Summary

• I have been honest on this report.
• I have attached all required documents.
• I understand the county may contact whomever to verify my eligibility.
• I have read the Calfresh Program Rules and Penalties.

Details

• I understand and certify, under penalty of perjury, that all my answers on this report are correct and complete to the best of my knowledge.
• I understand and agree to give copies of all documents needed to complete my semi-annual report
• I understand that in some instances, I may be asked to give consent to the County to make whatever contacts are necessary to determine eligibility