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<br /> <br /> <br />CERTIFICATION AND ACKNOWLEDGMENT <br /> <br />As authorized by the Formal Resolution for the Prohousing Designation Program (Resolution <br />No. ), which is attached hereto and incorporated by reference as if set forth in full, I <br />hereby submit this full and complete application on behalf of the applicant. <br /> <br />I certify that all information and representations set forth in this application are true and <br />correct. <br /> <br />I further certify that any proposed Prohousing Policy identified herein will be enacted within <br />two (2) years of the date of this application submittal. <br /> <br />I acknowledge that this application constitutes a public record under the California Public <br />Records Act (Gov. Code, § 6250 et seq.) and is therefore subject to public disclosure by the <br />Department. <br /> <br /> <br /> <br />Signature: __________________________________________ <br /> <br /> <br /> <br />Name and Title: ______________________________________ <br /> <br /> <br /> <br />Date: _______________________________________________ <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />