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i <br /> STATE OF MINNESOTA OFFICE USE ONLY CASHIER USE ONLY <br /> DEPARTMENT OF COMMERCE Deputy <br /> DIVISION OF FINANCIAL EXAMINATIONS Asst. . <br /> 133 EAST STREET Chief <br /> Review ��� <br /> AU G <br /> S T. PAUL, MINNESOTA 55101 <br /> DataEntry <br /> (651)282-9855 cu=cy Excb ge HOC U <br /> • License Number Processing Date <br /> rr.ririrrrr 1 &In n ..M•n�i�ir.r�iii�.r• -- ini..irr�i�-rirm <br /> ON Surety Bond Number <br /> /I / e�17�6?cl�� <br /> CURRENCY EXCHANGE Insurance Company NAIC Number <br /> LICENSE APPLICATION <br /> The data, which you furnish on this form, will be used by the Department of Commerce to assess your <br /> qualifications for a license. Disclosure of your social security number is voluntary. You are not legally required <br /> to provide this data; however, if you do not provide your social security number, the Department of Commerce <br /> may be unable to grant a license. The Department may use social security numbers for revenue recapture as <br /> authorized by Minnesota Statutes, Chapter 270A and for identification purposes. After issuance of a license, all <br /> information contained in this application, except your social security number, is public pursuant to Minnesota <br /> Statutes, Chapter 13. <br /> A. TYPE OF LICENSE check one <br /> ❑ NEW ® RENEWAL L3 AMENDEDLICENSE <br /> I <br /> B. APPLICANT INFORMATION <br /> NAME OF CURRENCY EXCHANGE <br /> Pawn America Minnesota, L.L.C. <br /> NAME OF CORPORATION OR PAR SHIP <br /> Pawn America Minnesota, L.L.C. <br /> BUSINESS ADDRESS (No Post Office Boxes) <br /> 1715 North Rice Street <br /> CITY STATE ZIP CODE COUNTY <br /> Roseville MN 55113 Ramsey <br /> NAME OF INDIVIDUAL MANAGING THIS LOCATION STATE TAX ID NUMBER <br /> 5t6ve Caulfield 2773226 <br /> TELEPHONE NUMBER FAX ER E-MAIL ADDRESS <br /> t 6 51) 487-1595 ( 6 51) 487-1687 <br /> Check one: ❑ SOLE PROPRIETORSHIP ❑ASSOCIATION <br /> 0 PARTNERSHIP ❑ -LIABILITY PARTNERSHIP <br /> OCORPORATION LIAB=Y COMPANY <br /> May 31, 1996 Eagan Dakota Minnesota <br /> Date of Incorporation or Organization Place of Incorporation County State <br /> MNIDOC CURRENCY EXCHANGE APPL 7199 1 8/3/1999 <br />