Statements issued under the provisions of sections three and four of this act¹ by producers, wholesale dealers, retail dealers, and persons hauling anthracite from a railroad car direct to the consumer, and municipal weighmasters, shall set forth in ink or indelible pencil the date of the sale, resale or shipment of the anthracite, to whom sold, delivered or shipped, the size and weight of the anthracite, the registration of the vehicle in which the anthracite is being transported, and, in the case of wholesale dealers and producers, the railroad car number and the model of the vehicle in which the anthracite is transported: Provided, That any information appearing on the weighmaster's certificate need not be duplicated in the statement. Each statement shall bear the name under which the producer, wholesale dealer, retail dealer, or other person does business, and the signature or facsimile of the producer, wholesale dealer, retail dealer, or other person, if an individual, or of an officer or partner, if a corporation, partnership or association, or the signature or facsimile signature of the municipal weighmaster, where a statement of quality is issued by such weighmaster under the provisions of this act.²