Disclosures: Benefit Certification



As a recipient of a CDBG-CV funds under the applicable Agreement, I assert that:   

1. I will not apply for more funding than needed for the eligible activity or project for which CDBG-CV funds are provided. For example, if I have $100 available from another source towards each monthly gas bill and I am applying for funds to pay for my total monthly gas bill of $500, these funds will be limited to $400.  

2. I understand that duplication of benefits (DOB) are prohibited under the federal Robert T. Stafford Disaster Relief and Emergency Assistance Act (Stafford Act).  

3. I will immediately report to Tacoma/Pierce County Habitat for Humanity if I apply for or accept any financial assistance from other funding sources (federal, state, local or private) that constitute a duplication of benefits received under the Mortgage Assistance Grant Program.  

4. I acknowledge that any duplication of funds may either have to be paid back to Tacoma/Pierce County Habitat for Humanity or that the grant funds may be reduced by a corresponding amount.  

5. I understand that this affidavit is appended to and part of the applicable Agreement that the applicant executes with Tacoma/Pierce County Habitat for Humanity for CDBG-CV funds and is a condition of the receipt of such funds.  

I certify that the information that I have provided above is an accurate and complete disclosure. I understand that to perjure myself in order to obtain assistance is a fraudulent offense for which I can be prosecuted.