I certify that the information I have provided in this application is true and correct. I agree to provide proof of income, and understand that failure to do so will result in removal from the program. I agree to inform the utility if I no longer qualify to receive the discount. I understand that if I receive the discount without qualifying for it, or if I provide false information to support this application, I may be required to pay back the discount I received. I understand that the Northern California Power Agency where I have my utility account may share my information with other utilities or their agents to enroll me in their assistance programs. I give consent to have my eligibility verified yearly. I have read and understood the contents of the application and the Guidelines of the Program, and agree to abide by them.