The department shall prescribe and furnish the form of application for dealer registration under AS 08.66.010. The application must contain (1) the name under which the business is conducted;
(2) the location and telephone number of the business;
(3) the name and address of all persons having an interest in the business and, in the case of a corporation, the application shall contain the name and address of the two principal officers;
(4) the name and make of all vehicles handled;
(5) a statement of whether or not used vehicles are handled;
(6) a statement that the applicant is a bona fide dealer in motor vehicles with an established business at the location given;
(7) a statement that no person holding a five percent or greater interest in the business has, during the five-year period immediately preceding the date of the application, been convicted of a felony if the felony involved fraud, embezzlement, or misappropriation of property;
(8) a statement that the applicant has reviewed the workers' compensation insurance requirements of AS 23.30 and will maintain applicable workers' compensation insurance as required under AS 23.30;
(9) a copy of a certificate of insurance documenting that the applicant maintains the insurance coverage required under AS 08.66.085;
(10) if the applicant sells a motor vehicle as a new or current model motor vehicle having a manufacturer's warranty, the name of the manufacturer of the motor vehicle and the date and duration of the applicant's sales and service agreement with the manufacturer; and
(11) other information the department requires to administer this chapter.