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If married, state maiden name and date of birth of spouse: <br /> Yes Name: <br /> No Date of Birth: <br /> Address at which spouse has lived during the past five years: <br /> Has spouse ever been convicted of any felony,misdemeanor or violation of any ordinance <br /> other than traffic? <br /> Yes If yes, give time,place, offense and penalty: <br /> No <br /> Occupations of spouse for the past five(5)years: <br /> Full Legal Date of <br /> Name: Birth: <br /> Alias Social Security <br /> Names: Number: <br /> Driver's License <br /> Number: <br /> Home Business <br /> Address: Telephone: <br /> Home <br /> Telephone. <br /> 4. Does the applicant or any of the associates hold a current pawnbrokers license from any <br /> other governmental unit or licensed under MN. Statue 471.924? <br /> Yes If yes, give nature and extent of involvement: <br /> No <br /> 5. Has applicant previously been denied a pawnbroker license from any other governmental <br /> unit or had a license revoked or canceled? <br /> 6. List names, residence address and business address of 3 references who are of good moral <br /> character and who are not related to the applicant or not holding any ownership in the <br /> premises,who may attest to the character of the applicant or manager. <br /> (1)—Name <br /> Residence Address <br /> Business Address <br />