Last updated: 6/13/2023
Application For Importers Representatives Card
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Description
Minnesota Department of Public Safety Alcohol and Gambling Enforcement Division 445 Minnesota Street, Suite 222, St. Paul, MN 55101 651-201-7500 Fax 651-297-5259 TTY 651-282-6555 APPLICATION FOR IMPORTER'S REPRESENTATIVE'S CARD (FEE PER PERSON CARD IS $20.00 PLEASE RETURN THIS APPLICATION WITH FEE.) Page of CARD NUMBER (Office Use Only) License Type Licensee Name Email Address Business Phone Number Business Address City Zip Code State Expiration Date ID Number DBA NameNameNameName Authorized Signature American LegalNet, Inc. www.FormsWorkFlow.com
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