An applicant for benefits under ORS 243.956 (5) to (10) shall file a supplemental application under oath on a form furnished by the Public Safety Memorial Fund Board. The supplemental application must include:
(1) The amount of benefits, payments or awards, if any, payable from any source, that the applicant has received or for which the applicant is eligible as a result of the qualifying death or disability of a public safety officer; and
(2) Any other information that the board determines is necessary.