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

PLEASE TYPE OR PRINT ALL INFORMATION Page 6 STATE ASSIGNED LICENSE NUMBER fisf- Sa -0,t*- Oot 6. ALL APPLICANTS ANSWER THE FOLLOWNG HAS THE APPLICANT EVER BEEN DENIEDA LIQUOR LICENSE IN NEWJERSEY? IF THE ANSWER TO THIS QUESTION IS 'YES,' ANSWER THE FOLOWNG: Type of License or Permit Denied: _ _Wholasale _ Manufaclurer Retail Warehouse _ -Yes _ Transporlation unit of Government which denied License or Permit: Date of Denial (approximate if nol known) _l _l _ Reason for Oenial 6.2 HASANY CORPORATION, PARTNERSHIP OR INDIVIDUAL MENTIONED IN THIS APPLICATION, OTHER THAN THE Yes APPLICANT, BEEN OENIED A LIQUOR LICENSE OR PERMIT? -jZ1 No IF THE ANSWER IS'YES,'ANSWER THE FOLLOWNG: No-o ^f E.tit" - Lasl Name First rvpe or License or Permit Denied: llarne ft,:,1,n""* - Unit oI Government which denied License or Permit Middle Initial rransportation -H:f::[re, - Date of Denial (approximat€ if not known) Resson br Denial 6.3 HAS THE APPLICANT OR ANY OTHER PERSON, CORPORATION OR ENTIW MENTIONED IN THIS LICENSE APPLICATION, OR ANYONE WTH A BENEFICIAL INTEREST IN IT, HAD AN INTEREST IN A NEW JERSEY -l WAS SURRENDERED, SUSPENDED OR HAD A PENALTY IMPOSED IN -l ALCOHOLIC BEVERAGE LICENSE WHICH LIEU OF SUSPENSION, NOT RENEWED, REVOKED OR CANCELLEDWTHIN THE lOYEARS PRIOR TOTHE DATE Yes y' No oF THIS APPLICATIoN? tF THE ANSWER lS 'YES," PROVIDE DETAILS OF EACH BELOW lcomplete a separate Page 6 for each actionj: LastName DATE OF ACTTON _t _l Name of lndividual Middle lnitial FiBt Name _ PENALry WAS IMPOSED BY DocKET NO. !ndicate \rihether by Division ofABC or identify Local lssuing Authorityl PENALTY CONSISTED OF; FINED $ NOT RENEWED [amount] REVOKED SUSPENDED (number of days) - OTHER lexplain] 6.4 CANCELLED HAS THE APPLICANT OR ANY OTHER PERSON OR CORPORATION MENTIONED IN THIS LICENSE APPLICATION, oRANYONEVV|TH A BENEFTCTAL TNTEREST rN THE BUS|NJSS UNDER LTCENSE ORTO BE LICENSED, EVER BEEN CONVICTED OF A CRIMINAL OFFENSE? IF THE ANSWER IS "YES,'ANSTiVER THE FOLLOWNG: Name of lndividual Middle lnitial Ftrst Last Name I Conviction Date of Birth Court of Jurisdiclion State Description of offense (specific dtarge) J/:-No A. -Yes ---------- N re Date-/- l-l- - - Disposition (fine, penalty, etc.) Nature of interest in entity to be licensed B. lf applicable, provide the date the Direclor ofthe N.J. Division ofAlcoholic Beverage

----- N re Date-/- l-l- - - Disposition (fine, penalty, etc.) Nature of interest in entity to be licensed B. lf applicable, provide the date the Direclor ofthe N.J. Division ofAlcoholic Beverage Control issued an order approving (No license may be issued without an order or disapproving disqualification removal: from the Direclor of the Division of Alcoholic Beverage Control determining no disqualification or removing disqualification.) (See R.S. 33:1-31.2 and N.:L1]Q. 13:2-'15.) Provide Agency Docket No. :lNNl- -l -l-.