Any person seeking a certificate of registration as a community association manager shall apply to the department on a form provided by the department. Such application shall include:

1. (a) Applicant's name;
2. (b) Applicant's business status (individual, partnership or corporation);
3. (c) Applicant's date of birth;
4. (d) Applicant's social security number or federal tax identification number;
5. (e) Applicant's residence address;
6. (f) Applicant's business address and telephone number;
7. (g) Any trade name used by the applicant;

8. (h) If the applicant is a corporation:

   1. (1) the names and residence addresses of the corporate officers;
   2. (2) a copy of the certificate of incorporation;
   3. (3) verification that it is a corporation in good standing with the state in which it is incorporated; and (4) the name and address of the agent for service of process;
9. (i) the names and addresses of the associations to be managed;
10. (j) proof of the existence of the bond required for each association by section 20-460 of the general statutes;

11. (k) a list of other businesses engaged in by the applicant;

    (l) a list of other professional or occupational licenses and registrations held by the applicant, and any past actions taken against such licenses or registrations;

12. (m) any past criminal convictions for the offenses listed in section 20-456 of the general statutes or any bankruptcy filings;
13. (n) any past changes of name; and
14. (o) the applicant's signature, or the signature of a person legally authorized to act on behalf of the applicant, verified under oath, and the date of the signature.

(Effective November 25, 1991)