The application for a commercial learner's permit or commercial driver license, shall include the following:
(1) The full legal name and current mailing and residential address of the applicant;
(2) A physical description of the applicant including sex, height, weight, and eye color;
(3) Date of birth;
(4) The applicant's social security number;
(5) The applicant's signature;
(6) The applicant's color photograph;
(7) Certifications including those required by 49 C.F.R. Part 383.71(a) as amended through January 1, 2015;
(8) A consent to release driving record information; and
(9) The names of each state where the applicant has previously been licensed to drive any type of motor vehicle during the ten-year period immediately preceding the date of the application.