a. Insurance claims forms shall contain a statement in a form approved by the commissioner that clearly states in substance the following: “Any person who knowingly files a statement of claim containing any false or misleading information is subject to criminal and civil penalties.” b. (Deleted by P.L. 1987, c. 342) c. Insurance application forms shall contain a statement in a form approved by the commissioner that clearly states in substance the following: “Any person who includes any false or misleading information on an application for an insurance policy is subject to criminal and civil penalties.” NJAC 11:16-1.2 (a) Insurers shall either place on or attach to all claim forms the following warning: “Any person who knowingly files a a statement of claim containing any false or misleading information is subject to criminal and civil penalties.” (b) Pursuant to NJSA 17:33A-6, all applications for insurance shall prominently and clearly contain the following statement: “Any person who includes any false or misleading information on an application for an insurance policy is subject to criminal and civil penalties.” (c) In lieu of the statement in (a) or (b) above, insurers may use a substantially similar statement with the prior approval of the Commissioner. 1. The Commissioner may approve the use of a statement substantially similar to that set forth above upon finding that the statement properly describes the prohibited conduct and references both criminal and civil penalties. 2. Request for approval of substantially similar statements shall be directed to the Department at the following address: Division of Anti Fraud Compliance New Jersey Department of Banking and Insurance PO Box 324 Trenton, NJ 08625-0324