(1) Each licensee shall submit a report of authorized delegates within forty-five days after the end of each calendar quarter. The director is authorized to utilize the Nationwide Mortgage Licensing System and Registry for the submission of the report required by this section provided that such functionality is consistent with the requirements of this section.

(2) The authorized delegate report shall include, at a minimum, each authorized delegate's:

(a) Company legal name;

(b) Taxpayer employer identification number;

(c) Principal provider identifier;

(d) Physical address;

(e) Mailing address;

(f) Business conducted in other states;

(g) Fictitious or trade names;

(h) Contact person name, telephone number, and email;

(i) Start date as the licensee's authorized delegate;

(j) End date acting as the licensee's authorized delegate, if applicable; and

(k) Any other information the director reasonably requires with respect to the authorized delegate.