Section 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.