rent. Funds paid by CAPECO are to prevent eviction for nonpayment of rent. Funds may reflect past, present and future rent. If tenant leaves the unit with credit of rent not utilized, rent must be returned to the tenant.
By signing this form, you are certifying the amounts you have detailed below and agree you will not evict based on nonpayment of rent for the periods covered in the payment amount.