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Jan 7 2005 10:08 P.02 <br />Renewal <br />CITY OF LITTLE CANADA <br />APPLICATION FOR PAWN SHOP.LICENSE <br />Type of License Being Applied For: <br />Pawn Brokers License; <br />x Second Hand Goods Dealer; <br />Multiple Dealer. <br />Every question must be answered. Please indicate if applicant is <br />Natural Person; Partnership; x Corporation; Other <br />If Partnership, complete separate application form for each partner. <br />If Corporation, complete separate application form for each operating <br />officer, proprietor, or other agent, as well as other persons owning or <br />controlling an interest. <br />A. 1. The Salvation Arm y NA NA <br />Name of Applicant Place of Birth Date of Birth. <br />900 No. 4th Street Minneapolis mm/55401 <br />Street Address <br />N/A <br />Driver's License Number <br />NA <br />City State /Zip <br />NA 612/332 -5855 <br />Home Phone Business Phone <br />Social Security Number <br />Captain Scott Salsbur a, Administrator <br />If Corporation, position within Corporation <br />N/A <br />of Interest in Corp. <br />2. Applicant known by -a name other than true name? Yes X No <br />`7f yes; 'what was the name or names? <br />3. Applicant is a U.S. citizen? x Yes No <br />4. Applicant is a resident alien? <br />Yes X No <br />5. Business Name, Address, Phone Number- The salvation Army ARC, <br />900 No. 4t1: Street, Mpls, MN 5540. <br />1 <br />