Cert Statement for Signature

Applicant Certification:

I, the applicant, hereby certify under penalty of perjury, that I have read, or have had read to me, all the questions and statements on this application and I understand all the questions and statements on this application. I, the applicant further certify that the answers, and information furnished, including the required and supporting documentation submitted with this application are true and correct to the best of my knowledge and belief.

The certification will also show the applicant’s name, the date and time the application was certified.

Third Parties Certification:

I hereby certify, under penalty of perjury, that I have read to the individual whose name appears on this application (applicant) all the questions and statements on this application. I further certify that the applicant certifies that he or she has read, or has had read to him or her, all the questions and statements on this application, including the Applicant’s Certification. The answers, information furnished, including the required and supporting documentation submitted with this application are true and correct to the best of the applicant's knowledge and belief.

The third party certification will also show the attorney’s name, the date and time the application was certified.

Example of the Check Box for e-SAFE, the above verbiage would be under Consent: