(a) The name of the foreign investment trust and the state or country under the laws of which it is organized.

(b) That the foreign investment trust is not transacting business in this state.

(c) That the foreign investment trust surrenders its authority to transact business in this state.

(d) That the foreign investment trust revokes the authority of its registered agent in this state to accept service of process and consents that service of process in any action, suit or proceeding based upon any cause of action arising in this state during the time the foreign investment trust was authorized to transact business in this state may thereafter be made on such foreign investment trust by service thereof on the secretary of state.

(e) A post-office address to which the secretary of state may mail a copy of any process against the foreign investment trust that may be served on him.

(f) Such additional information as may be necessary or appropriate in order to enable the secretary of state to determine and assess any unpaid fees payable by such foreign investment trust as in Sections 79-15-101 through 79-15-139 prescribed, and a certificate of the state tax commission that the foreign investment trust owes no sales taxes.

The application for withdrawal shall be made on forms prescribed and furnished by the secretary of state and shall be executed by the trust by at least three (3) of its trustees and verified by them, or if the foreign investment trust is in the hands of a receiver or trustee, shall be executed on behalf of the foreign investment trust by such receiver or trustee and verified by him.