(a) Through its proper officer or agent, each licensee promptly shall notify the Commissioner of the name, title, and address of each individual the licensee desires to appoint as a representative in the State.
(b) The notice required by this section shall be:
(1) filed with the Commissioner on the form that the Commissioner provides; and
(2) accompanied by:
(i) an initial registration fee of $5; and
(ii) a statement in writing, by the appointee, that gives:
1. the appointee’s name, age, residence address, business address, present occupation, and occupation for the 5 years immediately preceding the date of the notice;
2. the names of motor clubs represented during the 5 years immediately preceding the date of the notice and where represented; and
3. any other information the Commissioner requires.