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I HEREBY CERTIFY THAT I HAVE READ THE ABOVE QUESTIONS AND STATEMENTS, AND I CERTIFY THAT THERE ARE NO MISREPRESENTATIONS, OMISSIONS, OR FALSIFICATIONS IN THIS QUESTIONAIRE, AND THAT ALL MY ANSWERS ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. I UNDERSTAND THAT MISREPRESENTATIONS, OMMISSIONS, OR FALSIFICATIONS ON THIS QUESTIONAIRE MAY RESULT IN MY APPLICATION NO LONGER BEING CONSIDERED OR IN TERMINATION OF MY EMPLOYEMENT WITH THE NORWOOD PARK FIRE PROTECTION DISTRICT. I FURTHER UNDERSTAND AND AGREE THAT MY PERSONNEL FIRE MAY BE REVIEWED BY THE CHIEF OR CHIEF'S DESIGNESS.Dated at city/town Illinois, this day of Type a label 20year .