(2) The tenant or household member of a tenant who is the victim:
(A) Initiates legal action to obtain a protective order and provides written verification thereof to the lessor or owner; or
(B) Reports the domestic violence, sexual assault, or stalking to a law enforcement agency and provides written verification thereof to the lessor or owner; or
(C) Provides written verification from a law enforcement official, victim's advocate, attorney, or health care provider that he or she is a victim of domestic violence, sexual assault, or stalking; or
(D) Provides a signed self-certification form provided by the circuit court. The circuit court shall develop and provide forms for self-certification modeled after those developed by the New Hampshire housing finance authority in accordance with the Violence Against Women Act, 24 CFR section 5.2007(b)(1)(i). The self-certification form developed by the circuit court shall include the same information as is required by 24 CFR section 5.2005(a)(1)(ii); and
(i) Language swearing that the facts provided by the tenant in the self-certification form are true and accurate to the best of their knowledge and recollection; and
(ii) Language informing the tenant that false statements may be subject to criminal penalties, including potentially perjury.