Form 281 - Application for License to Sell Cigarettes at Retail.
(Chapter 382, Laws of 1951.)   BUSINESS RECORDS CORPORATION
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STATE OF MINNESOTA, County of _________________________________

____________ of ____________  Application No. _________________

APPLICATION FOR LICENSE TO SELL CIGARETTES AT RETAIL

The undersigned resident _____________ of the _________________

of ________________________, State of Minnesota, HEREBY MAKE

APPLICATION FOR LICENSE to be issued to _______________________

___________________ to sell cigarettes and cigarette papers and

wrappers at retail at _________________________________________

_______________________________________________________________

in the __________________ of ________________________ in said

county and state for the term of _____________________________,

beginning with the _________________ day of __________________,

20_____, subject to the laws of the State of Minnesota and the

ordinances and regulations of said __________________________ of

_________________________ pertaining thereto, and herewith

deposit _____________ $________________ in payment of the fee

therefor.

Date ___________________, 20______  ___________________________

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No. _________________ APPLICATION OF __________________________

FOR LICENSE TO SELL CIGARETTES ________________________________

_______________________________________________________________

_______________________________________________________________

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Filed in my office this _______________________________________

day of ___________________, 20_____ ___________________________

_______________________________________________________________

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Approved by the Governing Body of the _________________________

of ____________________________________________________________

this ___________ day of ____________________, 20_______________

_______________________________________________________________

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License grated ______________________________ 20_______________

Expires _____________________________________ 20_______________

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The County Board may license and regulate the sale of
Cigarettes in unorganized territory.