A person is guilty of a class B misdemeanor if:

1. (1) He makes a written false statement which he does not believe to be true on or pursuant to a form bearing a notification authorized by law to the effect that false statements made therein are punishable; or

2. (2) With intent to deceive a public servant in the performance of his official function, he:

   1. (a) Makes any written false statement which he does not believe to be true; or
   2. (b) Knowingly creates a false impression in a written application for any pecuniary or other benefit by omitting information necessary to prevent statements therein from being misleading; or
   3. (c) Submits or invites reliance on any writing which he knows to be lacking in authenticity; or
   4. (d) Submits or invites reliance on any sample, specimen, map, boundary mark, or other object which he knows to be false.
3. (3) No person shall be guilty under this section if he retracts the falsification before it becomes manifest that the falsification was or would be exposed.