(1) A person is guilty of unsworn falsification to authorities when, with an intent to mislead a public servant in the performance of his duty, he:
(a) Makes a material false written statement, which he does not believe, in an application for any pecuniary or other benefit or in a record required by law to be submitted to any governmental agency;
(b) Submits or invites reliance on any writing which he knows to be a forged instrument, as defined in KRS 516.010; or (c) Submits or invites reliance, except as provided in KRS 516.110, on any sample, specimen, map, boundary mark, or other object he knows to be false.
(2) Unsworn falsification to authorities is a Class B misdemeanor.