14.16.640 Statement of truthfulness—Required with all submissions.

All applications, reports, or information submitted to the city must contain the following certification statement and be signed as required:

Statement of Truthfulness

I certify under the penalty of law that document and all attachments were prepared under my direction and supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is to the best of my knowledge and belief true, accurate, and complete.

I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations.

Company Name ____________________

Address _____________________

_____________________

Date:______ _____________________

Authorized Representative