A. The relative providing informal kinship care shall submit to the receiving agency an affidavit verifying the informal kinship care relationship.
B. The affidavit shall include:
(1) The name and date of birth of the child;
(2) The name and address of the child's parent or legal guardian;
(3) The name and address of the relative providing informal kinship care;
(4) The date the relative assumed informal kinship care;
(5) The nature of the serious family hardship and why it resulted in informal kinship care;
(6) The kinship relation to the child of the relative providing informal kinship care;
(7) The name and address of the school the child previously attended;
(8) Notice that the county superintendent may verify the facts given by the relative providing informal kinship care in the affidavit and conduct an audit of the case after the child has been enrolled in the county public school system;
(9) Notice that if fraud or misrepresentation is discovered during an audit, the county superintendent shall remove the child from the public school or county public school system roll;
(10) Notice that any person who willfully makes a material misrepresentation in the affidavit shall be subject to a penalty payable to the county for three times the prorated share of tuition for the time the child fraudulently attends a public school in the county; and
(11) Attached instructions that:
(a) Explain the necessity for both an affidavit and supporting documentation of the serious family hardship resulting in informal kinship care; and
(b) Encourage the relative providing informal kinship care to submit the affidavit and supporting documentation before September 30 of each year.