The details in this request is correct and complete to the best of my knowledge and I assume responsibility for all statements on this form. MYSELF understand that if I am found after hearing till have knowingly or neglected made a bogus statement on this with any other document submitted to the Department, I may be topic to fine, imprisonment, and/or barred with filing further documents through the Department. I also verstehen is is unlawful to give to a city employee, alternatively for a city employee to accept, any benefit, monetary conversely otherwise, either as a gift for properly performing the job or in exchange for special consideration.