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Minnesota Department of Public Safety <br /> dl�E® Alcohol and Gambling Enforcement Division (AGED) <br /> 445 Minnesota Street,Suite 222,St. Paul, MN 55101-5133 <br /> Alcohol&Gambling Enforcement Telephone 651-201-7500 Fax 651-297-5259 TTY 651-282-6555 <br /> Certification of an On Sale Liquor License,3.2% Liquor license, or Sunday Liquor License <br /> Cities and Counties: You are required by law to complete and sign this form to certify the issuance of the following liquor <br /> license types: 1) City issued on sale intoxicating and Sunday liquor licenses <br /> 2)City and County issued 3.2%on and off sale malt liquor licenses <br /> Name of City or County Issuing Liquor LicenseN� License Period From: 02/10/2026 To: 12/31/2026 <br /> Circle One: New License License Transfer Suspension Revocation Cancel <br /> (former licensee name) (Give dates) <br /> License type: (check all that apply)Xon Sale Intoxicating Sunday Liquor ❑3.2%On sale ❑ 3.2%Off Sale <br /> Fee(s): On Sale License fee:$ 3,000 Sunday License fee: $200 3.2%On Sale fee: $ 3.2%Off Sale fee:$ <br /> Licensee Name: El Novillo Alegre DOB Social Security# <br /> (corporation,partnership,LLC,or Individual) <br /> Zip Code I,2- County Ramsey Business Phone Home Phone <br /> Business Trade Name Business Addressg3 5 CityAwV41 \Stw <br /> Licensee's Federal Tax ID# lbvJ6. <br /> o app y ca - 29-4933) <br /> If above named licensee is a corporation,partnership,or LLC,complete the following for each partner/officer: <br /> Home Address City Licensee's MN Tax ID# <br /> Partner/Officer Name (First Middle Last) DOB social Security# I lome Address <br /> Partner/Officer Name (First Middle Last) DOB Social Security# Home Address <br /> Partner/Officer Name (First Middle Last) DOB Social Security# Home Address <br /> Intoxicating liquor licensees must attach a certificate of Liquor Liability Insurance to this form. The insurance certificate must <br /> contain all of the following: <br /> 1)Show the exact licensee name(corporation, partnership, LLC,etc)and business address as shown on the license. <br /> 2)Cover completely the license period set by the local city or county licensing authority as shown on the license. <br /> ❑ Yes ❑ No During the past year has a summons been issued to the licensee under the Civil Liquor Liability Law? <br /> Workers Compensation Insurance is also required by all licensees: Please complete the followin <br /> Workers Compensation Insurance Company Name: �/J �LG Policy# <br /> I Certify that this license(s)has been approved in an official meeting by the governing body of the city or county. <br /> City Clerk or County Auditor Signature Date_ <br /> (title) <br /> On Sale Intoxicating liquor licensees must also purchase a$20 Retailer Buyers Card. To obtain the application <br /> for the Buyers Card, please call 651-201-7504,or visit our website at www.dps.state.mn.us. <br />