(2)__"Is there a formal charging instrument now pending against you in this or any other jurisdiction for a juvenile offense that involves conduct that, if committed by an adult, would be punishable by imprisonment for one year or more or would constitute a misdemeanor crime of domestic violence?"

(3) "Have you ever been convicted of a crime described in subparagraph (1)__or adjudicated as having committed a juvenile offense as described in subparagraph (2)?"

(4)__"Are you a fugitive from justice?"

(5)__"Are you a drug abuser, drug addict or drug- dependent person?"

(6)__"Have you been discharged from the United States Armed Forces under dishonorable circumstances within the past 5 years?"

(7)__"Are you an illegal alien?"

(8)__"Have you been convicted within the past 3 years of 3 or more crimes punishable by imprisonment of less than one year?"

(9)__"Have you been adjudged within the past 3 years to have committed 3 or more juvenile offenses involving conduct that, if committed by an adult, would be punishable by imprisonment of less than one year?"

(10)__"To your knowledge, have you engaged within the past 3 years in reckless or negligent conduct that is substantiated by the records of a governmental entity?"

2.__Signature as certification.__The applicant, by affixing the applicant's signature to the application, certifies the following:

A.__That the statements made in the application and any documents made a part of the application are true and correct;

B.__That the applicant understands that an affirmative answer to one or more of the questions in subsection 1, paragraph D is cause for refusal; and