Application for an agent's or dealer's license shall be made to the department upon forms prescribed and furnished by the department, and the application shall state:
(1) the applicant's name, principal address in this state, and age;
(2) the applicant's principal address in any location outside Utah;
(3) the name and principal address of the person authorized by the applicant to accept service of process in this state on behalf of the applicant during the licensure period;
(4) the name and principal address of the applicant's surety if the application is for a dealer's license;
(5) a schedule of the commissions, fees, and other charges the applicant intends to collect for services during the period of licensure;
(6) the name and address of each principal the applicant intends to represent during the period of licensure; and
(7) any other information that the department may require by rule.