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FEE $150.00 per site License # Page 1 APPLICATION FOR TRANSIENT MERCHANTS LICENSE To the Director of Licensing of ANOKA COUNTY, Minnesota: For the purpose of securing a license to engage in and to transact business as a Transient Merchant under the provisions of M.S. Section 329.099 within the County of Anoka and State of Minnesota, for and during the term commencing on 20___ and terminating on the undersigned respectfully makes application for such license, and submits the following statement of facts as provided by law: 1. Name of Applicant 2. Place of residence(s) for the prior two year period 3. Business address(es) for the prior two year period 4. Type of business engaged in for previous two years 5. Name and address of Representative who will conduct sale(s) 6. Proposed place of business 7. Kind of business proposed to be conducted 8. Length of time for which applicant desires to do business 9. That hereto attached is an itemized list of merchandise to be offered for sale. * 10. That applicant has paid any personal property taxes payable, pursuant to Minnesota Statutes 1949, Sections 288.01 to 288.03, as shown by the county treasurer’s receipt presented herewith. 11. That applicant has given bond to the county, approved by the treasurer, conditioned as required by law, the treasurer’s receipt therefore being hereto annexed. 12. That applicant has paid into the Director of Licensing the sum of one hundred and fifty dollars license fee as shown by the receipt presented herewith. Wherefore, applicant prays that a transient merchant’s license by issued to him/her in conformity with the laws in such case, made and provided. Dated: 20___ Applicant Subscribed and sworn to before me this day of Notary Public *NOTE; Recite in attached list as to each item a description thereof including serial number, if any, the owner’s actual cost thereof, and a designation by number corresponding with a tag which must be kept fastened to the item at all times until sold. ---PAGE BREAK--- FEE $150.00 per site License # Page 2 APPOINTMENT OF DIRECTOR OF LICENSING AS AGENT The undersigned does hereby constitute and appoint Steve Novak, Director of Licensing of Anoka County, Minnesota, and his successor or successors in office, his agent and attorney to accept service of process an upon whom service of process may be had in any action to which he is a party arising out of the sale of merchandise for which the license referred to in the proceeding application is sought, and service on said agent shall be taken and held as a personal service. The appointment shall be and continue in force until all causes of action arising out of such sale shall be barred by the statute of limitations. Dated: 20___ Applicant Subscribed and sworn to before me this day of Notary Public