Any noncustodial parent in the Commonwealth whose absence or failure to provide support and maintenance is the basis upon which an application is filed for child support services or public assistance and any custodial parent who applies for public assistance or child support services shall be required to complete a statement of his or her current monthly income, his or her total income over the past twelve months, amounts due from or to such person or parent under any court or administrative orders for support of a child or child and spouse, the number of dependents for whom he or she is providing support, the amount he or she is contributing regularly toward the support of all children or custodial parents for whom application is made, and such other information as is pertinent to determining his or her ability to support his or her children or custodial parent. Such noncustodial parent shall certify under penalty of perjury the correctness of the statement. Such statement shall be provided upon demand made by the Department or any attorney representing the Department. Additional statements shall be filed annually thereafter with the Department as long as a debt to the Department exists or as long as there is an authorization for the Department to collect or enforce a support obligation. Failure to comply with this section shall constitute a Class 4 misdemeanor.