Each applicant shall sign the application which acknowledges the statement below:

"I acknowledge that, under RSA 641:3, I, knowingly making a false statement on this application form is a misdemeanor. I certify that the information I have provided on all parts of the application form and in the documents that I have personally submitted to support my

application is complete and accurate to the best of my knowledge and belief. I also certify that I have read RSA 153:27 through RSA 153:38 and the rules of the board and will abide by them."

Source. #10648, EMERGENCY RULE, eff 7-25-14, EXPIRES: 1-21-15; ss by #10761, INTERIM, eff 1-21-15, EXPIRES: 7-20-15; ss by #10847, eff 7-1-15