(1) A clear and concise statement of each error which the petitioner alleges to have been committed by the commission in refusing to issue a license, or suspending or revoking a license, with each assignment of error being shown in separately numbered paragraphs;
(2) A clear and concise statement of fact upon which the petitioner relies as sustaining each assignment of error;
(3) A prayer setting forth the relief sought;
(4) The signature of the petitioner; and
(5) Verification by the petitioner.
(b) The person demanding a hearing shall give security for the cost of the hearing in the amount of three hundred dollars in the form of a certified check, cashier's check or money order, which shall accompany the petition demanding a hearing.