COlumbia County, PA

I hereby authorize and request the Columbia County Housing Authority, hereinafter called the CCHA, to make payment of any amounts owed to me by initiating credit entries to my account indicated below in the bank named below, hereinafter called the BANK, and I authorize and request the BANK to accept any deposits initiated by the CCHA to such account and to credit the same to such account without responsibility for the correctness thereof. In the event of an overpayment in error, I hereby authorize the CCHA to initiate correcting entries to my account in the amount of such error.

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I hereby release, waive, discharge and covenant not to sue Columbia County Housing & Redevelopment Authority and any of their agents, web developers or employees (hereinafter referred to as the “RELEASEES”) for any liability, claim and/or cause of action arising out of or related to any security breach, identity theft, data theft, loss of data, or irreparable damage (including but not limited to monetary and reputation) that occurs as a result of but not limited to the use of this website, this web form, submitted data or any related website software / plugins.

I further understand and consent that I am sharing/submitting my information to Columbia County Housing & Redevelopment Authority and that my data will be stored on the web servers they use. I agree that my typed data in form fields that are designated to be encrypted will be encrypted in transmission and at rest in the database, but Uploaded files attached to the submission will be encrypted in transmission and may not be encrypted at rest.

I agree to indemnify and hold harmless the RELEASEES whether
data loss is caused by negligence, the negligence of the RELEASEES or the
negligence of a third party. I further agree that this Release and
Waiver of Liability shall bind me. I hereby further agrees that this Release and Waiver of Liability shall be construed in accordance with the laws of the State of Pennsylvania, United States of America. By agreeing to this Release and Waiver of Liability, I state that I have read and understand the conditions set forth in this Release and that I agree to all conditions set forth herein, and that I agree to this voluntarily.