The report of a corporation seeking to qualify hereunder as a family farm corporation or an authorized farm corporation shall contain, in addition:
(1) The number of shares owned by persons residing on the farm or actively engaged in farming, or their relatives within the third degree of kindred;
(2) The name, address, and number of shares owned by each shareholder; and
(3) A statement as to percentage of gross receipts of the corporation derived from rent, royalties, dividends, interest, and annuities.