I authorize Centro Legal de la Raza to release the information contained in this application to any funder of this program in order to verify my eligibility for the program. This may also include any other agency or property management company/property owner who could be helpful in understanding my situation. Upon approval of my application I further authorize the release and sharing of information between Centro, the funding agency, and the landlord. I understand information shared will be necessary and appropriate for administering the financial assistance program provided and for coordinating and verifying services on my behalf. I understand that information that I share will remain confidential, and will only be used for the purposes described above. I hereby affirm that the information provided my application is true and complete to the best of my knowledge. I understand that if I provide any false information or misrepresentation during the application process that it will be grounds for denying my application to the Program. I understand in submitting this application I am not guaranteed financial assistance from the Program. In addition, my signature below acknowledges my understanding and consent to the release of information as described above. I understand that I have the right to revoke this consent in writing at any time, except for information already released, and that unless I decide to revoke it sooner, this consent will terminate two years after receipt of assistance from the program. If my application is selected for processing, I agree to provide tenancy information to a representative of Centro through means such as text messages, phone, or email for the purposes of evaluation. I understand that in order for Centro to continuously improve its services and understand the effectiveness of the Program, they may follow up after services have been provided.
Your signature below states that you recognize that electronic communications (text message) are not secure; you hereby authorize Centro to communicate with you regarding services received from the Program using electronic communications as indicated below and have provided the phone number above to text message, Additionally, you understand that text messaging is to be used to the purposes of communicating on a limited basis and text messages are not intended to provide additional support. If you are in need of additional support when you receive a text message, you understand that you should not text your concerns; rather, you should contact Centro via phone. You understand that you can end (“revoke”) this waiver at any time during service.