Application for a permit to receive explosives shall be made by filing a sworn statement with the Director of Revenue and Taxation, upon a form prescribed by the Director showing:
(a) The name and address of the applicant;

(b) The place where and the purpose for which the explosives are intended to be used;

(c) The employer or agent designated to receive the explosives and the means by which the same are to be transported.
SOURCE: GC § 8928.