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PART 10: REPAIR WORK NEEDED: <br /> Give a brief description of the repair work needed; <br /> PART I I: APPLICANT'S CERTIFICATION <br /> GIVING TRUE AND COMPLETE INFORMATION <br /> I(We), the undersigned, cert]that all of the information provided in this application is true and correct to the best of <br /> my(our)knowledge and is submitted for the purpose of the Residential Repair Program. I"We understand that the <br /> above information is being collected to determine my(our) eligibility and is submitted for the purpose of obtaining a <br /> County rehabilitation loan. I(We)authorize the County of Hawai"i to verify all information contained herein and agree <br /> that this application and related verification and statements shall remain the property of the County of Hanoi'i. <br /> (Si nature of A licant}.. ..................... <br /> Date <br /> to <br /> (Signature of Other Household Adult Member) Date <br /> ae <br /> (Signature of Other Household Adult Member) Date o <br /> (Signature of Other Household Adult Member) Date <br />