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

Page 10A STATE ASSIGNED LICENSE NUMBER 2rd56.r.ff oR Pt)lALL ruFoTMAroN SOLE OWNERS AND PARTNERSHIPST Complele this page in full. LIMITED PARTNERSHIPS: All information about a general partner or partners of a limited partnership musl 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 applicationwith an identification ofthe percentage ofeach limited partneras it relatesto totalownership ofthe business entity to be licensed. CORPORATIONS: All corporation applicants or licensees and any corporation that has an ownership interest in lhe corporation under license or to be licensed must have been reporled on Page 10. lnformation on this Page, 10A, will identify all officers, directors and stockholders holding one percenl or more oflhe shares ofthe respective company. Club licenses must lisl namesofofficers and directors and attach a current membelship list. TO ADD *******+**********************************************t************t*********************************************** NAME OF CORPORATION OR CLUB COVERED BY THIS PAGE (COMPLETE ONLY IF APPLICANT OR STOCKHOLDER IS A CORPORATION OR PARTNERSHIP): TO ADD Name of individual (last name first), stockholder, partner, officer or director: CenErella Robert Middle lnitial Last Name Home Street Address Street Name Number P.O. Box # _ State Municipality zip E-lvlailAddress Date of Birt Social Security Number Home telephone number Number Offlce lelephone number Number Exchange Area Number of shares % of business owned or controlled Sole owner Check position that applaes: President Vice-President _ _ _ 0 Partner Stockholder Secretary Treasurer Director Executor/Administrator Receiver Agent Manager _jL Trustee Olher (specify) Beneficiary Name of individual (last name flrst) , stockholder, partner, officer or director: GilIie George Bruce Middle lnitial Last Name Home Street Address Street Name Number P.O.Box#- State Municipality E-MailAddress zip Date of Birth Social Security Numbe -qg- Home telephone numu Area - Exchange Number Exchange Number Office telephone number (-.-) Area Number of shares 7o of business owned or controlled Sole owner Check position that applies: President xx Trustee - -lvlanager -Vice-President Other

Number Office telephone number (-.-) Area Number of shares 7o of business owned or controlled Sole owner Check position that applies: President xx Trustee - -lvlanager -Vice-President Other (specify) Beneliciary - - - _ _ _ 0 Partner Stockholder Secretary Treasurer Director Agent ExecutoriAdministrator Receiver