(a)

1. (1) Applicants for licenses shall:

   1. (A) File applications under oath with the Office of Long-Term Care upon forms prescribed by the Division of Medical Services; and
   2. (B)

(i) Pay an annual fee of ten dollars ($10.00) to the division.

1. (ii) Such fee shall be refunded if the license is denied.
2. (2) Applications shall be filed by the prospective licensee.

(b) Applications shall set forth the following information:

1. (1) The full name and address of the facility for which the license is requested;
2. (2) The name of each person owning, directly or indirectly, five percent (5%) or more of equity interest of the facility;
3. (3) The name and address of each officer and director, if the applicant is a corporation;
4. (4) The name of each partner, whether general or limited, if the applicant is a partnership;
5. (5) Such additional information as the division may require on the application form; and
6. (6) The agent name and address of the agent for service of process if the applicant is other than an individual.