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(1) contains the following for the preceding calendar year:
(a) the name and address of any producer or associate that owns a financial interest in the new or newly affiliated title entity;
(b) for each producer and associate identified under Subsection (1)(a), the percentage of the new or newly affiliated title entity's affiliated business that is the result of an affiliated business arrangement with the producer or associate;
(c) a description of any affiliated business arrangement the new or newly affiliated title entity has with a person other than a producer or associate identified under Subsection (1)(a);
(d) the percentage of the new or newly affiliated title entity's annual title insurance business that is affiliated business;
(e) proof of sufficient capital and net worth; and
(f) any other information required by the division by rule; and
(2) is certified by an officer of the new or newly affiliated title entity that the information contained in the report is true to the best of the officer's knowledge, information, and belief.