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

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