Please complete the following declaration and sign it in the appropriate place below. If this declaration is not completed and signed, your application will not be considered. I acknowledge that Peoples Needs UK is under a duty to protect the public funds it administers and to this end I agree it may use information provided on this form for prevention and detection of crime and it may share this information with other bodies solely for these purposes. I hereby give consent to such collection, storage and processing of my personal data and I agree that the information given on this form may be used for data registration purposes. I hereby certify that:

• All the information given on this form is correct to the best of our knowledge.
• All questions have been accurately and fully answered.
• If given funds, they will be used appropriately and within the legal framework of the country.
• Peoples Needs UK retains their right to withdraw existing and future support at any time and without lllnotice.
• Peoples Needs UK will not be held responsible for actions undertaken by recipients who are deemed to lllbe unlawful.