DECLARATION (Please read and sign below):
I state that the information in this application is correct and true. I agree to provide proof of residency, income for all owners and adults, and the number of household occupants upon request. I agree to inform Santa Margarita Water District (SMWD) within 30 days if I no longer qualify for the CAP. I understand that if I receive the adjustment to my bill without qualifying for it, I may be required to return any credit I received. By signing below, I consent to the recovery by SMWD of all or a portion of a previous granted adjustment, if I’m found to have made false statements or unsubstantiated claims through the addition of a surcharge on my water bill over whatever period of time is deemed appropriate by SMWD. I understand SMWD can share my information with other utilities or their agents to enroll me in their assistance program. I understand I must reapply each year to qualify for the CAP.