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<br />FROM LEONARD, STREET AND DEI NARD ' <br /> <br />STATE OF MINNESOTA' <br />DEPARTMENT OF COMMERCE <br />133 EAST SEVENTH STREET <br />ST. PAUL, MINNESOTA 55101 <br />651 296-&'319 <br /> <br />(WED) 1. 13' 99 17: 28/8117: 27/NO. 4260433848 P 2 <br /> <br />(For Department Use Only) <br /> <br /> <br />UCENSC NUMBER <br /> <br />PROCESSING DATE <br /> <br />HAlC NUMBER <br /> <br />INSURANCE COMPANY <br /> <br />"CURRENCY EXCHANGE <br />,UCENSE APPLICATION <br /> <br />BONO NUMBER <br /> <br />The data which you furnish on this torm will be used bY the Department of Commerce to asseSs your qualifications for a <br />license~ Di$closure of your sociar security number is volunt&/}': You are not legally required to provide'thJSdata. <br />' however, if you do not provide your social security number the Department of Commerce may be unable, to grant a <br />license., The Department may use social security numbers for revenue recapture as authorized by Minnesota Statutes, <br />Chapter 270A and for identification purposes. After issuance of a license, all information. contained in this application, <br />except your social security number, is public pursuant to MiMesota Statutes, Chapter 13. ' <br /> <br />A. tyPE OF UCENSE <br />~NEW <br />o RENEW , <br />, CJ AMENDED NAME <br /> <br />C INDIVIDUAL PROPRIETORSHIP <br /> <br />(j CORPORA TJON <br /> <br />, ;fkUMITED UABIU1Y <br /> <br />CJ PARTNERSHIP <br /> <br />s. ,APPLICANT INFORMATiON, <br /> <br />NAME OF,CUAAENCY EXOIANGE , <br />Pawn America Minnesota, L.L.C. <br />NAMe OF CORPORATION OR, PARTNERSHIP (see 15 of insllUCtions) , <br />" Pawn America Minnesota~ L.L.C~ , " " <br />BuSINESS ADCRESS (No Pest Office Boxes) T~HONE NUMBER <br />1715 North Rice St. ('651+487~1595 <br />CITY , STATEMN I ZiP CODE, COUNTY <br />, Roseville 55113 Ramsey <br />NAME OF INDIVIOUALMANAGING THIS LOCATION ST~TETAXIO NUMBER <br />Steve Caulfield 2773226 <br /> <br />, , <br />& applicantS must answer thefoJlowing questionS. ,If any questions are answered .YES., you must attach a detailed <br />written explanation and all legal documentation, if applicable. " , <br /> <br />Have you, !.!:!% of the ownersJ partners, officers. directors or shareholders ownjng more than 10% of the <br />corporate steck. or any employee with the authority to exercise management or policy control over the <br />company ever: <br /> <br />YES ,NO <br />a Ux 1. Held a currency exchange license in any other state other than Minnesota? If YES, the new license <br />application must include a verification of license certified by, the state(s); all other applicants must <br />verify that the certification(s) previousJy submitted is accu~te. <br /> <br />(J ~ 2. Been the subject of any, inquiry or investigation by any division of the Minnesota Commerce <br />Department? <br /> <br />CJ 2Ci 3. Had any occupational license censured, suspended, revoked, cancelled, terminated or been the <br />subject of any type of administrative action in any state including Minnesota? <br /> <br />REV. 7/98 (OVER) <br />