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- -- CERTIFICATION -OF- CONTINUED OCCUPANCY <br />Date: <br />Owner(s) Name: <br />Address: <br />We are the Owners of an Inclusionary Unit that was produced under the <br />requirements of the City of Santa Ana Inclusionary Housing Ordinance. We <br />understand and agree that the Inclusionary Unit must be used as our Primary <br />Residence and for no other purpose. <br />By this Certification, we declare under penalty of perjury that: <br />1. We currently occupy the Inclusionary Unit; and <br />2. We have occupied the Inclusionary Unit for at least 10 out of the past 12 <br />m- onths; and__ <br />3. We have not used the Inclusionary Unit for any other purpose than as our <br />Primary Residence; and <br />4. We are not renting or leasing any part of the Inclusionary Unit to another <br />party. <br />We have attached true and accurate copies of two utility bills or other <br />documentation evidencing our continued occupancy of the Inclusionary Unit. <br />We acknowledge that any intentional or negligent misrepresentation in this <br />Certification may result in civil liability and /or criminal penalties including, but not <br />limited to, fine or imprisonment, or both, and liability for monetary damages under <br />the provisions of Title 18, United States Code, Section 1001, et seq. <br />[Signatures on the Following Page] <br />Inclusionary Housing Covenants Declaration Page 1 <br />Occupancy Recertification Form January 2015 <br />