A copy of an application for insurance or a notice of proposed insurance delivered under Section 1153.158 must:
(1) be signed by the debtor;
(2) specify:
(A) the name and home office address of the insurer;
(B) the name of each debtor;
(C) the full amount of the premium or the total identifiable insurance charge, if any, to be paid by the debtor, separately for credit life insurance and credit accident and health insurance; and
(D) the amount, term, and a brief description of the coverage to be provided;
(3) refer exclusively to insurance coverage;
(4) be separate from the instrument or agreement for the loan or sale or other credit statement of account, unless the information required by this section is prominently set forth in that instrument, agreement, or statement; and
(5) provide that on acceptance by the insurer, the insurance becomes effective as provided by Section 1153.157.