Last updated: 6/13/2023
Application For Wholesalers-Manufacture Salesperson Identification Card
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Description
MINNESOTA DEPARTMENT OF PUBLIC SAFETYALCOHOL AND GAMBLING ENFORCEMENT DIVISION 445 Minnesota Street Suite 222 St. Paul, MN 55101-5133 Phone (651) 201-7500 TDD (651) 282-6555 Fax (651) 297-5259 APPLICATION FOR WHOLESALER222S/MANUFACTURER SALESPERSON222S IDENTIFICATION CARD FEE PER PERSON CARD IS $35.00 PLEASE RETURN THIS APPLICATION WITH FEE Name Name Name Business Phone Authorized Signature Name of Firm Street Address City, State, Zip Code Expiration Date License Type ID NumberCARD NUMBER(Office Use Only) American LegalNet, Inc. www.FormsWorkFlow.com
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