The Baltimore Regional Housing Partnership will check the information you provide on this form with other Federal, State, or local governments and with private agencies. Certifying false information is fraud. If you commit fraud to obtain assisted housing, you could be:

• Evicted from your apartment or house
• Required to repay all overpaid rental assistance you receive
• Fined up to $10,000
• Imprisoned for up to five years
• Prohibited from receiving future assistance
• Subject to state and local government penalties