Housing Rehabilitation Eligibility Pre-Determination Form

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This is a program funded by H.U.D. through the Community Development Block Grant (CDBG). The information I willingly provide, in connection with this Housing Eligibility Pre-Determination will be accurate and true to the best of my knowledge.

WARNING: Title 18, Section 1001 of the U.S. Code states that a person is guilty of a felony for knowingly and willingly make false or fraudulent statements to any department of the United States Government.

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