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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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Page 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) Steele HGC Investment II, LLC Name of individual (last name first), stockholder, partner, officer or director: v Siegel Steven Ss Last Name Middle Initial Home Street Address __| Number —— Name P.O. Box Municipality State Zz Zip Social Security number oosteorinn Home telephone number rea xchange jumber % of business owned or controlled 0% Number of shares Check position that applies: Sole owner Partner Stockholder _v President _ Vice-President _W Secretary Treasurer Director Trustee Manager Agent Executor/Administrator __ Receiver Beneficiary Other (specify) Name of individual (last name first) Vv Martin James ("Charlie") Charles Last Name Middle Initial Home Street Address | Number lame POBox Municipality coe i Social Security number Home telephone number % of business owned or controlled 0% Number of shares Check position that applies: Sole owner Partner Stockholder ____ President ____ Vice-President Secretary _W Treasurer Director Trustee Manager Agent Executor/Administrator ____ Receiver Beneficiary _W Other (specify) _Chief Financial Officer and Assistant Secretary

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