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Bed And Breakfast Registration Form PS009102 - Minnesota

Bed And Breakfast Registration Form Form. This is a Minnesota form and can be used in Alcohol And Gambling Enforcement Division Statewide .
 Fillable pdf Last Modified 10/15/2010
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Department of Public Safety ALCOHOL AND GAMBLING ENFORCEMENT DIVISION 444 Cedar St., Suite 133 St. Paul, MN 55101-5133 (651) 201-7507 TDD (651) 282-6555 FAX (651) 297-5259 BED AND BREAKFAST REGISTRATION FORM To register your Bed and Breakfast establishment to serve wine without a license to your registered guests, you must complete this form and return to the Alcohol & Gambling Enforcement Division __________________________________________________________________________________________ FULL BUSINESS NAME OF BED AND BREAKFAST ESTABLISHMENT Proprietor's Name ___________________________ DOB __________Social Security # ___________ Proprietor's Home Address____________________________________CITY_________________ ZIP_______ Bed and Breakfast Address____________________________________CITY_________________ ZIP_______ Maximum Number of Rooms for Rent________ Phone__________________________________ Maximum Number of Guests to Accommodate ____________ Will meals other than breakfast be served to guests at your Bed and Breakfast facility? YES__________ NO_________ NOTE: As provided for in Minnesota Statute 340A.4011 Subdivision 2. No license is required for a Bed and Breakfast Facility to provide, at no additional charge, to a person renting a room at the facility no more than two four ounce glasses of wine per day, only to be consumed on the Bed and Breakfast premises. PROPRIETOR'S SIGNATURE DATE ALCOHOL AND GAMBLING ENFORCEMENT DIVISION DIVISION DIRECTOR________________________________________________________________ SIGNATURE PS009102 (5/06) DATE American LegalNet, Inc. www.FormsWorkflow.com
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