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Applications for licenses required in this chapter shall be made in writing to the Division on forms provided by the Division and shall contain, but not be limited to, the following information:

(a) The name, home address and date of the birth of the applicant.

(b) The trade name and address of the establishment.

(c) Whether the applicant is a person, corporation or partnership.

(1) If the applicant is a corporation, the application shall contain the registered agent’s name, home address and date of birth.

(2) If the applicant is a partnership, the application shall include the names, home addresses and date of births of the partners.

(d) The signature of all applicants and their agents to confirm that all information on the application is correct and acknowledge that any change in the information on the application shall be reported to the Health Officer within 14 days of the change. [Code § 16.01-5, 2018.]