Application for license shall be verified by oath or affidavit and contain the following information:
(A) The name, age and address of the applicant in the case of an individual and, in the case of a co-partnership, of the persons entitled to share in the profits thereof; and in the case of a corporation, the date of incorporation, the objects for which it was organized, the names and addresses of the officers and directors; and if a majority in interest of the stock of such corporation is owned by one person or his or her nominee(s), the name and address of such person(s);
(B) The citizenship of the applicant, his or her place of birth, or if a naturalized citizen, the time and place of his or her naturalization;
(C) The address of the place where the applicant proposes to operate;
(D) A statement whether the applicant has made a similar application for a similar license on premises other than those described in the application and the disposition of such other application;
(E) A statement that the applicant has never been convicted of a felony and is not disqualified to receive the license under this section; and
(F) The trade name and general description of the device or devices to be permitted, the name of the manufacturer and the serial number and the number of devices to be licensed.
(1999 Code, § 7-4-3)