(a) The written application shall be submitted on a form prescribed by the board and shall include:
(1) The name, the street and mailing address and the contact information, including telephone number and e-mail address, of the person or firm seeking registration;
(2) The name, the street and mailing address and the contact information, including telephone number and e-mail address, of each owner of more than ten percent of the firm seeking registration;
(3) The name, the street and mailing address and the contact information, including telephone number and e-mail address, of the controlling person of the firm seeking registration; and
(4)(A) If the applicant is a domestic firm, the designation of an agent for service of process; or
(B) If the applicant is a foreign firm, documentation that the foreign firm is authorized to do business in West Virginia and that an agent for service of process has been designated and the following has been submitted:
(i) A copy of the filing with the Secretary of State’s Office appointing an agent for service of process; and
(ii) A certificate of authority issued by the Secretary of State.
(b) The board shall maintain a list of all applicants for registration that includes the information in the written application.