You acknowledge that you understand the program terms and guidelines, that you understand these requirements and agree to abide by the terms as outlined below:

1) Application & Required Checklist Documents are for Verification of Non-profit organizations information only. The Application and required documents will be used to verify information provided by the applicant for the TCTX Serve Program full application only. All TCTX Serve Program applications and documents will only be retained through ZoomGrants. No information will be retained in hard copy or electronic files.  During the full application process, a comprehensive review of all Non-profit organizations information will be completed. The results of that review establishes the approved grantees and the grant amounts that will be awarded.

2) Consent to share information. I have requested assistance under the TCTX Serve Program.  I authorize representatives from BCL of Texas to supply and receive information I provide related to the TCTX Serve Program to/from BCL of Texas.  I understand and consent to the disclosure of public and non-public information by and between BCL of Texas and Travis County in connection with BCL’s responsibilities under the TCTX Serve Program, including but not limited to application data and documentation verification, review, program and assistance evaluation, monitoring, and oversight. I understand that Travis County may make information about applicants to the TCTX Serve Program available that are deemed public information by the Travis County Attorney’s Office and the Texas Attorney General.

3) All information provided is truthful and accurate. I certify that I am legally authorized to submit Application and Required Application Documents and the information and statements that I have provided are truthful and accurate. I understand the information and documentation submitted in this application will be provided to a governmental agency and is subject to the guidelines of a CARES Act federal program and the Travis County’s TCTX Serve Program and, by submitting this application, I agree to comply with the Federal, State, and local guidelines. Failure to provide truthful and accurate information may determine the Non-profit organization ineligible and or may cause the full application to be rejected.

WARNING:  The information provided on this form is subject to verification by the Department of Treasury at any time, and Title 18, Section 1001 of the U.S. Code states that a person is guilty of a felony and assistance can be terminated for knowingly and willingly making a false or fraudulent statement to a department of the United States Government.