Before formation of a cooperative financial institution under this chapter, originating members who wish to associate themselves in a cooperative financial institution shall sign and execute an organization certificate on a form prescribed by the commissioner, which must state:

1. The name of the cooperative financial institution. The name may not be the name of any other bank, credit union, or financial institution previously incorporated within the this state;

2. The location of the principal office of the cooperative financial institution at which business will be conducted;

3. The names and places of residence of the originating members; and

4. The respective dates on which the cooperative financial institution will commence business.