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<br />ApPLICATION AUTHORIZATION <br /> <br />6.2A <br />Page 9 <br /> <br />This application was prepared by: <br />T eri Chin <br />Name <br /> <br />r~ <br /> <br />Signature <br /> <br />Human SeNices Manager <br />Title <br /> <br />1/17/08 <br />Date <br /> <br />This application is submitted by: <br /> <br />l!We certify that the information and statements submitted in and attached to this application, are true, accurate <br />and complete to the best of my/our knowledge. I/We authorize the Department of Housing to verify any <br />information pertaining to this applicadon. I{We acknowledge and understand that if facts and/or information <br />herein are found to be misrepresented, it may constitute grounds for rejection of the application or default of <br />the allocation for which this application is being made. <br /> <br />Teri Chin <br />Name <br /> <br /> <br />~~ <br /> <br />Human SeNices Manager <br />Title <br /> <br />1/17/08 <br />Date <br /> <br />Name <br /> <br />Title <br /> <br />Signature <br /> <br />Date <br /> <br />Please tab to next page for list of required attachments. <br /> <br />5 <br />