(a) A disclaimer of affiliation or a request for termination of registration claiming that a person does not, or will not upon the taking of some proposed action, control another person, hereinafter referred to as the "subject", shall contain the following information:

1. (1) The number of authorized, issued, and outstanding voting securities of the subject;

2. (2) With respect to the person whose control is denied and all affiliates of such person:

   1. (A) The number and percentage of shares of the subject's voting securities which are held of record or known to be beneficially owned; and
   2. (B) The number of shares concerning which there is a right to acquire, directly or indirectly;
3. (3) All material relationships and bases for affiliation between the subject and the person whose control is denied and all affiliates of such person; and
4. (4) A statement explaining why the person should not be considered to control the subject.