The return shall be filed with the administrator on a form or forms furnished by or obtainable upon request from such Administrator, setting forth:
(a) The aggregate amounts of salaries, wages, commissions, lottery winnings, other gambling winnings, other compensation and other income earned or received and gross income from business, profession or other activity, less allowable expenses incurred in the acquisition of such gross income earned or received during the preceding year and subject to said tax; and
(b) The amount of the tax imposed by this chapter on such income; and
(c) Such other pertinent statements or other information as the Administrator may require. (1969 Code 92.16)