1. (a) the name and business address of the person filing the statement; and, if a corporation, the state of incorporation;
2. (b) the nature of the business of the person filing; and

3. (c) the type of container with which the name, mark or device is used.

   The statement shall include or be accompanied by a copy, specimen, facsimile or counterpart of such name or mark, together with the filing fee prescribed by section 96 of the Executive Law.

A person who uses a name or mark to indicate ownership of carts, cases, trays, baskets, boxes and other containers may file in the Office of the Secretary of State, on a form to be furnished by the Secretary, the following information: