1.  Name and address.  The name and local and permanent business address of the applicant;  

2.  Employees of applicant.  Names of all employees of the applicant employed in this State;  

3.  Statement.  A statement of all judgments secured or outstanding against the applicant arising out of sales to consumers during the 2 years immediately prior to making the application and of all suits of either a criminal or civil nature pending against the applicant that arise out of sales to consumers, at the time of making the application;  

4.  Statement of yearly gross revenues.  A statement of anticipated yearly gross revenues from sales of consumer merchandise in this State;  

5.  Security deposits.  The name and address of the person to whom security deposits made with the department pursuant to this subchapter are returned; and  

6.  Seller's certificate.  The number of a valid registration certificate issued to the applicant by the State Tax Assessor pursuant to Title 36, chapter 211 or satisfactory evidence that the applicant is not required to be registered under that chapter.