5.   A business shall apply to the authority for a grant on a form prescribed by the authority which shall include:

   a.   The name of the business, the proposed location of the project, and the type of activity which will be engaged in at the project site;

   b.   The names and addresses of the principals or management of the business, and the nature of the form of business organization under which it is operated;

   c.   The most recent financial statement of the business;

   d.   The number of eligible positions proposed to be created during the base years and thereafter; and

   e.   An estimate of the total withholdings.

   L.1996,c.26,s.5; amended 2003, c.166, s.3.