Town CrierWest Orange, New Jersey
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Supporting Documentation · Dec 4, 2024

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

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PLEASE TYPE OR PRINT ALL INFORMATION Page 7 STATE ASSIGNED LICENSE NUMBER ALL APPLICANTS OTHER THAN CLUB LICENSE ANSWER THE FOLLOWING 7 .1 DOES THE APPLICANT, A MEMBER OF THE APPLICANT'S IMMEDIATE FAMILY (SPOUSE, CHILDREN, PARENTS, IN.LA\A/S OR SIBLINGS) OR ANY PERSON WTH A BENEFICIAL INTEREST IN THE SUBJECT LICENSE OF THIS APPLICATION, HAVE ANY INTEREST IN ANY OTHER NEW JERSEY ALCOHOLIC BEVERAGE LI9ENSE? Yes J No IF THE ANSWER IS 'YES,' COMPLETE THE FOLLOWNG BY LISTING THE NEW JERSEY LIQUOR LICENSE TWELVE DIGIT NUMBER(S) AND 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 Name (Last Name, First Name, Middle lnitial or Corporate Name) Relationship to Applicant ***********t***********t*************i*t*****r**********t*t***a***'lt'l'lt***************************:r:r******r**+* B. License Number Name (Last Name, First Name, Middle lnitial or Corporate Name) - Relationship to APPIicant *********:l*********************t********t******************t**********a**'r************************************'r* C. License Number - Name (Last Name, First Name, Middle lnitial or Corporate Name) - Relationship to Applicant *********t********+********i++******+*ti********tt****att***********************t*t****************ar*********** 7.2 WOULD ANY PERSON OR CORPORATION NAMED IN THIS APPLICATION FAIL TO QUALIFY FOR OWNERSHIP OF THE LICENSE IF APPLYING AS AN INDIVIDUAL BECAUSE OF AGE, CRIMINAL coNVlcTloN oB PROHIBITED INTERESTS lN OTHER LICENSES? Yes V No IF THE ANSWER IS'YES,'ANSWER THE FOLLOWING BY INSERTING THE NAME OF THE INDIVIDUAL OR CORPORATION AND THE SOCIAL SECURITY NUMBER AND DATE OF BIRTH, IF AN INDIVIDUAL. USE ADDITIONAL PAGE(S) 7 AS NEEDED, Name (Last Name, First Name, Middle lnitial or Corporate Name) Social Security Number--- OR - NJ Sales Tax Certificate of Authority No. I Date of Birth - -l

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Page I PLEASE TYPE OR PRINTALL INFORMATION STATE ASSIGNED LICENSE NUMBER ALL APPLICANTS ANSWER lHE FOLLOWNG OR ANYONE MENTIONED IN THIS APPLICATION OWE THE STATE OF NEW JERSEY OR 8,1 DOES THE APPLICANT -.- THE UNITED STATES ANY LICENSE FEE, PENALTY, INTEREST OR ALCOHOLIC BEVERAGE TAX WTIICH HAS ACCRUED PUREUANT TO THE ALCOHOLIC BEVERAGE TAX LAW THE ALCOHOLIC BEVERAGE I.AW OR ANY OTHER NEWJTRSEYOR FEOERAL LAW? Ye Jm A,Z TgE T.rcE'TISC BEEN ISSUEO, OR IS IT BEING REAUESTEO TO EE ISSUED, FOR A HOTEL/MOTEL AS AN -TNS EXCEPT|oN 10 THE POPULATTON RESTRICTION UNDER THE PROVISIONS OF R.S. 33:1-12.20? Yes No IF THEANSWER IS'YES.'IS IT FORA HOTEUMOTEL FACILITYOF 50 OR 1OO ROOMS? 100 ROOMS ROOMS CHECKONE: -L _50 _ 8,3 HAS THE LICENSE BEEN ISSUED, OR IS IT BEING REQUESTED TO BE ISSUED, ASAN EXCEPTION TO THETWO LICENSE LIMITATION LAW (R,S, 33:1J2,32) FOR A HOTEUMOTEL. RESTAURAMT, BOWLING ALLEY OR INTERNATIONALAIRPORT? _!Z: NO lF THE ANSWER tS "YES,' CHECK ONE oF THE FOLLOWNG: HOTEUMOTEL -YES -INTERNATIONALAIRPORT -EOWLINGALLEY -RESTAURANT 8,4 LICENSE NUMEER SOUGHTTO 8E TRANSFERREO THE FOLLOWNG ARETO BEANSWERED WHENAPPLICATION IS FORA LICENSE TMNSFER, 85 TRANSFER,INSERT NAME(S) OF PERSON (LASI NAME Fi6t), PARTNERSHIPORCORPORATIONCURRENTLYHOLOINGTHE LICENSEI IF THIS IS A REQUEST FORA PERSON-TO.PERSON -. lnitialor-.Corporate Name) (la$ Name, Firsl Name, Middle 8,6 IF THIS IS A REOIJEST FOR A PLACE.TO.PLACE TRANSFER OF A POCKET LICENSE {NO SITED PREMISES), IIIARK AN X HERE: IFTHIS ISA REOUEST FORA PLACE.TO.PLACE TRANSFER OFASITED LICENSE. INSERTTHEADDRESS OFTHE CURRENT SIIE FROMWTIICH THE LICENSE IS TO BETRANSFERREO, StreatAdd€sg Number Slrcet Name New Jers€Y Munidpality zip THE FOLLOWNG ARE TO BE ANSWEREO BYAPPTICANTS FORA NEW LICENSE ORA LICENSE TRANSFER. 87 INSERT THE ANTICIPATEO DAIES WHEN PUBLIC NOTICE OF APPLICATION WIL BE PUBLISHED. PUALICATION II4AY NOT BE SOONER THAN THE DATE OF FILING OF THIS APPLICATION, -'- Date of flIsl notice I Oale of second notice I 8.8 NAME OF NEWSPAPER TO PUBLISH NOTICE E.9 THE FOLLOWNG ARE TO BE ANSWERED BY CORPORATIONS REPORTING A CHANGE OF CORPORATE - ACOUIRES MORE THAN 1 PERCENT OF THE STOCK OF THE - A NEW -lSTOCKHOLDER STRUCTURE WHEREIN - -l- LICENSED COMPANY (ONE PUELICATION OF NOTICE REOUIRED), OaG of notic€ Name of newsoEoer publishing notce THE FOLLOWNG QUESTIONSARE FOR CLUB LICENSE

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THE - A NEW -lSTOCKHOLDER STRUCTURE WHEREIN - -l- LICENSED COMPANY (ONE PUELICATION OF NOTICE REOUIRED), OaG of notic€ Name of newsoEoer publishing notce THE FOLLOWNG QUESTIONSARE FOR CLUB LICENSE APPLICANTS ONLY: -/-/AEEN IN ACTIVE OPERATION IN THE STATE OF NEW JERSEY FOR AT LEAST THREE YEARS 810 HAS THE CLUB C9(TINUOUSLY IM[,lEDIATELY PRIOR TOTHE SUBMISSION OF ITS APPLICATION FOR A LICENSE? No ' Yes- 8 11 IS TH-E APPLICANT A CONSTITUENT UNIT, CHARTERED OR OTHERWISE DULY ENFFIANCISED CHAPTER OR MEMBER CLUBOFA NATIONAL OR STATE ORDER? t'lo ves -1- 8,12 HAS T-HE CLUA HAD EXCLUSIVE POSSESSIONANO USEOF CLUB OUARTERS FORTHREE CONTINUOUSYEARS? -l_Ye3 813 DOESTHE CLUB HAVE AT LEAST 60 VOTING MEMBERS? .-Yss -No No - -

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Page 9 PLEASE TYFE OR PRINTALL INFORMATION STATE ASSIGNED LICENSE NUMBER ALt APPLICANTS ANSWER THE FOLLOWNG 9.1 DOES ANY INDIVIDUAL, PARTNERSHIP, CORPORATION OR ASSOCIATION OIIEBIHANIEESPPT I HAVE AN INTEREST DIRECTLY OR INOIRECTLY IN THE LICENSE APPLIED FOBIOR IS THE STOCK OF ANY STOCKHOLOER HELO IN ESCROWOR PLEDGED IN ANYWAY? -Z:- No IF THE ANSWER IS'YES,'ANSWER THE FOLLOWNG USINGA SEPARATE PAGE 9 FOR EACH INDIVIDUAL OR CORPOFATION OF INTEREST, ATTACH A SEPARATE PAGE OF EXPLANATION IF MORE SPACE IS NEEDED, -Yes Name of lndividual (Last Name FiBt)or Corporalaon (Lasl Name. FiBl Name l,liddle lnilialor Co@orate Name) ---- SocialSecunty Number oR NJ Sales Tax Cedificate olAuihonly Number Slreel Address P.o. Box# _ Number Slreel Name Stale zip oescribe Nalurc of lnteresl 92 DOESANY INDIVIOUAL. PARTNERSHIP. CORPOFIATION ORASSOCIATION HOLDANY CHATTEL I'4ORTGAGE OR CONDTTIONAL BILL OF SqLE OR OTHER SECURITY INTEREST ON ANY FURNITURE, FIXTURES, GOODS OR EOUIPMENT TO BE USED IN CONNECTION WTH THE BUSINESS TO BE OPERATEO UNDER THE LICENSE APPLIEo FoR? --jl lo IF THE ANSWER IS'YES,'ANSWER THE FOLLOWING USING A SEPARATE PAGE 9 FOR EACH INDIVIDUAL OR CORPORATION TO BE REPORTED, ATTACH A SEPARATE PAGE OF EXPLANATION IF MORE SPACE IS NEEDED, -ves Name of lndividual (Last Nam€ First) orColpor3lion SocialSecudty Number- (Lasl Name, First Name, Middle lnitial or Corpolate Name) NJ Sales Tax Certficate olAulhonly P.O. Box NJmber- Numbff #- Slreet Name Muniopalilv -oR Siate zip Descflbe Nalure ol lnteEst 9,3 HAS THEAPPLICANIAGREEDTO PERMITANYONE NOT HAVINGAN OW{ERSHIP INTEREST IN THE LICENSETO RECEIVE ORAGREEDTO PAY ANYONE (8Y WAY OF RE}T. SALARY OROTHERWSE}ALL OR ANY PERCENTAGE -' oF THE GROSS RECEIPTS OR NET PROFIT OR lNc9tr E OERIVEO FROM THE AUSINESS TO BE CONDUCTED UNOERTHE LICENSEAPPLTED FOR? -:- No IF THE ANSWER IS 'YES,'ANSWER THE FOLLOWNG USING A SEPARATE PAGE 9 FOR EACH INDIVIOUAL OR -Yes CORPORATIONTO BE REPORTED, ATTACH A SEPAPATE PAGE OF EXPTANATION IF MORE SPACE IS NEEOED' Name of lndividual(Lasl Name FiBo o. Corporation - --oR Social Secunty Number - NJ Sares Tax Cenrl'cale of Aurhonty Numbe.- Numb€r Slrcei Namo - Munidpaliry-- P.O. Box* State zip Describe Nature of lnteresl - APPLTCANTS THAT ARE SOLE PROPRIETORS OR PARTNERSHIPS GO TO PAGE 1OA, CORPORATIONS AND LIMITED LIABILIry COMPANIES COIIIPLETE PAGE

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- Munidpaliry-- P.O. Box* State zip Describe Nature of lnteresl - APPLTCANTS THAT ARE SOLE PROPRIETORS OR PARTNERSHIPS GO TO PAGE 1OA, CORPORATIONS AND LIMITED LIABILIry COMPANIES COIIIPLETE PAGE 10, -' - -

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Page 10 PLEASE TYPE OR PRINT ALL INFORMATION STATEASSIGNED LICENSE NUMBER OUESIIONS TO BE ANSWERED BY CORPORATIONS AND LIMITED LIABILITY COMPANIES ONLY, ANY CORPORATTON OR LIMITEO LIABILITY COMPANY THAT IS REPORTED TO HAVE AN INTEREST IN THE BUSINESS TO BE LICENSED MiETHER THE LICENSEE COMPANY. THE PARENT CORPORATION OF THE LTCENSED COMPANY, HOLDING COMPANY OR OTHERWSE AFFILIATEO IN THE CORPORATE CHAIN, MUST ANSWER THE FOLLOWNG USING A SEPARATE PAGE 1O AND PAGE lOA FOR ON BOTH PAGE 10 AND PAG FOR EACH CORPORATION EACH CORPORATION, ANS\1'ER QUESTI -.- Or" 10.1 Nam€ ofcoDoration 10 (N ( Slate if 'I $ N.. SP RJtn Ze< '7t 2 Streel address of home offc€ Slrcel Name c2 /-tuoOi ( ziP NJ SalesTax Certifcate of Authority Number 10./t IF CORPORATION ADORESS IN NUMBER 10,2 ABOVE IS OUT OF STATE, REPORT BELOWTHEAODRESS OFANY OFFICE LOCATION IN NEWJERSEY, INSERT N/A IF NONE. Numbe,r Municipalrty- slre NewJersey zip 10.5 rs rHE coRPoFraroN NowAN ExlsflNc, vALl 10.6 DATE CHARTEREDOR IN -- - "OA**"' 10.7 CERTIFICATE OF INCORPORATION NUMBER 10.8 IF NOT INCORPORATED UNDER THE LAWS OF NEW JERSEY, HAS THE CORPORATION RECEIVED AN AUTHORIZATION TO CONDUCT BUSINESS IN NEW JERSEY FROM THE NEW JERSEY OFFICE OF THE No Yss SECRETARY OF STATE? 10,9 HAS THE CORPORATION -CHARTER EVER - BEEN REVOKED BY THE OFFICE OF THE SECRETARY OF STATE IN NEWJERSEY? Yes No IFTHEANSWER IS'YES,'INSERT THE DATE OF REVOCATION, OR IF SUSPENDED, THE BEGINNINGAND ENOING DATE OF THE SUSPENSION, Date of revocatron Beginning date Ending date 10.10 INSERTTHE NAMEANDADDRESS OF THE REGISTEREO ORAUTHORIZEDAGENT IN NEWJERSEY UPON WHOi"I SERVICE OF PROCESS IN ANY PROCEEDINGS AGAINST THE APPLICANT. PURSUANT TO THE NEW JERSEY ALCOHOLIC BEVEFiAGE TAW, THE ALCOHOLIC BEVERAGE TAX I.AW OR PROCEEDINGS IN A STATE OR U S. DISTRICT COURT, MAY 8E MADE, tlasl Name. Firsi Name. Mrddle ln ialor CoPo6ton) Number MJnrcDalrlv Street Name _ NewJeEeY Tsbphone Numb6r zip (-) AI!a Exchange Numbsr 10,11 IF THE LICENSED COMPANY IS OWNED BY OTHER CORPORATION(S) OR IS IN A CORPORATE CHAIN ATTACH A DIAGRAM DEPICTING THE CORPORATE RELATIONSHIPSAND THE PERCENTAGE OF STOCK INTEREST IN THE COMPANY TO BE LICENSED, OWNED BY OTHER CORPORATIONS OR OTHER NON.CORPORATE ENTITITES (NDIVIOUAI.S, PARTNERSHIPS, ASSOCIATIONS), -'

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PLEASE TYPE OR PRINT ALL INFORMATION Page 10A STATE ASSIGNED LICENSE NUMBER ALL APPLICANTS ANSWER THE FOLLOWNG IADD PAGES AS NECESSARYI SOLE OWNERS AND PARTNERSHIPS: Complete this page in full LIMITED PARTNERSHIPS: All information about a general partner or partners ofa limited partnership must be reporled, whether the general partner is an individual or a corporation. A lisl of the names and addresses o, all limited partners must be submitted as an attachment to this application with an identification of the percentage of each limited partner as it relates to total ownership of the business entity to be licensed. CORPORATIONS: All crrporation applicants or licensees and any corporation that has an ownership interest in the corporation under license or to be licensed must have been repo(ed on Page 10. lnformation on this Page, 10A, will identify all officers, directors and stockholders holding one percent or more ofthe shares ofthe r€spec{ive company. Club licenses must list names ofofficers and directors and attach a cunent membership list. ******r****************t****t********t******************tt*t*++tt*t***************l*t**********************t**r**** NAME OF CORPORATION OR CLUB COVERED BY THIS PAGE (COMPLETE ONLY IF APPLICANT OR STOCKHOLDER IS A CORPORATION OR PARTNERSHIP): Name of individual (last name frst), slockholder, partner, officer or direclor: Street Name Number P.O.Box#_ Middle lnitial First Name Last Name Home Street Address State Municipality zip NumberHome telephone number (-)-- -Offic€ telephone number (- Date of Birth - Social Security Area - Area Exchange Number Exchange Number 1 Number of shares % of business owned or controlled Check position that applies: owner Parlner Stockholder President Vice-President Secretary Treasurer Director Executor/Administrator Receiver Truslee -SoleManager -_ Beneficiarv Olher (specify) -Agent Name of individual (last name Iirst) , stockholder, parlner, officer or direclor: Street Name Number P.O.Box#_ Middle lnitial First Name Last Name Home Street Address - State Municipality zip Number(-)-Home telephone number Area -Offica tglephone number ( Ar€a - Exchange ) Number Exchange Number _ _ - Sole owler President _ Trustee - Vice-President Beneficiary Other (specify) - - -l - Number of shares % of business owned or controlled Check

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- Exchange ) Number Exchange Number _ _ - Sole owler President _ Trustee - Vice-President Beneficiary Other (specify) - - -l - Number of shares % of business owned or controlled Check position that applies: I DaG of Birlh Social Security Manager _ _ _ Partner Stockholder SecEtary Treasurer Director Agent Executor/Administrator Receiver

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i Page 1 'l PLEASE TYPE OR PRINT ALL INFORMATION STATE ASSIGNED LICENSE NUMBER AFFIDAVIT LICENSE PERIOD APPLIED FOR TO FROM DATE: ) State of ) SS: ) County of ) ) As provided by law (R.S. 33:1-35), (Check One) 1. The lndividual Applicant 2. Members ofthe Partnership Applicant of (Presidenwice-President) (Corporation or Club Name) consent(s) that the licensed premises and all portions ofthe building constituting the licensed premises, including all rooms, cellars, closets, out-buildings, passageways, vaults, yards, attics and every part ofthe struclure of which the licensed premises are a part and all buildings used in connection therewith which are in his/her/their possession or under his/her/their control, may be inspecled and searched without warrant at all hours by the Direc'tor of the Division of Alcoholic Beverage Control, his or her duly authorized deputies, inspectors or investigators and allothersworn lawenforcement officers, and being duly swom according to law, upon his/her/their oath(s), depose(s)and say(s) that he/she is (they are)the person(s) duly authorized to sign the application, that in instance ofcorporate ownership, the signator is authorized by corporate resolution to sign on behalf of the corporiltions; and that the contents of this application represent complele disclosure of the fact, and that the contenb of this application are lrue. (Signature of lndividual Agent / Soie Proprietor) (Corporations Only) Attestation by Corporate Secretary (Partnership Name) (Signature of Parlner) Attest: q Corporate Name By (Signatu Secretary (Signature of Partner) rporate President orVice President) (Signature of 0 Signature (sis Affix Corporate Seal ie of Partner) Sworn to and subscribed before me yof this re BY DULY AUTHORIZED NOTARY PUBLIC 20 /3 c€r Administering Oath) a(Printed Name of Officer Administering Oath) OR AN ATTORN EY.AT.LAW OF NEWJERSEY B N I{OIARY PUSLIC. }€IV JERSEY lry CnnB. Erti! Lt t, Otl (Date of Expiration of Commission, if applicable) -

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State of New Jersey Department of Law and Public Safety Division of Alcoholic Beverage Control PO Box 087, Trenton, NJ 08625-0087 License Number: 0722-33-053-002 Plenary Retail Consumption License Amendment Application #119574 Term: 10/13/2016 to 6/30/2017 Licensee: MONTCLAIR GOLF CLUB Mailing Address: Physical Address: 25 PROSPECT AVE WEST ORANGE, NJ 07052 USA Contact: MONTCLAIR GOLF CLUB (973) 239-1800 Establishment Information DBA / Trade Names: MONTCLAIR GOLF CLUB AT ROCK SPRING Mailing Address: | 90 ROCK SPRING ROAD WEST ORANGE, NJ 07052 USA Physical Address: 90 ROCK SPRING ROAD WEST ORANGE, NJ 07052 Contact: DANIEL SOMOGYI (973) 731-6464 USA Additional License Info County: ESSEX COUNTY Municipality: WEST ORANGE TOWN Questions and Answers - Application #119574 Documents Submitted With the Application - Application #119574 Page 1 of 1

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