Arizona Revised Statutes Title 20. Insurance § 20-466.03. Notice of penalty for false or fraudulent claims;  definition

A. The claims forms provided by an insurer to an insured or any other person for filing a notice or making a claim in connection with a policy or contract issued by the insurer shall include in substance the following statement in at least twelve point type:  “For your protection Arizona law requires the following statement to appear on this form.  Any person who knowingly presents a false or fraudulent claim for payment of a loss is subject to criminal and civil penalties.”

B. For the purposes of this section, “claims form” means any document supplied by an insurer to an insured, claimant or other person that the insured, claimant or other person is required to complete and submit in support of a claim for benefits.