I/we certify that the statements on this application are true and to the best of my/our knowledge and belief and understand that they will be verified. I/we authorize the release of information to the Housing Authority by my/our employer(s), the Department of Public Assistance, the Social Security Administration, credit reporting agencies, and /or other business or government agencies. I/we also authorize the release of Criminal History Record Information. I/we understand that any false statement made on this application will cause me/us to be disqualified for admission.
Upon completion of this application you will receive additional forms to sign and return. We will also need a copy of every family members social security card, birth certificate and photo ID for family members over the age of 18.
Warning: 18 U.S.C. 1001 provides among other things that whoever knowingly and willfully makes or uses a document or writing containing false, fictitious, or fradulent statement or entry in any matter within the jurisdiction of any department or agency of the United States shall be fined not more than $10,000 or imprisoned for not more than five years or both.
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