The form for a fund claim shall be executed under penalty of unsworn falsification in the second degree and must include (1) the name and address of each mortgage loan originator licensee involved; (2) the amount of the alleged loss; (3) the date or period of time during which the alleged loss occurred; (4) the date when the alleged loss was discovered; (5) the name and address of the claimant; and (6) a general statement of the facts related to the fund claim.
Alaska Legal Code