Filing Letter to Board in Response to M Bennett Email with Exhibits 12 02 2024

----- N re Date-/- l-l- - - Disposition (fine, penalty, etc.) Nature of interest in entity to be licensed B. lf applicable, provide the date the Direclor ofthe N.J. Division ofAlcoholic Beverage Control issued an order approving (No license may be issued without an order or disapproving disqualification removal: from the Direclor of the Division of Alcoholic Beverage Control determining no disqualification or removing disqualification.) (See R.S. 33:1-31.2 and N.:L1]Q. 13:2-'15.) Provide Agency Docket No. :lNNl- -l -l-.

PLEASE ryPE OR PRINTALL INFORMATION srArE ASSTGNED LTCENS A{ .rurr.* -,1N -L OA- ALL APPLICANTS OTHER THAN CLUB LICENSE ANSWER THE FOLLOWNG 7,1 DOES THE APPLICANT, A MEMBER OF THE APPLICANT'S IMMEDIATE FAI\,IILY (SPOUSE, CHILDREN, PARENTS,IN-LAWS OR SIBLINGS)ORANY PERSON WTH ABENEFICIAL INTEREST IN THE SUBJECT LICENSE OF THIS APPLICAT|ON, HAVE ANY INTEREST IN ANY OTHER NEW JERSEY ALCOHOLIC K BEVERAGE LICENSE? IF THE ANSWER IS 'YES,' COMPLETE THE FOLLOWNG BY LISTING THE NEW JERSEY LIOUOR LICENSE TWELVE DIGIT NUMBER(S) ANO THE NAME(S) OF THE PERSON{S) OR CORPORATION(S) WHO HOLD(S) SUCH INTEREST, USE ADDITIONAL PAGE(S) 7 AS NEEDED. A. License Number Relationship to Applicant B. Licenbe Numbor Namo (Last Name, First Name, Middle lnitial or Corporale Name) Relationship to Applicant C. License Number Name (Last Name, First Name, Middle lnitialor Corporate Name) Relalionship to Applicant 7,2 WOULD ANY PERSON OR CORPORATION NAMED IN THIS APPLICATION FAIL TO OUALIFY FOR OVVNERSHIP OF THE LICENSE IF APPLYING AS AN INDIVIDUAL BECAUSE OF AGE, CRIIIINAL CONVICTION OR PROHIBITED INTERESTS IN OTHER LICENSES? IF THE ANSWER IS'YES,'ANSWER THE FOLLOWNG BY INSERTING THE NAME OF THE INDIVIDUAL OR CORPORATION AND THE SOCIAL SECURITY NUMBERAND DATE OF BIRTH,IFAN INDIVIDUAL. USE ADDITIONAL PAGE(S) 7 AS NEEDED. social Security Number- oR - - NJ Sal6s Tax Certifcate of Aulhon9 No. Dale of Birth ......,..,............'......._ I _l - -

PLEASE TYPE OR PRINTALL INFORMATION Page E STATE ASSIGNED LICENSE NUMBER l^ai.3a_.qr/ aa I ALL APPLICANTS ANSWERTHE FOLLOWNG 8,1 DOES THE APPLICANT OR ANYONE MENTIONEO IN THIS APPLICATION OWE THE STATE OF NEW JERSEY OR THE UNITEO STATES ANY LICENSE FEE, PENALTY, INTEREST OR ALCOHOLIC BEVERAGE TAX WTIICH tl,AS ACCRUED PURSUANT TO THE ALCOHOLIC BEVERAGE TAX tAW THE ALCOHOLIC BEVERAGE IAW OR ANY OTHER NEWJERSEYOR FEDEML LAW? ----yG 8,2 HAS THE LICENSE BEEN ISSUED, OR IS IT BEING REQUESTED TO BE ISSUED, FOR A HOTEL/MOTEL AS AN -ves EXCEPTION TO THE POPULATION RESTRICTION UNDER THE PROVISIONS OF R.S.33i1-12.20? -vas -Y6 IF THE ANSWER IS'YES,' IS IT FOR A HOTEL/MOTEL FACILIry OF 50 OR lOO ROOI\,IS? 100 ROOIVS ROOMS CHECKONE: 8,3 HAS THE LICENSE BEEN ISSUED. OR IS IT BEING REAUESTEO TO BE ISSUED. ASAN EXCEPTION TO THE TWO - 33:1.12.32)JOR A HOTEUMOTEL, RESTAURANT, EOWLING ALLEY OR -50 LAW (R,S, UCENSE LIMITATION INTERNATIoNALAIRPORT? -lZ:No lF THEANSWER !S 'YES,' CHECK ONE OFTHE FOLLOWNG: -Yes HOTEUI OTEL -INTERNATIONALAIRPORT -BOWLINGALLEY -RESTAURANT E,4 LICENSE NUMBER SOUGHTTO 8E TRANSFERRED THE FOLLOr'V]NG ARETO 8E ANSWERED vv}]EN APPLICATION IS FOR A LICENSE TRANSFER. 8.5 IFTHIS ISAREOUEST FORA PERSON.TO.PERSON TRANSFER,INSERT NAME(S)OF PERSON (LASINAME F Si) PARTNERSHIP OR CORPORATION CURRENTLY HOLOING THE LICENSE: (Last Name, First Name, MiddLe lniialor CoQorate Name) 86 IF TI"IIS IS A REOUEST FOR A PLACE.TO.PLACE TRANSFER OF A POCKET LICENSE (NO SITEO PREMISES), MARKAN X HERE: IFTHIS ISA REOUEST FORA PLACE.TCIPLACE TRANSFER OF A SITED LICENSE, INSERT THE ADDRESS OFTHE CURRENTSTTE FROMWHICH THE LICENSE IS TO BETRANSFERRED, Street Addrcss Numb€r Streel Name Municipality Nsw Jersey Zio THE FOLLOWNG ARETO BE ANSWERED BYAPPTICANTS FOR A NEWLICENSE ORA LICENSE TRANSFER, 67 INSERT THE ANTICIPATED OATES WHEN PUBLIC NOTICE OF APPLTCATION WLL BE PUBLISHED PUBLICATION IVAY NOT BE SOONERTHAN THE OATE OF FILING OF THIS APPLICATION. Dale of iirsi noiice I l-lDare ol second notice8.8 NAME OF NEWSPAPER TO PUBLISH NOTICE BY CORPOFATIONS REPORTING A CHANGE OF CORPOFATE 89 THE FOLLOWNG- ARE TO-lBE ANSWEREO STRUCTURE WTIEREIN A NEW STOCKHOLDER ACOUIRES MORE THAN 1 PERCENT OF THE STOCK OF THE LICENSED COMPANY (ONE PUBLICATION OF NOTICE REOUIRED). Date of notice Name ol nev\Epapsr publishing notice THE FOLLOWNG OUESTIONSARE FOR CLUB

CKHOLDER ACOUIRES MORE THAN 1 PERCENT OF THE STOCK OF THE LICENSED COMPANY (ONE PUBLICATION OF NOTICE REOUIRED). Date of notice Name ol nev\Epapsr publishing notice THE FOLLOWNG OUESTIONSARE FOR CLUB LICENSEAPPLICANTS ONLY: 8,10 HAS THE CLUB BEEN IN ACTIVE OPERATION IN THE STATE OF NEW JERSEY FOR AT LEAST THREE YEARS CONTINUOUSLY I!IMEDIATELY PRIOR TOTHE SUBMISSION OF ITSAPPLICATION FORA LICENSE? -/-/- Yes - 8.11 IS THE APPLICANT A CONSTITUENT UNIT, CHARTERED OR OTHERWSE OULY ENFRANCISED CHAPTER OR -NoOF A NATIONAL OR STATE ORDER? -IVTEMBER CLUB _Yes 8.12 tlASTHE CLUB HAO EXCLUSIVE POSSESSIONAND USE OFCLUB OUARTERS FORTHREE CONTINUOUSYEARS? Yes -No 8,13 DOESTHE CLUB HAVE AT LEAST 60 VOTING MEMBERS? _Yes -No _ No

Page I PLEASE ryPE OR PRINTALL INFORMATION STATE ASSIGNED LICENSE Nt]MBER lA6-9 -,ul - oct ALL APPLICANTS ANSWER THE FOLLOWNG S,1 DOES ANY INDIVIDUAL. PARTNERSH IP, CORPORATION OR ASSOCIATION OIEEEIEAN.IIE.AEPUEANI HAVE AN INTEREST DIRECTLY OR INDIRECTLY IN THE LICENSE APPLIEO FOR OR IS THE STOCK OF ANY yes srocKHoLoER HELo rN EScRow oR PLEDGED rN ANy wAy? _ lzfo IF THE ANSIVER IS 'YES,'ANSIVER THE FOLLOWNG USING A SEPARATE PAGE 9 FOR EACH INOIVIDUAL OR CORPORATION OF INTEREST, ATTACH A SEPARATE PAGE OF EXPLANATION IF MORE SPACE IS NEEOED, Name of lndividual (Last Name FiBt)or Corporation (Lasl Nam€, Firsl N6me, Middle lnitialor Colpolale Name) OR Social Secudty Number NJ Sales Tar Cerlificale ofAuhoniy Number_ Slrcel Address N0mber Street Name Municioelilv Po Bor * State zip Descnbe Nature ol lnteresi 92 DOES ANY INDIVIOUAL PARTNERSHIP, CORPORATION ORASSOCIATION HOLDANY CHATTEL IVORTGAGE OR CONDITIONAL BILL OF SALE OR OTHER SECURITY INTEREST ON ANY FIJRNITURE, FXTURES, GOODS OR EQUIPMENT TO BE USED IN C9NNECTION vvlTH THE BUSINESS TO BE OPERATEO UNDER THE LICENSE Yes -jZ1No APPLIEO FOR? -- - IF THE ANSWER IS'YES,'ANSWER THE FOLLOWNG USINGA SEPARATE PAGE 9 FOR EACH INDIVIOUAL OR CORPORATION TO BE REPORTED, ATTACH A SEPARATE PAGE OF EXPTANATION IF MORE SPACE IS NEEDED' - - Name of lndividual (Le3l Name FiGl) or Corporation (Last Name, Filst Name, Middle lnilialor Corporate Name) _ OR Social Secudty Number NJ Sales Tar Cenrfic.te of Auinority Numbe, N6me Number Streel - MunioPaltty P.o. Box #- State ziP Descfloe Nalu€ of lnlorest 9,3 HAS THE APPLICANTAGREEOTO PERMITANYONE NOT HAVINGAN OW!ERSHIP INTEREST IN THE LICENSETO RECEIVE ORAGREEOTO PAYANYONE (BYWAY OF RENT, SALARY OR OTHERWSE)ALL ORANY PERCENTAGE OF THE GROSS RECEIPTS OR NET PROFIT OR INCOMI'ERIVED FROM THE BUSINESS TO BE CONDUCTED UNDER THE LICENSE APPLIEO FOR' -.IZ: NO -' - IF THE ANS\A/ER IS 'YES,'ANSWER THE FOLLOWNG USING A SEPARATE PAGE 9 FOR EACH INDIVIDUAL OR CORPORATION TO BE REPORTED. ATTACH A SEPARATE PAGE OF EXPTANATION IF MORE SPACE IS NEEDED. -YES - Name of lndividual(Last Name Fid) orCorporation - lvliddle lnitial Last Name -- Sodal Seorily Numb6r - NJ SalesTax Ceruncale ofAuthodty Number- P.O. Boxr- Number - oR St€€t Name Munidpalrty- Stale zip - Describe Nature of lnleresl APPLICANTSTHATARE SOLE PROPRIETORS OR PARTNERSHIPS GO TO PAGE

SalesTax Ceruncale ofAuthodty Number- P.O. Boxr- Number - oR St€€t Name Munidpalrty- Stale zip - Describe Nature of lnleresl APPLICANTSTHATARE SOLE PROPRIETORS OR PARTNERSHIPS GO TO PAGE 1OA, CORPORATIONSANO LIMITED LIABILITY COI\TPANIES CONTPLETE PAGE 10. -

Page 10 PLEASE ryPE OR PRINT ALL INFORI\,IATION srarEAssrGNED LrcENse NuMeea /J o.}1 ' oJy- oo i ,, QUESTIONS TO BE ANSWERED BY CORPORATIONS ANO LIMITED LIABILITY CONIPANIES ONLY, ANY CORPORATTON OR LIMITED LIABILITY COMPANYTHAT IS REPORTEDTO HAVE AN INTEREST IN THE BUSINESS TO BE LICENSEO. WHETHER THE LICENSEE COMPANY, THE PARENT CORPORATION OF THE LICENSED COMPANY, HOLDING COMPANY OR OTHERWSE AFFITIATED IN THE CORPORATE CIIAIN, MUSTANSWERTHE FOLLOWNG USINGASEPARATE PAGE lOANO PAGE 1OA FOR PAGE D PAGE 1OA FOR coR EACH CORPORATION, ANSWER OUESTI at 10.1 Name ol corporalion 102 Street address of home office Uirry-t ztp a(flto "or" /W 10.3 NJ Sales Tax Cedinc€rc ofAuihonly Number '10.4 IF CORPOfIATION AODRESS IN NUMBER 10.2 ABOVE IS OUT OF STATE, REPORT BELOWTHEAODRESS OFANY INSERT N/A IF NONE, OFFICE LOCAT ION IN NEW Number zip No 10.5 IS THE CORPORATION NOWAN EXISTING, V 10.6 OATE CHARTEREO OR INCORPORATED 10.7 CERTIFICATE OF INCORPORATION NUI\,1BER 10.8 IF NOT INCORPORATED UNDER THE LA\AIS OF NEW JERSEY, HAS THE CORPORATION RECEIVED AN AUTHORIZATION TO CONDUCT BUSINESS IN NEW JERSEY 6ROM THE NEW JERSEY OFFICE OF THE SECRETARY oF srArE? 10.9 -Ye3 -No 4)/A HAS THE coRpoMTroN CI|ARTJ:R EVER BEEN REVoKED BYTHE oFFlcE oF THE SECRETARY oF srATE lN NEWJERSEY? ---]Z: NO IFTHEANSWER IS YES,'INSERTTHE DATE OF REVOCATION, OR IFSUSPENDEO, THE BEGINNINGAND ENDING -Y€3 OATE OF TIIE SUSPENSION, Beginning dals Ending dale 10,10 INSERT THE NAME AND AODRESS OF THE REGISTEREO OR AUTHORIZEO AGENT IN NEWJERSEY UPON WHOI\'I SERVICE OF PROCESS IN ANY PROCEEDINGS AGAINST THE APPLICANI, PURSUANT TO THE NEW JERSEY ALCOHOLIC BEVEF{AGE TAW, THE ALCOHOLIC BEVERAGE TAX LAW OR PROCEEDINOS IN A STATE OR U,S DISTRICT COURT, €s .) [. rfla.; n.Slrt tf # (3 (Lasl Filsl Name, Middle lnitialor llro ok=, zp D'19 ?L Telephone Number 3t -l G '|L . ,9 oF, E(chang€ Number Aroa 10.11 lF THE LTCENSED COMPANY lS OWNED BY OTHER CORPOFATION(S) OR lS lN A CORPORATE CHAIN, ATTACH A DNGBEM DEPICTING THE CORPORATE RELATIONSHIPS ANDTHE PERCENTAGE OF STOCK INTEREST IN THE COMPANY TO BE LICENSED, OWNEO BY OTHER CORPORATIONS OR OTHER NON'CORPORATE ENTITITES (tNDIVIOUALS, PARTNERSHIPS, ASSOCIATIONS).

Page 10A PLEASE TYPE OR PRINT ALL INFORMATION STATE ASSIGNED LICENSE NUMBER Uo.r-33-oq-ooI ALL APPLICANTS ANSWER THE FOLLOWING IADD PAGES AS NECESSARY] SOLE OWNERS AND PARTNERSHIPS: Complete this page in full. LllrlTED PARTNERSHIPS: All information about a general pa(ner or parlners of a limiled partnership must be reported, Mether the general partner is an individual or a corporation. A list of the names and addresses of all limited partners must be submitted as an attachment to this application with an identification ofthe percentage of each limited partner as it relates to total ownership of the business entity to be licensed. CORPORATIONS: All corporation applicants or licensees and any corporation that has an ownership interest in the corporation under license or lo be licensed must have been repo(ed on Page 10. lnformation on this Page, 10A, will identity all officers, directors and stockholders holding one percent ormore ofthe shares ofthe respeclive company. Club licenses must list names of officers and directors and attach current membership list OF CORPORATION OR CLUB COVERED BY THIS.PAGE (COMPLETE ONLY IF APPLICANT OR ST OCKHOLDER IS A RPORATION OR PARTNERSHIP) fl^irvh't (J c.r^ rr/vtr U"L rlime or inEviouar lrasi nime nis|, stoctnoEer, p cer ireclor. Last Name Home Street Address lnitial Number P.O. Box # State Municipality zip oaeoraia SocialSecurity Number Home telephone number ( Number EXCnange Office telephone number Exchange Number Area Check position that applies: _ Vics Presid€nt ]u"n"n", --1r-o* other (spedfy) Beneficiary _ Name of individu Partner Sole owner l4resident / Number of shares % of business owned or controlled Stockholder _ Secretary _Agent Treasurer Director Executor/Admin istrator Receiver (last name lirst) , stockholder, parlner, offcer or direclor: - O\itial Last ome Street Address Number P.O. Box # _ Municipality zip Dete of Birth Social Security Number Home telephone number Areq" Etr4hqnge Area Exchange Number Office telephone numbe o/o of business owned or controlled Check position that applies: _ Sole owner Number 0 Partner _President _Vice-President -y(secretary Manager tArustee _ Agent Other (specify) _ Beneficiary - Number of shares o Stockholder Treasurer _ Executor/Adm in istrator Direclor Receiver -

Page '10A PLEASE ryPE OR PRINT ALL INFORMATION sTATEASsTGNEDLTcENSENUMBER //0i-- 33 --la't- oo t ALL APPLICANTS ANSWER THE FOLLOWNG [ADD PAGES AS NECESSARY] SOLE OWNERS AND PARTNERSHIPS: Complete this page in full. LIMITED PARTNERSHIPS: All ioformation about a general partner orpartnersofa limited partnership must be reported, whether the general partner is an individual or a corporation. A list of the names and addresses of all limited partners must be submitted as an attachment to this application with an identification ofthe percentage of each limited partner as it relates to total ownership ofthe business entity to be licensed. CORPORATIONS: All corporation applicants or licensees and any corporation that has an ownership interest in the corporation under license or to be licensed musl have been reported on Page '10. lnformation on this Page, 10A, will identify all officers, directors and stockholde[s holding one percent or more ofthe shares ofthe respeclive company. Club licenses must list names of officers and directors and attach a current membechip list. ***l*********************************t**t*********t*t********!r*ff*+**********t***************t*:r****,1************* NAME OF CORPORATION OR CLUB C OVERED BY THIS AGE COMPLETE ONLY IF APPLICANT OR STOCKHOLDER IS A CORPORATION OR PARTNERSHIP): Name of ind C dual (last name first), stockholder, p , officer or direclor Last Name ome Street Address Number P.O. Box # Municipality State zi Social Security N Date of Birth Home telephone num ae Area Office telephone number (_)_-_ Area Exchange Number Exchange Number % of business owned or controlled Number of shares _ PrBsident Check position that applies: Sole owner Vice-President Manager --a Beneficiary _ -lz1ruslec _ - _ Partner _ Secretary _Agent Stockholder Treasurer Direclor Executor/Administralor Receiver Other (speciry) Name of indjyidlal (last name fiEt) , stockholder. partner, offcer or dire-clor: b" o.n i,ch .L k b F -7,n|ffu| Last Name Street Address Number P.O. Box # Municipality State zip DateofBir Socialsecurity Numbe Home telephone numOer Office telephone number Area Exchange Number % of business owned or conlrolled _ President L/ f ruslee --/. _ Beneficiary _ - Check position that applies: Number of shares Sole owner Vlce-President Manager Other

umber Area Exchange Number % of business owned or conlrolled _ President L/ f ruslee --/. _ Beneficiary _ - Check position that applies: Number of shares Sole owner Vlce-President Manager Other (specify) Partner _ _ Secretary Agent _ _ _ Stoclholder Treasurer Direclor Executor/Administrator Receiver