§ 573. Statement of registration. Each statement of registration
hereinbefore required shall contain the following information:

1. The name and principal address of the company;

2. The state of its incorporation or origin;

3. The names and addresses of its principal officers, partners or
proprietors;

4. The address of its principal office in this state;

5. The name and address of its principal officer, employee or agent
therein;

6. The addresses of the places where its stamps are redeemable
therein;

7. A short form of its balance sheet as of the end of its last fiscal
year prior to such filing, certified by an independent public accountant
or certified under oath by one of its principal officers, a partner or
the proprietor.

8. A statement of its total gross receipts from its business in this
state as a trading stamp company during such last fiscal year, certified
by an independent public accountant or certified under oath by one of
its principal officers, a partner or the proprietor, unless the
principal sum of the bond hereinafter required is the maximum amount
required under this article.