Every applicant for certification by endorsement shall pay the required application fee, shall submit the information required by the Board in the manner and form specified by the Board, and shall submit written evidence that the applicant:
1. Is certified to practice as a nurse aide by another state or territory of the United States (with requirements that are essentially similar to the requirements for certification set out in this article) and that such certification is in good standing;
2. Has not committed any act or omission that would be grounds for discipline or denial of certification under this article;
3. Has no record of abuse, negligent practice, or misappropriation of a patient’s or resident’s property or any disciplinary action taken or pending in any other state or territory against such certification.