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My signature below certifies all information on this application is true and accurate, I have experienced qualifying hardship due to COVID-19, and I can submit secure and verifiable documents showing I have such hardship and I am lawfully present in the United States if requested. I further acknowledge that making a false, fictitious, or fraudulent statement or representation in this sworn affidavit is punishable under the criminal law of Colorado as perjury in the second degree under C.R.S. 18-8-503, and it shall constitute a separate criminal offense each time a public benefit is fraudulently received. I further acknowledge that I may need to verify the basis of my declared hardship to state or federal taxing authorities.
I understand this funding will be applied only to the electric portion of my past-due balance. A past-due balance may remain on my account, and it is my responsibility to bring my account into good standing.
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