Supporting Documentation · Dec 4, 2024
Filing Letter to Board in Response to M Bennett Email with Exhibits 12 02 2024
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Show all pagesPage 10A PLEASE TYPE OR PRINT ALL INFORMATION STATE ASSIGNED LICENSE NUMBER _1802___- 33 -_005 - 011 ALL APPLICANTS ANSWER THE FOLLOWING (ADD PAGES AS NECESSARY) SOLE OWNERS AND PARTNERSHIPS: Complete the page in full. LIMITED PARTNERSHIP: 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 of the 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 to be licensed must have been reported on page 10. Information on this page, 10A, will identify all officers, directors, and stockholders holding one percent or more of the shares of the respective company. Club licenses must list names of officers and directors and attach a current membership list. NAME OF CORPORATION OR CLUB COVERED BY THIS PAGE (COMPLETE ONLY IF APPLICANT OR STOCKHOLDER IS A CORPORATION OR PARTNERSHIP) HGC Basking Ridge, LLC pName of individual (last name first), stockholder, partner, officer or director: 7 HGC Holdings III, LLC Last Name First Middle Initial Home Street Address __ 100 St. Paul Street, Suite 800 Number Street Name P.O. Box # Municipality _ Denver state __ CO Zip _ 80206 - Social Security number Date of birth sf Home telephone number ( ) : Area Exchange Number Office telephone number (720) _ 284 -__ 6400 Area Exchange Number % of business owned or controlled 100% Number of shares Check position that applies: Sole owner Partner Stockholder ___ President _____ Vice-President Secretary Treasurer Director Trustee Manager Agent Executor/Administrator ____ Receiver Beneficiary _¥ Other (specify) Member Name of individual (last name first): Last Name First Middle Initial Home Street Address Number Street Name P.O. Box # Municipality State Zip : Social Securitynumber == Date of birth o/s Home telephone number ( ) : ‘Area Exchange Number Office telephone number ( ) : ‘Area Exchange Number % of business owned or controlled ___— Number of shares Check position that applies: Sole owner Partner Stockholder ___ President ____ Vice-President Secretary
phone number ( ) : ‘Area Exchange Number % of business owned or controlled ___— Number of shares Check position that applies: Sole owner Partner Stockholder ___ President ____ Vice-President Secretary Treasurer Director Trustee Manager Agent Executor/Administrator ____ Receiver Beneficiary Other (specify)
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