(1) The name, address and telephone number of the applicant.

(2) The applicant's qualifications meeting the standards of Section 5326 of this subchapter.

(3) A disclosure of any licenses issued to the applicant by the department pursuant to this chapter.

(4) A disclosure of any convictions of misdemeanors or felonies.

(5) The applicant's signature certifying to the accuracy of the application.

(6) For each new applicant, fingerprints must be submitted through the Live Scan fingerprint process. Unless exempted by DOJ, applicants shall provide a properly completed and legible copy of a Request for Live Scan Service, form HCD OL 8016 (New 11/05), which is incorporated by reference, or the equivalent form provided by DOJ. The form HCD OL 8016 or DOJ equivalent form must provide evidence that the fingerprints have been submitted to DOJ and that the department is properly listed as the agency to receive any criminal history information. Applicants applying for an exemption from the Live Scan process must submit their exemption requests through the department on the forms prescribed by DOJ. Fingerprints must be processed by a law enforcement agency or a DOJ-certified fingerprint roller. Additional fingerprinting may be required if the submitted fingerprints are rejected by DOJ or the Federal Bureau of Investigation.

(7) Two (2) full facial photographs, minimum size 1 ¼ ″ x 1″, taken from a maximum distance of six (6) feet.