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

Page 10A PLEASE TYPE OR PRINT ALL INFORMATION srArE ASSTGNED LrcENsE NUMBER /l f- % - U.{ __oil o - ALL APPLICANTS ANSWER THE FOLLOWNG IADD PAGES AS NECESSARY] SOLE OWNERS AND PARTNERSHIPS: Comptere this page in fu . LIMITED PARTNERSHIPS: All information about a general partner or partners of a 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 parlner as it relate; to btal ownership of the business entity to be licensed. coRPoRATloNs; All corporation applicants or license€s and any corporation that has an ownership interest in the corporation under license or to be licensed must have been reported on Page 10. information on this page, 1oA, wili identity all officers, directors and stockholders holding one percent ormore ofthe shares ofthe respec{ive company. club li;nses must list names of officers and directors and attach a currenl membership list. ******t*t****lrt*************'l'r****rttt*******fa*t*******t*t*******talr******ttit*******i***************r************:r NAME OF CORPORATION OR CLUB COVERED BY CORPORATION OR PARTNERSHIP) Name of individual (la c IS PAGE (COMPLETE ONLY IF APPLICANT OR STOCKHOLDER IS A &r name first), stockholder, partner, offce directot. F Last Name Address Number P.O. Box #_ Municipatity State zip Social Security Nu Home telephone n -a* uno office telephone num "orBirrh o., Number % of business owned or controlled Number ofshares _Sole owner _ Vice-president Secrelary _ _ _ TPresident Manager _Agent _ --gl trustee _ Beneficiary _ Other (specify) - Check position that applies: pa me of individual (last name first) , stockholder, partner, officer or di 1 Stockholder _ Treasurer Execrlor/Administrator Oirector Receiver e r: Last Name ome Street Address Number P.O. Box # zip Municipality - State _ .o,r"'i"*r',r rurro"n of Birth Home telephone numb Office te,ephone number Exchange o/o _ P/esident _ _ _l7lTrustee _ _ Beneficiary _ Check position that applies: Number d of business owned or controlled Number of shares Sole owner Partner _ Vice-president Secretarv _Treasurer Direc{or _ Receiver _Agent Other

iciary _ Check position that applies: Number d of business owned or controlled Number of shares Sole owner Partner _ Vice-president Secretarv _Treasurer Direc{or _ Receiver _Agent Other (specify)_ Manager Stockholder Executor/Administralor

Page 10A PLEASE TYPE OR PRINT ALL INFORMATION srArE ASSTGNED LrcENsE NUMBER /ldf- 3Z - d* -oo I ALL APPLICANTS ANSWER THE FOLLOWNG IADD PAGES AS NECESSARY] SOLE OVVNERS AND PARTNERSHTpS: Comptete this page in fu . LIMITED PARTNERSHIPS: All information about a general partner or partners ofa 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 parlner as it relate; to total ownership ofthe business entity to be licensed. coRPoRAT|oNS: 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. information on this Page, 1oA, wili identify all officers, direciors and stocl$olders holding one percenl or more ofthe shares ofthe respec{ive company. club li;nses musflist na;es of offlcers and directors and attach a current membership list. *****t********#*t***************t*t*****t***t********ttr****tt*********t*****rr**,rtt********t+********i* NAME OF CORPORATION OR CLUB COVERED BY CORPORATION OR PARTNERSHIP) Na ******* S PAGE (COMPLETE ONLY IF APPLICANT OR STOCKHOLDER IS A of individual (last name first ), stockholder, partner, officer or direclot. Last N e Street Address Number P.O. Municipality 7l-- zip State Social Security Numb", Date of Birth Home telephone numoer ( offic€ telephone number Area Exchange % of business owned or controlled Check position that applies: _ Number of shares _ Sole owner President _ Vice-President ___la:Trustee _ Manager _ Other (specify) Beneficiary _ rlner _ _ Secretary Agent _ _ _ Stockholder Treasurer ExeqJtor/Administrator _ _ Direclor Receiver ame of individual (last name flrst) , stoclholder, partner, officer or direc{or: I Last Name Home Street Address Number P.O. Box#_ Municipatity State zi SocialSecurity Number Date of Birth Home telephone number ( Office telephone number ( Area Exchange Check position that applies: President _ _ Number d % of business owned or controlled Sole owner y'f rustee _-dre-president. Manager Beneficiary _ Other (specify) Partner Secretary Agent Number of

osition that applies: President _ _ Number d % of business owned or controlled Sole owner y'f rustee _-dre-president. Manager Beneficiary _ Other (specify) Partner Secretary Agent Number of shares _ _ _ Stockholder a. Treasurer Direclor Executor/Administrator Receiver

Page 10A PLEASE TYPE OR PRINT ALL INFORMATION srArE ASsTcNED L rceNse Nuuaea Pa!1 33 - o)/- oal ALL APPLICANTS ANSWER THE FOLLOWNG IADD PAGES AS NECESSARY] SOLE OWNERS AND PARTNERSHIpS: Complete this page in fu[. LIMITED PARTNERSHIPS: AII information about a general partner or partners of a 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 must have been reported on Page 10. lnformation on this Page, 1OA, wili identiry all officers, directors and stockholders holding one percent ormore ofthe shares ofthe rcspective company. Club li;nses must list names of oflicers and directors and attach a current membership list. ***t*********t*l************'.**r***rt*********t**********t+*******+t********t*+***r******************************* NAME OF CORPORATION OR CLUB COVERED BY CORPORATION OR PARTNERSHIP) t @l N of individual ( ame fi I E (COMPLETE ONLY IF AP PLICANT OR STOCKHOLDER IS A Cl*b * ), stockholder, partner , officer or diredor. Last Name e Street Address Number P.O. Box#_ Municipality State z SocialSecurity Number te of Birth Home telephone numbe office terephone nunoer umber % of business omed or controlled Check position that applies: _ Number of shares _ Sole owner Presidenl _ Mce-president y' Trustee _ _ Beneficiary _ Manager _ _ _ _ Parlner Secretary _ Agent Stockholder y'rreasurer Director Executor/Administrator Other (speciry) Name of individual (last name first) , , officer or d ireclor h r't Last Name ial Home Street Address N P.O. Box#_ Receiver Street N ame Muntcipality Stale zi SocialSecurity Number Home telephone numbe te of Birth r offce telephone numOe Area Exchange N % of business owned or controlled _ _ P4sident _!! Trustee _ -/. _ Beneficiary _ Check position that applies: Number of shares Sole owler Vice-president Manager Other

hone numOe Area Exchange N % of business owned or controlled _ _ P4sident _!! Trustee _ -/. _ Beneficiary _ Check position that applies: Number of shares Sole owler Vice-president Manager Other (specify) artner _ -P _Agent Secretary _ _ _ Stockholder Treasurer Executor/Administrator _ _ Direclor Receiver

Page 10A PLEASE TYPE OR PRINT ALL INFORMATION sTATEAssTcNEDLToENsENUMBER /7rJ: Sl - <rti -_OlL ALL APPLICANTS ANSWER THE FOLLOWING [ADD PAGES AS NECESSARY] SOLE OWNERS AND PARTNERSHIPS: Complete this page in tu . LIMITED PARTNERSHIPS: All information about a general partner or partners of a 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 ofeach limited partner as it relates to lotal owlership 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 must have been reported on Page 10. lnformation on this Page, 1OA, wila identify all officers, directors and stockholders holding one percenl ormore oflhe shares ofthe respeclive company. Club licenses must list names of officers and directors and attach a current membership list. **t********t*************tt************t********* *******************'l************* NAME OF CORPORATION OR CLUB COVERED BY THIS PAGE PLETE ONLY IF APPLI R STOCKHOLDER IS A CORPORATION OR PARTNERSHIP) ^t of ind ividual (last name first), stockholder, partn rord /o c'tor Last Name o StreetAddre Number P.O.Box#_ Municipality State zt So"i"r S""rrity lf rrnO"r. Birth - Home telephone numOer Office telephone number Area Exchange Num % of business owled or controlled Check position that applies: _ _ Sole President artner Secretary Manager _Agent _ _ _ Stockholder Treasurer Director Executor/Administratol Receiver r)thEr /<m.itu\ Bcncficierv _ of individua owter _p Vice-President _ y' frustee _ -,/ _ Number of shares last name fi ) , stockholder, partner, officer or dire clor J lq-o Last Name Home Street Address Number P.O. Box # Municipality State zi o"t"otaia Social Security Number Home telephone number Area Number Office telephone num bet Area Exch Number % of business owned or controlled Check position that applies: _ _ President _ Arustee _ Number of shares Sole o\irner Vice.President Manager Beneficiary _ - Other

um bet Area Exch Number % of business owned or controlled Check position that applies: _ _ President _ Arustee _ Number of shares Sole o\irner Vice.President Manager Beneficiary _ - Other (specify) _ _ _ Partner Secretary Agent _ _ _ Stockholder Treasurer Director Executor/Administrator Receiver

Page 10A PLEASE TYPE OR PRINT ALL INFORMATION srArE ASSTGNED LrceNse rrrur,reen /,Iora - o)t' - oo t ALL APPLICANTS ANSWER THE FOLLOWNG IADD PAGES AS NECESSARY] SOLE OWNERS AND PARTNERSHIPS: Complete this page in fu . LIMITED PARTNERSHIPS: All information about a general partner or partners of a 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 ofeach 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 lhe corporation under license or to be licensed must have been repo(ed on Page 'lO. lnformation on this Page, 1OA, will identify all officers, directors and stockholders holding one percent or more oflhe shares ofthe respeclive company. Club licenses must list names of officers and directors and attach a current membership list. ****t************t*********!r******t*t*****************t NAME OF CORPORATION OR CLU B COVERED BY CORPORATION OR PARTNERSHIP) ame of individ '7 a S PAGE (co MPLETE ONLY IF APPLI , stockholder, partner, name fi NT OR STOCKHOLDER IS A or dire Last me Home Street Address Number P.O. Box # Municipality State zt Social security Numb. DareorBir Home telephone numOer Office telephone numoe Area Excha nge % of business owned or controlled _ PJ€sidenl ,r/ Truslee -/ _ Beneficiary _ - Check position that applies: e of individual (la .\ Sole owner _ Vice-President Manager Other (specify) b Number Number of shares Partner Secretary _Agent - first) , stockholder, partner, _ _ _ Stockholder Treasurer Executor/Administrator _ _ Receiver _ _ Receiver Oireclor r or director: Last N e Street Address Number P.O.Box#_ Municipality State zi SocialSecurity Number Oate of Birth Home telephone number Office telephone number ( _ ) Area Exchange Number % of business owned or controlled _ Pretident L/Trustee _ --.. Beneticiary _ _ Check position that applies: Sole owner ra Number of shares Partner Vice-President Secretary Manager Agent Other (speciry) _ _ _ Stockholder Treasurer Executor/Administrator Direc{or

Page 10A PLEASE TYPE OR PRINT ALL INFORMATION srArEASSTGNED Lrceruse rurt,raen /zio,i- -li - _94- _!_9J ALL APPLICANTS ANSVVER THE FOLLOWNG IADD PAGES AS NECESSARY] SOLE OWNERS AND PARTNERSHTPS: Complete this page in fu . LIMITED PARTNERSHIPS: All information about a general parlner or partners ofa limited partnership must be reported, whelher 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 omership 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 to be licensed musl have been reporled on Page 10. information on this Page, 1OA, wili identiry all officers, directors and stockholders holding one percent or more ofthe shares ofthe respeclive company. Club li&nses mus isl namesof oflicers and direclors and attach a current membership list. ***************t***********t*********t*********'tt*******tt*ttt***!r*ttti********+t**********t*********************** NAME OF CORPORATION OR CLUB COVERED BY CORPORATION OR PARTNERSHI SP (COMPLETE ONLY IF APPLICANT OR STOCKHOLDER IS A A.r ame of individual (last name first), stockholder, partner officer or di l: \ALast Name ome Street Address "b ftl iddle lnitial N P.O. Box #_ Municipa zie oateofgin Social Security Number Home telephone nunoer Area Oflice telephone number ( _ Exchange Number Exchange Number ) Area % of business owned or controlled Check position thal applies; _ _ Sole owner P/esident _ Vice-President i ./ f ruslee _ Manaoer Beneficiary _ / Number of shares Partner _ _ _ Secretary Agent Stockholder Treasurer _ Executor/Administrator _ _ Receiver _ _ Receiver Direclor Other (specify) (r) irldfie of individual (l ast name fi rst) , stockholder, partner, cer or director: Last Name me Street Address Num P.O. Box # Municipaljty State zi9 *3 " Home telephone numoe Social Security N oflice tetephone num Date of Birt *, Area Number % ol business owned or controlled Check position that applies: _ _ _ Number of shares Sole owter Partner Stockholder President _ Mce-President Secretary Treasurer Trustee