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m MINNeSOTA <br /> OFFICE OF CANNABIS MANAGEMENT <br /> Retail Registration Form and Checklist <br /> Local Unit of Government: <br /> Business Name: <br /> Business Address: <br /> Minnesota Cannabis Business License Number: <br /> Registration Period <br /> OInitial 0 Renewal <br /> Cannabis Microbusiness ($0.00) � Cannabis Microbusiness ($1000.00) <br /> Cannabis Mezzobusiness ($500.00) 0 Cannabis Mezzobusiness ($1000.00) <br /> Cannabis Retailer ($500.00) O Cannabis Retailer ($1000.00) <br /> Is Applicant Current on All Property Tax and Assessments at Retail Location: <br /> Yes O No <br /> Preliminary Local Ordinance Compliance: O Pass Q Fail <br /> Notes: <br /> The above named applicant having paid the appropriate fees, being current on all <br /> applicable tax obligations, and having passed a preliminary compliance review, is <br /> authorized to engage in retail cannabis sales in the above named jurisdiction. <br /> Approved By: <br /> Title: <br /> Date: <br />