On or before the 20th day of each month after the county commission has imposed the additional excise tax, each person upon whom the excise tax is imposed shall furnish to the county commission on forms prescribed by it a true and correct statement of all sales and withdrawals of gasoline or motor fuel made by that person during the preceding month. Each person shall furnish to the county commission any additional information required by the county commission and shall pay to the tax collector an amount of money equal to the excise tax due under this part. The statement made by the distributor, retail dealer, or storer shall be sworn to before an officer authorized to administer oaths and any false statement sworn to shall constitute perjury and, upon conviction, the person so convicted shall be punished as provided by law.