Any affidavit filed for reinstatement of driving and/or registration privilege shall include, but shall not be limited to the following items:

1. (1) Date and location of accident;
2. (2) Effective date of suspension; and
3. (3) Statement that one (1) year has elapsed following the date of suspension and that during such period no action at law upon such agreement has been instituted and is pending.

Codification Notes: This section as promulgated prior to codification into the Code of Arkansas Rules provided as follows: "8-27-19-612 FORM OF THE AFFIDAVIT"