I/we understand that North Carolina Statute provides that willful false statements or misrepresentation concerning income; asset or liability information relating to financial condition is a misdemeanor of the first degree, punishable by fines and imprisonment provided under Statutes. I/we further understand that any willful misstatement of information will be grounds for disqualification. I/we certify that the application information provided is true and complete to the best of my/our knowledge. I/we understand that this application is being administered by Charlotte Works on behalf of Mecklenburg County and United Way and I/we consent to the disclosure of information for business income verification related to deciding of my/our eligibility for program assistance by the City of Charlotte or their Partners and that the information may be used for program evaluation purposes. I/we agree to provide any documentation needed to assist in determining eligibility and are aware that all information and documents provided are a matter of public record. The City reserves the right to conduct criminal background checks on business members. Criminal convictions may not necessarily disqualify you from the program.
