Utah Code § 4-7-106

Application for an agent's or dealer's license shall be made to the department upon forms prescribed and furnished by the department, and the application shall state: (1) the applicant's name, principal address in this state, and age; (2) the applicant's principal address in any location outside Utah; (3) the name and principal address of the person authorized by the applicant to accept service of process in this state on behalf of the applicant during the licensure period; (4) the name and principal address of the applicant's surety if the application is for a dealer's license; (5) a schedule of the commissions, fees, and other charges the applicant intends to collect for services during the period of licensure; (6) the name and address of each principal the applicant intends to represent during the period of licensure; and (7) any other information that the department may require by rule.