Each non-coal surface mining permit application shall contain:

1. (1) statement of whether the applicant, any subsidiary, affiliate, or persons controlled by or under the common control with the applicant has:

   1. (A) Had a mining permit suspended or revoked in the last five years; or
   2. (B) Forfeited a mining bond or similar security deposited in lieu of such bond.

2. (2) If any such suspension, revocation, or forfeiture has occurred, a statement of the involved, including;

   1. (A) Identification number and date of issuance of the permit or date and amount of the bond or similar security;
   2. (B) The current status of the permit, bond, or similar security involved;
   3. (C) The date, location, and type of any administrative or judicial proceedings initiated concerning the suspension, revocation, or forfeiture; and
   4. (D) The current status of these proceedings.