I certify this application has been complete to the best of
my knowledge with complete & accurate information. I understand that false
statements or omissions of facts relevant to my eligibility for assistance will
be considered fraud and that I may be prosecuted under applicable U.S. Codes
for this fraud. Furthermore, I understand that assistance granted to my
household based on fraudulent information must be reimbursed in whole to the
City of Allen.
Important; Section 101 of Title 18 of the U.S. Code makes it
a criminal offense to make willful false statements or misrepresentation to any
department or agency of the United States Government as to any matter within
its jurisdiction.I am signing this Application and Affidavit by electronically entering my name below .