(3) "Disclosure statement" means a notarized, written statement by the applicant containing:
- (A) A complete list of business names or identities under which the applicant has previously operated a business engaged in carrying passengers for hire;
- (B) A complete list of names used by affiliated persons or the owner or owners of the applicant entity within the previous ten (10) years;
- (C) The case style, case number, or a copy of a judgment entered or lien filed against the applicant or any affiliated person; and
- (D) The case style, case number, or copy of pleadings of any bankruptcy proceeding in which the applicant or an affiliated person was named as a debtor or a discharge of a debt against the applicant or an affiliated person was obtained;