Minnesota Department of Public Safety ALCOHOL AND GAMBLING ENFORCEMENT DIVISION 444 Cedar Street, Suite 222, St. Paul, MN 55101 (651) 201-7500 TDD (651) 282-6555 FAX (651) 297-5259 TOUR BOAT APPLICATION TO SELL INTOXICATING LIQUOR (Operating on Lake Superior, St. Croix River, and Mississippi River) LICENSE FEE(S) $1,500 Each Vessel Sunday Liquor $75 Duplicate Sunday License $30 License Number: Workers Comp. Ins, Co. Policy Period FROM TO State Tax ID Number Date Approved: License Expiration Date: Policy Number Federal Tax ID Number Phone Number Applicant's Name and Title Tour Boat Carrier's Name Main Address of Carrier Body of Water Boats Will Travel Total Number of Boats Total Number of Boats Being Licensed For Sunday Liquor GIVE HOME PORT CITY FOR EACH VESSEL: (If home port is located outside a city, then give county) Name of Boat Name of Boat Name of Boat Name of Boat Name of Boat Name of Boat Home Port Home Port Home Port Home Port Home Port Home Port (Attach a separate sheet if necessary) Licensee is required to provide proof of liquor liability insurance for the full license period and must submit a Coast Guard Certification for each vessel along with application. LICENSEE SIGNATURE DATE OFFICE USE ONLY-(Make check payable to: ALCOHOL AND GAMBLING ENFORCEMENT DIRECTOR) Amount Received Refund Amount Refund Made To American LegalNet, Inc. www.FormsWorkFlow.com