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DEPARTMENT OF FINANCIAL SERVICES
Mandatory Criteria Certification
Attachment C
This form must be completed by the Respondents authorized representative. The Respondent acknowledges
that the Department
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What is 1 does respondent certify?
Respondent certifies that the information provided is true and accurate to the best of their knowledge.
Who is required to file 1 does respondent certify?
Any individual or entity who is required to provide specific information as outlined in the form.
How to fill out 1 does respondent certify?
The form should be completed by providing all requested information accurately and signing where required.
What is the purpose of 1 does respondent certify?
The purpose is to ensure that the information provided is truthful and reliable for the intended purpose.
What information must be reported on 1 does respondent certify?
The specific information required will vary based on the purpose of the form.
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