§ 2b

Every application for assistance made under this chapter shall be in writing on application forms prescribed by the commissioner and shall include but not be limited to the following; the name, age and residence of the applicant; the name, date and place of birth of each dependent; the social security number of the applicant, the spouse and all dependent children over sixteen years of age; a list of any motor vehicle or trailer owned by the applicant or dependent; wages, salaries, pensions, fees, tips, bonuses and all other sources of income of all such persons; said application form shall include a statement not inconsistent with federal regulations giving consent to the department to investigate all facts related to the applicant's eligibility for assistance.\nThe application form prescribed in paragraph one shall contain a statement that it is signed by the applicant under the penalties of perjury.