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

PLEASE ryPE OR PRINT ALL INFORMATION Page 11 .TATEASSTGNEDL,"r LICENSE PERIOD "r*u*rr APPLIED FOR &) llof 7 FROM ) ) ) ) ) County of As provided by law (R.S. 33:1-35), + 0 TO State of AFFIDAVIT -d-Ogt DATE SS (Check One) 1. The lndividual Applicant 2. Members ofthe Partnership Applicant, . IJ Pa*-AJo--"[*l{i Pr;sid;;ffi " ce+'rsioent ) ration or Club Name) consentl s; ifi'aTmeflefi'sed premises a nd a I porlio ns ofthe building constituting the licensed premises, in ing allrooms, cellars, dosets, out-buildings, passageways, vaults, yards, aftics and every part ofthe structure ofwhich the licensed premises are a parl and all buildings used in connection therewith which are in his/her/their possession or under his/her/their control, may be inspected and searched without warrant at all hours by the Direclor of the Division of Alcoholic Beverage Control, his or her duly authorized deputies, inspectors or investigators and allothersworn lawenforcement offlcers, and being duly swom according to law, upon hivher/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 lhe corporations; and that the contents of this application represent complete disclosure ofthe fact, and that the contents of this application are true. -C I (Signalure of lndividual Agent / Sole Proprietor) (Corporations Only) Attestation by Corporate Seselary (Partnelship Name) (Signature of Partner) e Attest: c Secretary b A orate N ame (Signature of Partner) of rate President or Vice President) (Signature of Partner) Sign U sis Affix Corporate Seal (Signature of Partner) Sworn to and subsffibed before me 7I this AFFIDAVIT MUST BE SIGNED HERE ----> of BY DULY AUTHORIZED NOTARY PUBLIC (Printed OR AN ATTORNEY-AT.I.AW OF NEW JERSEY Notary s ssr 30 eof mtn h) Administering Oath) Officer AdminisGring Oath) 6rs6 c. zol? day of Expiration of Commission, if applicable)