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 5 STATE ASSIGNED LICENSE NUMBER 2020 33 027 002 ALL APPLICANTS ANSWER THE FOLLOWING - -- 5,1 IS THE APPLICANTOR ANY OTHER PERSON MENTIONED IN THIS APPLICATION A POLICE OFFICER OR HOLD ANY POSITION ENTRUSTED WITH THE ENFORCEMENI OF ANY LAWS CONCERNING ALCOHOLIC BEVERAGES IN ANY i.TANNER WHATSOEVER? ves -]]- rlo lfthe answer is "Yes," complete the following: -Name of individual First Name Last Name Middle lnitial Title of position held Name of Employinq Agency DOES THE APPLICANT OR ANY OTHER PERSON MENTIONED IN THIS APPLICATION, OR ANY PERSON HAVING A BENEFICIAL INTEREST IN THE LICEN.qED BUSINESS, HOLD OFFICE IN THE UNIT Yes No OF GOVERNMENT ISSUING THE LICENSE' -:L IF THE ANSWER IS 'YES,' COMPLETE THE FOLLOWING: - Name of lndivdual First Name Last Name Middle lnitial Title of Otrice l\4unicipality 5.3 DOES THE APPLICANT OR ANY OTHER PERSON MENTIONED IN THIS LICENSE APPLICATION, OR ANYONE WITH A BENEFICIAL INTEREST IN THE LICENSED BUSINESS, DTRECTLY OR INDIRECTLY, HAVE ANY INTEREST IN ANY BREWERY, WINERY, DISTILLERY, RECTIFYING AND BLENDING PLANT, IMPORTER OR WHOLESALE ALCOHOLIC BEVERAGE BUSINESS, AS OWNER, PART OWNER, LANDLORD, TENANT, MORTGAGE HOLDER OR AS A STOCKHOLDER, OFFICER, DIRECTOR, AGENT. EMPLOYEE OR OTHERWISE? Yes xx No IF THE ANSWER IS "YES,'ATTACH AN AFFIDAVIT EXPLAINING THE RELATIONSHIP AND NATURE OF THE INTEREST AND COMPLETE THE FOLLOWNG: A. New Jersey license number, ifapplicable B, IF THE BUSINESS DOES ILO] HOLD A NEW JERSEY LIQUOR LICENSE, ANSWER THE FOLLOWING OUESIIONS Name of entiv conducting business (Corporation, Partnership or lndividual) (Last Name, First Name, Middle lnitialor Corporate Name) Street Address Street Name Number PO Box # zip Type of Business Irunicipality State _

Page 6 STATE ASSIGNED LICENSE NUMBER 26bffs= g5= oR PRrtr#L rNFBdUrAroN ALL APPLICANTS ANSWER THE FOLLOWING 6.1 Yes XX No HAS THE APPLICANT EVER BEEN DENIED A LIQUOR LICENSE IN NEWJERSEY? IF THE ANSWER TO THIS QUESTION IS ^YES,'ANSWER THE FOLOWING: Retail _ Warehouse _ Type of License or Permit Denied: _ _ Wholesale Manufacturer _ Transportation Unit ofGovernment which denied License or Permit: Date of Denial (approximate it not known) _ / _ I _ Reason for Denial 6.2 HAS ANY CORPORATION, PARTNERSHIP OR INDIVIDUAL MENTIONED IN THIS APPLICATION, OTHER THAN THE APPLICANT, BEEN DENIEDA LIQUOR LTCENSE OR PERMTT? yes IF THE ANSWER IS "YES,' ANSWER THE FOLLOWING: xx No Name of Entity Last Name First Name Type of License or Permit Denied: _ _ Retail warehouse Middle lnitial Wholesale Manufacturer _ Transportation Unit ofGovernmenl which denied License - or Permit: Date of Denial (approximate if not known) _ I _t _ Reason for Denial 6.3 HAS THE APPLICANT OR ANY OTHER PERSON, CORPORATION OR ENIry MENTIONEO IN THIS LICENSE APPLICATION, OR ANYONE WITH A BENEFICIAL INTEREST IN IT, HAD AN INTEREST IN A NEW JERSEY ALCOHOLIC BEVERAGE LICENSE WHICH WAS SURRENDERED, SUSPENDED OR HADA PENALry IMPOSED IN LIEU OF SUSPENSION, NOT RENEWED, REVOKED OR CANCELLED WITHIN THE lOYEARS PRIOR TO THE DATE OF THIS APPLICATION? No lF THE ANSWER lS "YES," PROVIDE DETAILS OF EACH BELOW [Complete a separate Page 6 for each action]: Name of lndividual Last Name First Name Middle lnitial xx _Yes DATE OF ACTION I DOCKET NO PENALW WAS IMPOSED BY !ndicate whether by Divislon ofABC or identiry Local lssuing Authorityl PENALTY CONSISTED OF FINED $ NOT RENEWED [amount] SUSPENDED REVOKED CANCELLED (number of days) OTHER [explainJ 6.4 HAS THE APPLICANT OR ANY OTHER PERSON OR CORPORATION MENTIONED IN THIS LICENSE APPLICATION, OR ANYONE WITH A BENEFICIAL INTEREST IN THE BUSINESS UNDER LICENSE OR TO BE LICENSEO, EVER BEEN xx No CONVICTED OF A CRIMINAL OFFENSE? _Yes A, IF THE ANSWER IS "YES," ANSWER THE FOLLOWING: Name of lndividual Last Name Date of Birth ...-...".........._ I State Court of Jurisdiction Description of offense (specirlc charge) _l _ First Name Conviction Date_/_ Middle lnitial l_ - Disposition (Iine, penalty, etc.) Nature of interest in entity to be licensed B, lf applicable, provide the date the Director ofthe N.J. Division of

st Name Conviction Date_/_ Middle lnitial l_ - Disposition (Iine, penalty, etc.) Nature of interest in entity to be licensed B, lf applicable, provide the date the Director ofthe N.J. Division of Alcoholic Beverage Control issued an order approving or disapproving disqualilication removal . _t _l . (No license may be issued without an orde; from the Director of the Division ot niE6fi6iiE-aeiffi-c6iG6l-determining no disqualificarion or removing disqualification.) (See R.S. 33:1-3'1.2 and N.J.A.C . 13:2-15.') Provide Agency Dockel No. :[NNI- _

PLEASE ryPE OR PRINT ALL INFORI\,4ATION Page 7 2020 33 STATE ASSIGNED LICENSE NUMBER 027 002 ALL APPLICANTS OTHER THAN CLUB LICENSE ANSWER THE FOLLOWING /1 - DOES THE APPLICANT, A MEl\ilBER OF THE APPLICANT'S IMMEDIATE FAMILY (SPOUSE, CHILDREN, PARENTS, IN LAWS OR SIBLINGS) OR ANY PERSON WITH A BENEFICIAL INTEREST IN THE SUBJECT LICENSE OF THIS APPLICATION. HAVE ANY INTEREST IN ANY OTHER NEW JERSEY ALCOHOLIC BEVERAGE LICENSE? Yes xx No IF THE ANSWER IS "YES,'COMPLETE THE FOLLOWNG BY LISTING THE NEW JERSEY LIOUOR LICENSE TWELVE DIGIT NUI\4BER(S) AND THE NAME(S) OF THE PERSON(S) OR CORPORATION(S) WHO HOLD(S) SUCH INTEREST. USE ADDITIONAL PAGE(S) 7 AS NEEDEO A. License NumberNo-o Relalionship to APPlcant B Lrcense Number - Relalionshio to Aoplrcanl C License Number Name (Last Name, First Name, tdiddle lnitial or Corporate Name) Relationship to Applicant 7,2 WOULD ANY PERSON OR CORPORAIION NAMED IN THIS APPLICATION FAIL TO QUALIFY FOR OWNERSHIP OF THE LICENSE IF APPLYING AS AN INDIVIDUAL BECAUSE OF AGE, CRIMINAL CONVICTION OR PROHIBITED INTERESTS IN OTHER LICENSES? Yes xx No IF THE ANSWER IS "YES,'ANSWER THE FOLLOWING BY INSERTING THE NAME OF THE INDIVIDUAL OR CORPORATION ANDTHE SOCIAL SECURIry NUMBER AND DATE OF BIRTH,IFAN INDIVIDUAL, USE ADDITIONAL PAGE(S) 7 AS NEEDED, Name (Lasl Name First Name, Middle lnitial or Corporate Name) Social Security Number OR - NJ Sales Tax Cerlificate ot Authority No Date ot Brrlh ...- I -l

Page 8 STATE ASSIGNED LICENSE NUMBER i.o.ff.95. o* 16,D'I o.buSoRMAroN ALL APPLICANTS ANSWER THE FOLLOWING 8.1 DOES THE APPLICANT OR ANYONE MENTIONED IN THIS APPLICATION OWE THE STATE OF NEW JERSEY OR THE UNITED STATES ANY LICENSE FEE, PENALTY, INTEREST OR ALCOHOLIC BEVERAGE TAX WHICH HAS ACCRUED PURSUANT TO THE ALCOHOLIC BEVERAGE TAX LAW. THE ALCOHOLIC BEVERAGE LAW OR ANY OTHER NEW JERSEY OR FEDERAL LAW? Yes xX _ 8.2 No HAS THE LICENSE BEEN ISSUED, OR IS IT BEING REQUESTED TO BE ISSUED, FOR A HOTEUMOTEL AS AN EXCEPTION TO THE POPULATION RESTRICTION UNDER THE PROVISIONS OF R.S. 33:1-12.20? _Yes IL_No IF THE ANSWER IS "YES,' IS IT FOR A HOTEUMOTEL FACILITY OF 50 OR lOO ROOMS? CHECK 8.3 ONE: 50 ROOMS 100 ROOMS HAS THE LICENSE BEEN ISSUED, OR IS IT BEING REQUESTED TO BE ISSUED, AS AN EXCEPTION TO THE TWO LICENSE LIMITATION LAW (R.S.33:1-12.32) FOR A HOTEUMOTEL, RESTAURANT, BOWLING ALLEY OR INTERNATIONAL AIRPORT? YES X]< NO IF THE ANSWER IS 'YES," CHECK ONE OF THE FOLLOWING RESTAURANT BOWLING ALLEY HOTEUMOTEL INTERNATIONAL AIRPORT THE FOLLOWING ARE TO BE ANSWERED WHEN APPLICATION IS FOR A LICENSE TRANSFER 8.4 LICENSE NUMBER SOUGHT TO BE TRANSFERRED 8.5 lF THIS lS A REQUEST FOR A PERSON-TO-PERSON TRANSFER, INSERT NAME(S) OF PERSON (Last Name First), PARTNERSHIP OR CORPORATION CURRENTLY HOLDING THE LICENSE: (Last Name, First Name, Middle lnitial or Corporate Name) 8,6 IF THIS IS A REQUEST FOR A PLACE-TO-PLACE TRANSFER OF A POCKET LICENSE (NO SITED PREMISES), MARK AN X HERE: IF THIS ISA REQUEST FOR A PLACE-TO.PLACE TRANSFER OFA SITED LICENSE, INSERT THE ADDRESS OF THE CURRENT SITE FROM WHICH THE LICENSE IS TO BE TRANSFERRED, Street Address Number Street Name New Jersey lvlunicipality 7i^ THE FOLLOWING ARE TO BE ANSWERED BY APPLICANTS FOR A NEW LICENSE OR A LICENSE TRANSFER, 8.7 INSERT THE ANTICIPATED DATES WHEN PUBLIC NOTICE OF APPLICATION WILL BE PUBLISHED. PUBLICATION MAY NOT BE SOONER THAN THE DATE OF FILING OF THIS APPLICATION. Date offirst notice I I Date of second notice 8.8 NAME OF NEWSPAPER TO PUBLISH NOTICE 8-9 THE FOLLOWING ARE TO BE ANSWERED BY CORPORATIONS REPORTING A CHANGE OF CORPORATE STRUCTURE WHEREIN A NEW STOCKHOLDER ACQUIRES MORE THAN 1 PERCENT OF THE STOCK OF THE LICENSED COMPANY (ONE PUBLICATION OF NOTICE REQUIRED). Date of notice Name of newspaper publishing notice THE FOLLOW1NG QUESTIONS ARE FOR CLUB

HOLDER ACQUIRES MORE THAN 1 PERCENT OF THE STOCK OF THE LICENSED COMPANY (ONE PUBLICATION OF NOTICE REQUIRED). Date of notice Name of newspaper publishing notice THE FOLLOW1NG QUESTIONS ARE FOR CLUB LICENSE APPLICANTS ONLY: 8.10 HAS THE CLUB BEEN IN ACTIVE OPERATION IN THE STATE OF NEW JERSEY FOR AT LEAST THREE YEARS CONTINUOUSLY IMMEDIATELY PRIOR TO THE SUBMISSION OF ITS APPLICATION FOR A LICENSE? :: Yes _ No 8.11 IS THE APPLICANT A CONSTITUENT UNIT, CHARTERED OR OTHERWISE DULY ENFRANCISED CHAPTER OR MEMBER CLUB OF A NATIONAL OR STATE ORDER? _Yes 8,12 HAS THE CLUB HAD EXCLUSIVE POSSESSION AND USE OF CLUB OUARTERS FOR THREE CONTINUOUS YEARS? '- Yes -No 8.13 DOES THE CLUB HAVE AT LEAST 60 VOTING MEMBERS? l:- Yes-No No

Page I PLEASE ryPE OR PRINT ALL INFORMATION 2020 .33 STATE ASSIGNED LICENSE NUMBER _ 027 _002 ALL APPLICANTS ANSWER THE FOLLOWING 9,,1 DOES ANY INDIVIDUAL, PARTNERSHIP, CORPORATION OR ASSOCIATION THER THAN THE APPLI HAVE AN INTEREST DIRECTLY OR TNDIRECTLY lN THE LICENSE APPLIED FOSLOR lS THE STOCK OF ANY Yes ^^ No STOCKHOLDER HELD lN ESCROW OR PLEDGED lN ANY WAY? IF THE ANSWER IS 'YES," ANSWER THE FOLLOWING USING A SEPARATE PAGE 9 FOR EACH INDIVIDUAL OR CORPORATION OF INTEREST, ATTACH A SEPARATE PAGE OF EXPLANATION IF MORE SPACE IS NEEDED, - Name of lndividual (Last Name First) or Corporation (Last Name, First Name, Middle lnitial or Corporate Name) oR Social Security Number NJ Sales Tax Certifcate of Aulhority Number Street Address Number il - MuniciPality P.O. Box # State zip Describe Nature of lnterast 5,2 DOES ANY -INDIVIDUAL. PARTNERSHIP, CORPORATTON OR ASSOCIATION HOLD ANY CHATTEL MORTGAGE OR CONDITIONAL BILL OF SALE OR OTHER SECURITY INTEREST ON ANY FURNITURE, FIXTURES, GOOOS OR -TO -BE USED IN CONNECTION WITH THE BUSINESS TO BE OPERATED UNDER THE LICENSE EQUIPMENT Yes xx No APPLIED FOR? IF THE ANSWER IS'YES,'ANSWER THE FOLLOWING USING A SEPARATE PAGE 9 FOR EACH INDIVIOUAL OR CORPORATION TO BE REPORTEO. ATTACH A SEPARATE PAGE OF EXPLANATION IF MORE SPACE IS NEEOED. Name of lndividual (Last Name First) or Corporation (Last Name, First Name, Middle lnitial or Corporate Name) - - Social Security Number OR - NJ Sales Tax Certificate of Authority Number Street Address Number - P.O.Box#- Street Name Municipality - State zip Describe Nature of lnterest HAS THE APPLICANT AGREED TO PERMITANYONE NOT HAVINGAN OWNERSHIP INTEREST IN THE LICENSETO RECEIVE OR AGREED TO PAY ANYONE (BY WAY OF RENT, SALARY OR OTHERWISE)ALL OR ANY PERCENTAGE OF THE GROSS RECEIPTS OR NET PROFIT OR INCOME DERIVED FROM THE BUSINESS TO BE CONDUCTED NO YES UNOER THE LICENSE APPLIED FOR? ]L- 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. - Name of lndividual (Last Name First) or Corporation Middle lnitial First Name Last Name OR Social Security Number NJ Sales Tax Certiricate of Authority Number Street Address Number Street Name Municipality P.O. Box # State zip Describe Nature of lnterest - APPLICANTS THAT

Name OR Social Security Number NJ Sales Tax Certiricate of Authority Number Street Address Number Street Name Municipality P.O. Box # State zip Describe Nature of lnterest - APPLICANTS THAT ARE SOLE PROPRIETORS OR PARTNERSHIPS GO TO PAGE 1OA, CORPORATIONS AND LIMITED LIABILITY COMPANIES COMPLETE PAGE 10. -' -