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STATE OF MINNESOTA <br />· :J.'~...' LIQUOR CONTROL COMMISSIONER <br /> <br />APPLICATION FOR OFF SAI,E INTOXICATING LIQUOR LICENSE <br /> <br /> This application and the bond sh~,]l be submitted in duplicate <br /> Whoever shall knowingly and wilfully falsify the answers to the following questionnaire shaH be <br /> deemed guilty o£ perjury and shall be punished accordingly. <br /> In answering the following questions "APPLICANTS" shall be governed as follows: For a Corpora- <br /> tion one officer shall execute this application for all officers, directors and stockholders. For a partnership <br /> one of the "APPLICANTS" shall execute thls application for all members of the partnershlp. <br /> <br /> · EVERY QUESTION MUST//BE ANSWERED. ' <br /> . ; ~...~ tJ~ ~'/L'. ' ~, ~~u~ .~' '.' ' <br />...... .......... ,_.· .............. ... <br /> <br /> Intoxicating <br /> Liquor <br /> License <br /> to <br /> be <br /> located <br /> (Street .4ddre~sand/or Lot/and Block Number.) . <br /> <br /> __ <br /> State of Minnesota, m accordance ~Oith the prov~ion~-of lVl'~,nesota Statutes, Chapter 840, commencing. . . <br /> <br /> ,19 ,andending " ~' "-' 19 · " '" ' <br />,., .... . ..... .: ...., .:...,..,.~::,:~.~.,..,. ,..-_~V. ....... ... <br /> 2. Give applicants' date of birth '" ":c~-~-~ - ' ~';-: <br />:';~::: "':': '" ~;;:;' '' 7-~J -------- (/~o.,~) (Year) ..... ' <br />.. "Birthdates o[ Partners ' :' ' :" ' ' ": "' " 7~ " <br /> <br /> '"'"" .... -o~--'~ .~, _-~.,.;~....... <br /> _ :_ .L1 .... (lffon~b) ' . .................. (Year)' , .. ....... <br /> Officers '~ Co;~;ation : 7-~ ~ ~-~ (Momb) (Year) <br /> <br /> !. The residence for each~qf the applicants/~amed herein for the past five years is as follows: · <br /> ~/~ /~ '.~~/~-~ . :... .... <br /> <br />4. Is the applicant a citizen of the United States? <br /> <br />If naturalized state date and place of naturalization <br /> <br />If a corporation, or partnership, statue citizenship status of all officers or partners. <br /> <br />5. The person who executes this application shall give wife's or husband's full name and a, ddress <br /> <br />6. What occupation~ have applicant and associates in this appHcatlon followed for the past five years?.. <br /> <br />7. If a partnership, state name and address of each member of partnership <br /> <br /> <br />