(b) Eligible applicants are applicants who:

1. (1) Are receiving assistance through the:

   1. (A) Arkansas, or current state of residence equivalent, Medicaid Program;
   2. (B) Supplemental Nutrition Assistance Program (SNAP);
   3. (C) Special Supplemental Nutrition Program for Women, Infants, and Children (WIC);
   4. (D) Temporary Assistance for Needy Families Program (TEA); or
   5. (E) Lifeline Assistance Program (LAP);
2. (2) Were approved for unemployment within the last twelve (12) months; or
3. (3) Have an income that does not exceed two hundred percent (200%) of the federal poverty income guidelines.

(c)

1. (1) Applicants shall provide documentation showing their receipt of benefits from the appropriate state agency.
2. (2) For Medicaid, SNAP, WIC, TEA, or LAP, documentation from the Department of Human Services, or current state of residence equivalent agency.
3. (3) For unemployment benefits approval in the last twelve (12) months, the Division of Workforce Services or current state of residence equivalent agency; or
4. (4) For proof of income, copies of all Internal Revenue Service forms indicating applicant’s total personal income for the most recent tax year, e.g., W-2, 1099, etc.

(d) Applicants shall attest that:

1. (1) The documentation provided under subsection (c) of this section is a true and correct copy; and
2. (2) Fraudulent or fraudulently obtained documentation shall be grounds for denial or revocation of license.