(a)

1. (1) An applicant shall receive a waiver of the initial licensure fee, if eligible.

2. (2) Eligible applicants are applicants who:

   1. (A) Are receiving assistance through the Arkansas Medicaid program, the Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Nutrition Program for Women, Infants, and Children (SSNP), the Temporary Assistance for Needy Families Program (TEA), or the Lifeline Assistance Program (LAP);
   2. (B) Were approved for unemployment within the last twelve (12) months; or
   3. (C) Have an income that does not exceed two hundred percent (200%) of the federal poverty income guidelines.

(b) Applicants shall provide documentation showing their receipt of benefits from the appropriate state agency:

1. (1) For Medicaid, SNAP, SSNP, TEA, or LAP, documentation from the Department of Human Services;
2. (2) For unemployment benefits approval in the last twelve (12) months, the Division of Workforce Services; or
3. (3) For proof of income, copies of all United States Internal Revenue Service forms indicating applicant’s total personal income for the most recent tax year, e.g., “W2”, “1099”, etc.

(c)

1. (1) Applicants shall attest that the documentation provided under subsection (b) of this section is a true and correct copy.
2. (2) Fraudulent or fraudulently obtained documentation shall be grounds for denial or revocation of license.