Indiana Code Title 4. State Offices and Administration § 4-33-8-5

(1) be made on forms prescribed by the commission;  and

(2) contain all information required by the commission.

(1) If the applicant has held other licenses relating to gambling.

(2) If the applicant has been licensed in any other state under any other name.  The applicant must provide under this subdivision the name under which the applicant was licensed in the other state.

(3) The applicant's age.

(4) If a permit or license issued to the applicant in another state has been suspended, restricted, or revoked.  The applicant must describe the date and length of a suspension, restriction, or revocation described in this subdivision.