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Attachment A <br /> CITY of ROMMILLS, NI ROTA <br /> FOR PAWN SHOP/PRE ICUS METAL DEER L3:CMTJIS <br /> Fart I - Ceneral Info=ation <br /> anua r .1 2012 t:hroUgh DOC der 31� 2012 <br /> Directions: <br /> Please complete with typewriter or by printing in ink. If <br /> the <br /> application is by a natural person, by such person; if � <br /> corporation, b an officer � e � � <br /> thereof iy a partnership, by one of <br /> the partners; if by an unincorporated assooi.ation by the manager <br /> or Managing officer thereof, <br /> 1. Name of Applicant (name- of individual, partnership, <br /> corporation, or association) <br /> Pawn America Minnesota, LLC <br /> (If Individual,) LAST FIRST FULL M31DDLE <br /> NAMS <br /> 2. Name under which applicant will be doing business, hueines <br /> address,, and telephone number <br /> Full Name Pawn America Minnesota, LLC/Pavan America <br /> Bus i_nes s Add ress 181 o River Ridge Circle, Burn svirle, SIN 55337 <br /> Business Telephone 952-646-1760 <br /> 3, Type of Appl ieant <br /> Individual Partners hip Corporation <br /> ;association Limited Liability Company �tY� <br /> 4. Type of License applicant seeks: <br /> W Re of License Pexmit FQe Per <br /> Year <br /> Pawn Shop to o0� <br /> � � #0 9 <br /> Precious Metal Dealer $10,000,00 <br /> XXX Pawn Shop and Precious Metal $13,000,00 <br /> Dealer <br /> 5. A. If applicant is an individual, state full name, <br /> and business address, anal telephone numbers t <br /> Name <br /> LAST FIRST FML NIDDLZ NAME' <br /> Date of Birth <br /> Residence Address <br />