New Client Application

Mozaic Terms and Conditions

By submitting this application, I agree to the following terms and conditions set forth by Mozaic 501(c)(3):

1. Accuracy of Information

I affirm that all information provided in this application is true, complete, and accurate to the best of my knowledge.
I understand that providing false, misleading, or incomplete information may result in immediate denial or termination of assistance and may subject me to legal consequences.

2. Eligibility and Required Documentation

I agree to provide valid, up-to-date supporting documentation, including but not limited to:

• Government-issued ID
• Social Security or Tax ID
• Lease or mortgage agreement
• Bank statements

3. Program Participation Requirements

I understand that:

• Assistance beyond three (3) months requires submission of a new application with updated documents.
• I am required to attend all assigned workshops, mentorship sessions, or follow-up meetings (weekly, bi-weekly, or monthly).
• Failure to attend required sessions or communicate with Mozaic in a timely manner may result in immediate termination or suspension of aid.

4. Use of Funds and Support

All assistance provided by Mozaic must be used exclusively for essential and basic living expenses as stated in this application, including but not limited

I understand and agree that:

• Assistance may not be used for any illegal activity, including but not limited to the purchase, distribution, or use of controlled substances, weapons, or participation in fraudulent schemes.
• Assistance shall not be used for non-essential or recreational expenses, including but not limited to entertainment, travel, luxury items, gambling, or non-educational subscriptions or memberships.
• Any misallocation or misuse of funds, whether intentional or due to negligence, will result in immediate termination of support, may require full or partial repayment, and may lead to civil or criminal liability in accordance with applicable laws.

5. Reapplication Policy

If further support is needed beyond the initial 3-month term:

• I agree to submit a new, fully updated application.
• I understand that approval for continued aid is not guaranteed and is subject to Mozaic’s review of need, compliance history, and available resources. AuthorizationI authorize Mozaic to verify information with relevant third parties, including:
• Employers, landlords
• Benefit agencies
• Community and resettlement partners

All information will be kept confidential and used solely for eligibility assessment and program coordination.

6. Program Discretion

Mozaic reserves the right to approve, reduce, deny, or revoke assistance at any time, based on:

• Funding availability
• Updated need assessment
• Program participation and compliance

7. Program Discretion

Mozaic operates in full compliance with federal, state, and local laws.
Any behavior involving fraud, forgery, or document manipulation will result in immediate termination of aid and referral to legal authorities.