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Organization Name <br />Address <br />M All � Mi mit <br />Mike Gralish -i 514' <br />Type of orgainlization <br />0 Fraternal El Veterian�s <br />0 Religion EX Othier Nonpitiofit Organization <br />Preirnises Address <br />11 4 5 Tgaed-V rwil—Dras N-e <br />=4 <br />Raff les <br />-Rosevillier, Ramseyf Minnesota, 55113 <br />Manager's Name Phone Number <br />If Other Nonprotit Organization (Check One) <br />OCIRSDesignation Tax exempt., 50103,#237086360 <br />0 Inclorporated with Secretary of State <br />M A X4P"L1v#%+a% .%4: 0+%r -r%w-%+ <br />February 22, 19� <br />Profit <br />Tipbloards <br />X <br />f'�;.�a[? ?+!.��'•`,°} � Kc, •� 4. Ln"r } <br />4V,�,•��'V,, �i4V..'"r� '} <br />% <br />.k -, qe N'Yd' k e S°�, .9., <br />i1Y... <br />k"` V <br />C � d �v } y � ` Y <br />r�{ ,?!'l } t ! <br />F <br />} .. <br />t s'!�1'�„', Fv .. <br />i, <br />. 'Lr3 i u <br />} 4, y�k <br />•. ° <br />Plull-Ta',bs- <br />X <br />0 <br />j", S.- • <br />T <br />-1A <br />V <br />........... . . ................................................... <br />r 4. 1 Y - . . :.". - , , <br />Use of Profit W, <br />46 - <br />Fund E S, or, id <br />e -an e U. I p�fte n <br />Oil <br />Distributor Fr rn-W66r� G�4�61!nq- t quipment A,6qulred' <br />s <br />Distributor S License No. <br />-4 <br />None'... <br />I affirm all information submitted to the Bloard is true,, ac u- <br />I affirm all -financial information submitted to the Board 1* S <br />fate, ainld complete. <br />tru, e, accurate; and complete <br />f -P) 21'.*4111 5?0 71 <br />IM . r <br />��4 0 MY 11[4 0 -10 "T 1 �4 k S JJ nel I L01 IMI&ITA 4 I'Lik, IN, LMill W4 <br />