§ 46-201 — Application for assistance; notice of penalties

A. Application for any form of assistance or service under this title shall be made to a department in this state as specified by the program. The application shall be in writing or reduced to writing on forms prescribed by the state department and shall include a statement subscribed by the applicant certifying that the contents of the application are true under penalty of perjury. The application shall bear the applicant's signature, which may be electronic. The application shall contain a statement of the amount of property both personal and real in which the applicant has an interest and of all income that the applicant has at the time of filing the application, and a statement of any property assigned or transferred by the applicant within one year immediately before filing the application for assistance, and any further information prescribed by the state department.

B. The department shall use application forms that contain appropriate notice of the penalties for fraud, including notice that it is mandatory for a recipient to cooperate with a fraud investigation and that any failure to cooperate may result in a case closure and the termination of benefits within ten days of notice of the termination from the department. The department shall deliver to each recipient before the first payment of assistance or delivery of service and each redetermination thereafter a notice explaining what changes in circumstances require written notification to the department pursuant to section 46-213, subsection A.