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PLEASE PROVIDE THE FOLLOWING INFORM TION ON LLNEW ORRENEW L PPLI TION : (unless otherwise noted) El All NEW applicants must provide a signed, notarized statement from the applicant Mating the proposed location of the currency exchange is not located within 1/2 mile of another currency exchange. LJ A current fee schedule of all fees charged by your currency exchange office for cashing checks, money orders or travelers' checks. The List MUST include the type of check cashed, the fee charged, and whether or not the fee varies depending on the amount of the check. *See Exhibit 4 LJ All owners, partners, officers, stockholders (owning 10% or more of the corporate stock), and employees with authority to exercise management or policy control over the company must request that the Bureau of Criminal Apprehension conduct a background investigation on the form provided. Completed form(s) MUST be submitted with your license or renewal application. *See Exhibit 5 LJ The work experience covering ten years prior to application for each person listed. *See Exhibit 2 LJ A surety bond for $10,000 (on the forms provided) with a power of attorney form. LJ A check or money order made payable to "Department of Commerce" for: New Applicants: $1500.00 ($1,000.00 non-refundable application fee and $500.00 licensing fee.) Amendment Fee: $100.00 License Renewal Fee $500.00 ❑ If applicant is a corporation, attach a copy of the Articles of Incorporation filed with the Secretary of State. The applicant is a Minnesota limited liability company. *Attached as Exhibit 6 is Pawn America Minnesota, LLC's Certificate of Organization and Articles of Organization. El If the applicant is a partnership, attach a copy of the Articles/Agreement of Partnership. ❑ The name under which the business will be conducted must be exactly the same as the name on your license. If operating under any name other than the exact corporate or partnership name or, if an individual proprietorship doing business under any name other than your first and last name, attach a copy of the Assumed Name Certificate by the Minnesota Secretary of State (651) 296-2803. To apply, complete (please type or print in ink) and submit this form with the required fee to the Department of Commerce,Division of Financial Examinations, 85 E. 7th Place Suite 500, St. Paul, NIN 55101. Check or money order must be payable to the "Department of Commerce".WE CANNOT ACCEPT CASH. Incomplete forms will be returned to the business address listed. For further information on the application process, applicants may contact the Division at (65 1) 282-9855 or via e-mail, financial state.mn.us. The application is available on the Commerce website, www.commerce.state.mn.us. 21035850 4