"I declare that, to the best of my knowledge and belief, the information provided on this form is true, correct and complete and acknowledge that knowingly making of a false statement on this form is punishable by law, including by the imposition of those penalties set forth at RSA 284: 14-d, II" and
N.H. Admin. Code § Pari 811.05
#8238, INTERIM, eff 1-1-05, EXPIRES: 6-30-05; ss by #8320, eff 6-30-05