Applications for annual placement on the Centralized List shall be filed on DOJ form BOF 4080 (Rev. 12/2019) which will require the following information signed, dated, and certified under penalty of perjury: applicant's name; dealership name; dealership physical address; dealership mailing address; dealership telephone number; dealership telephone facsimile number (if any); days and hours of operation; local licensing authority; local law enforcement agency; local inspection authority (if any); DOJ Certificate of Eligibility (COE) number and expiration date; Federal Firearms License (FFL) number and expiration date; local firearms license number and expiration date; and, the State Board of Equalization Seller's Permit number. The application shall include copies of the current FFL, COE, local firearms license, and State Board of Equalization Seller's Permit.