Note: Furnishing false information may constitute a violation of applicable state and federal laws. Falsifying documentation will result in the applicant being disqualified from future grant programs.
Certification: I certify that the above data is correct based on this organization's official accounting system and records, consistently applied and maintained, and that the costs shown have been made for the purpose of, and in accordance with the terms of the HCTDA funding application. The funds requested are for payment of actual costs made during this time period.
Failure to submit the Final Evaluation & Reimbursement Request Form within 45 days of the end of the event/project and by June 30 will result in non-payment of funds.