Hawaii Revised Statutes Division 2. Business § 431:4-233

(1) The name and address of the insurer;

(2) Detailed information about the participant;

(3) The participant's interest in the stock of the insurer;

(4) A description of the time and circumstances in which the participant became involved with the solicitation and the nature and extent of the activities or proposed activities of the participant; and

(5) The date and signature of the participant.