(a) An applicant for a license must apply in a form and in a medium as prescribed by the commissioner. The application must state or contain, as applicable:

1. (1) the legal name and residential and business addresses of the applicant and any fictitious or trade name used by the applicant in conducting business;
2. (2) a list of any criminal convictions of the applicant and any material litigation in which the applicant has been involved in the ten-year period next preceding the submission of the application;
3. (3) a description of any money transmission previously provided by the applicant and the money transmission that the applicant seeks to provide in this state;
4. (4) a list of the applicant's proposed authorized delegates and the locations in this state where the applicant and the applicant's authorized delegates propose to engage in money transmission;
5. (5) a list of other states in which the applicant is licensed to engage in money transmission and any license revocations, suspensions, or other disciplinary action taken against the applicant in another state;
6. (6) information concerning any bankruptcy or receivership proceedings affecting the licensee or a person in control of a licensee;
7. (7) a sample form of contract for authorized delegates, if applicable;
8. (8) a sample form of payment instrument or stored value, as applicable;
9. (9) the name and address of any federally insured depository financial institution through which the applicant plans to conduct money transmission; and
10. (10) any other information the commissioner or NMLS reasonably requires with respect to the applicant.

(b) If an applicant is a corporation, limited liability company, partnership, or other legal entity, the applicant must also provide:

1. (1) the date of the applicant's incorporation or formation and state or country of incorporation or formation;
2. (2) if applicable, a certificate of good standing from the state or country in which the applicant is incorporated or formed;
3. (3) a brief description of the structure or organization of the applicant, including any parents or subsidiaries of the applicant, and whether any parents or subsidiaries are publicly traded;
4. (4) the legal name, any fictitious or trade name, all business and residential addresses, and the employment, as applicable, in the ten-year period next preceding the submission of the application of each key individual and person in control of the applicant;
5. (5) a list of any criminal convictions and material litigation in which a person in control of the applicant that is not an individual has been involved in the ten-year period preceding the submission of the application;
6. (6) a copy of audited financial statements of the applicant for the most recent fiscal year and for the two-year period next preceding the submission of the application or, if the commissioner deems acceptable, certified unaudited financial statements for the most recent fiscal year or other period acceptable to the commissioner;
7. (7) a certified copy of unaudited financial statements of the applicant for the most recent fiscal quarter;
8. (8) if the applicant is a publicly traded corporation, a copy of the most recent report filed with the United States Securities and Exchange Commission under section 13 of the federal Securities Exchange Act of 1934, United States Code, title 15, section 78m, as amended or recodified from time to time;

9. (9) if the applicant is a wholly owned subsidiary of:

   1. (i) a corporation publicly traded in the United States, a copy of audited financial statements for the parent corporation for the most recent fiscal year or a copy of the parent corporation's most recent report filed under section 13 of the Securities Exchange Act of 1934, United States Code, title 15, section 78m, as amended or recodified from time to time; or
   2. (ii) a corporation publicly traded outside the United States, a copy of similar documentation filed with the regulator of the parent corporation's domicile outside the United States;
10. (10) the name and address of the applicant's registered agent in this state; and
11. (11) any other information the commissioner reasonably requires with respect to the applicant.