Any application for a certificate shall be signed and sworn to by the person or executive officer of the association or corporation making such application and shall contain the following information:
   I. Full name and address of the person, association, or corporation.
   II. If an association, the names and residences of the members of the association.
   III. If a corporation, the name of the state under which it is incorporated with its principal place of business and the names and addresses of its directors, officers and stockholders.
   IV. The location or locations where an applicant is to conduct its business.
   V. A statement of assets and liabilities of the applicant and other relevant financial information of such applicant.
Source. 1991, 295:1, eff. Jan. 1, 1992.