Provider Certification. I declare under penalty of perjury that the above information is true and that these children were provided services at the above location and on the days and times listed above. I understand that I must repay any overpayment resulting from false or incorrect information and that I may be prosecuted for fraud.
Appears in 4 contracts
Sources: CCDF Program Participant Agreement, CCDF Program Participant Agreement, CCDF Program Participant Agreement
Provider Certification. I declare under penalty of perjury that the above information is true and that these children were provided services at the above location and on the days and times andtimes listed above. I understand that I must repay any overpayment resulting from false or incorrect information and that I may be prosecuted for fraud.
Appears in 2 contracts
Sources: CCDF Program Participant Agreement, CCDF Program Participant Agreement