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<br />r <br /> <br />j{tJl5 <br /> <br />MINNESOTA 2006 LICENSE RENEWAL NOTICE <br />CURRENCY EXCHANGE <br /> <br />WAL-MART STORES INC. dba \~~~~ercenter License Type: CURRENCY EXCHANGE <br />dba: WAL-MART ""-1#3209 OEl\*. License Number: 20431046 <br />18185 ZANE ST SClp 01 200S C St ct CORPORATION <br />ELK RIVER, MN 55330 (;...&. J::.J'{....~.. . ompany ru ure: <br />w~ Renewal Fee: $500 <br />Phone Number: (763) 441-3461 ~ [ ] Check this box if you will not be renewing the license for the year 2006. <br />Returning the form will serve as a SURRENDER of the license. <br /> <br />AFFIRMATION: <br /> <br />I hereby certify that the information and responses contained in this renewal application are true and correct to the best of my knowledge and belief. <br /> <br />Rick tv. Brazile <br /> <br />~eZ <br />. . ~~! tf,r <br />Signature <br /> <br />VP of Finance <br />Title <br /> <br />8/17/05 <br /> <br />Date <br /> <br />NOTARY SEAL <br /> <br />Subscribed and :;worn to, before me, a Notary Public, this17 day of <br /> <br />a~OJ r; ~~ Smtem <br /> <br />.. Count of <br />Notary Public Signature \ y <br />My commission expires <br /> <br />Augus t , 2005. <br />Arkansas <br />Benton <br /> <br />6/22/13 <br /> <br />You must return this entire 2-page form with attachments, signed, along with your renewal payment, to: <br />Minnesota Department of Commerce <br />Financial Examinations Division <br />85 - 7th Place East, Suite 500 <br />S1. Paul, MN 55101-2198 <br /> <br />CORRECTIONS/AMENDMENTS: Make name, address or telephone number corrections directly on the form above. <br />. For a name change, attach a copy of the amended name filed and stamped by the Minnesota Secretary of State. <br />. If the company uses an assumed name in Minnesota and the name is not included in the above information, attach a copy of the <br />Assumed Name Certificate from the Minnesota Secretary of State. <br /> <br />. P.O. Box addresses are not acceptable. Renewals without a street address will be returned. <br /> <br />TIMELY RENEWAL: The renewal form must be signed, notarized, and dated and returned with the correct renewal fee by Sept. 2, 2005. <br />. Pursuant to Minnesota Statutes, Chapter 53A.04(a), regarding the licensing of currency exchanges, both state and local approval <br />of the issuance and renewal of a currency exchange license is required. This process may take up to 120 days; therefore, you <br />should return the required forms immediately to ensure a timely renewal. <br /> <br />. If all required forms are not fully completed and returned to our office with payment by September 2, 2005, your license will lapse <br />effective December 31,2005. If your license does lapse, you must reapply for a license using the license application form and <br />paying the new license fees. <br />. A properly renewed license will be valid through December 31,2006. <br /> <br />RENEWAL FEE: <br /> <br />. NO CASH ACCEPTED. Please make check or money order payable to MN. DEPT. OF COMMERCE. <br /> <br />. NOTICE: Dishonored checks will be assessed a $30 service fee by law and may result in failure to renew license. <br /> <br />. Renewal fees are non-refundable except that an overpayment of a fee will be refundable upon proper application. <br /> <br />If you have questions, please contact the Financial Examinations Division bye-mail at <br />robin.brown@state.mn.us or by telephone at (651) 282.9855. <br /> <br />WAL-MART STORE #3209 <br />18185 ZANE ST <br />ELK RIVER, MN 55330 <br /> <br />Page 1 of 2 <br /> <br />. <br />