Fix Lead SF: Program Application Form


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Owner(s)' Information: (As written in official property and tax records)
Owner









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Property Information









Please see the following link for figures for the questions below: Figures 1 - 4









Attestations:

I/We certify under penalty of perjury that:

1) I/We have read all the statements above and I/we acknowledge and agree with them, and
2) all the information contained in this application is true and accurate and completed to the best of my/our knowledge.
By typing your name and today's date below, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.


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