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ORANGE COUNTY LAFCO Project Application Fornt <br />Page 5 of 9 <br />1 certify, under penalty of perjury by the laws of the State of California, that the Information <br />contained in this application is true and correct. I acknowledge and agree that the Orange <br />County Local Agency Formation Commission is relying on the accuracy of the information <br />provided and my representations in order to process this application proposal. <br />Signature: <br />Name: <br />Title: <br />Date: <br />(The it formation contained in this applicatioa may ba.mbjeci to disclosure under the California Public Records Act Govenonent <br />Cade Section 6250 et seq.) — <br />75C-18 <br />