PI Assurance Form

Name First Last
This assurance concerns the grant application entitled:
I hereby assure:
1. 1) that the information submitted within the application is true, complete and accurate to the best of my knowledge;
2. 2) that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties; and
3. 3) that I agree to accept responsibility for the scientific conduct of the project and to provide the required progress reports if a grant is awarded as a result of the application.
ACKNOWLEDGEMENT
By checking this box, I confirm that the above information is complete and accurate to the best of my knowledge. *
I agree I do not agree
Date / MM / DD YYYY