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<br />PLEASE PROVIDE 'IHE,FOLLQWING INFORMATION ON ALL NEW ORRENEWALAPPIlCATIONS: <br />/ (unless otherwise not~ <br /> <br />v:h AD NEW applicants must provide a signed, notarized statement from the applicant stating the proposed location <br />of the currency exchange is not located within 1/2 mile of another currency exchange. <br /> <br />~ A current fee schedule of all fees charged by your currency exchange office for cashing checks, money orders or <br />travelers' checks. The list MUST include the type of check cashed, the fee charged, and whether or not the fee <br />varies depending on the amount of the check <br /> <br />g"" All owners, partners, officers, stockholders (owning 10% or more of the corporate stock), and employees with <br />authority to exercise management or policy control over the company must request that the Bureau of Criminal <br />Apprehension conduct a background investigation on the fonn provided. Completed formes) MUST be <br />submitted with your license or renewal application. <br /> <br />~ The work experience covering ten (10) years prior to application for each person listed. <br /> <br />~ A surety bond for $1 0,000 (on the forms provided) with a power of attorney fonn. <br /> <br />~A check or money order made payable to "Department of Commerce" for: <br />New Applicants: $1,500.00 ($1,000.00 non-refundable application fee and $500.00 licensing fee.) <br />Amendment Fee: $100.00 <br />License Renewal Fee $500.00 <br /> <br />~ If applicant is a corporation, attach a copy of the Articles of Incorporation filed with the Secretary of State. <br /> <br />D If the applicant is a partnership, attach a copy of the Articles/Agreement of Partnership. <br /> <br />~ The name under which the business will be conducted must be exactly the same as the name on your license. If <br />operating under any name other than the exact corporate or partnership name or, if an individual proprietorship <br />doing business under any name other than your first and last name, attach a copy of the Assumed Name <br />Certificate by the Minnesota Secretary of State (651) 296-2803. <br /> <br />To apply, complete (please type or print in ink) and submit this form with the required fee <br />to the Department of Commerce, Division of Financial Examinations, 85 East 7th Place, <br />Suite 500, St. Paul, MN 55101-2198. Check or money order must be payable to the <br />"Department of Commerce". WE CANNOT ACCEPT CASH. Incomplete forms will <br />be returned to the business address listed. <br /> <br />For further information on the application process, applicants may contact the Division at <br />(651) 282-9855 or via e-mail.financial.commerce@state.mn.us. The application is <br />available on the Commerce website: www.commerce.state.mn.us. <br /> <br />4 <br />