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

Page 10A PLEASE TYPE OR PRINT ALL INFOBMAIION STAIE ASSIGNED LICENSE NUMBER 202Q 33 _ 027 _ 00L ALL APPLICANTS ANSWER THE FOLLOWING JADD PAGES AS NECESSARY] SOLE OWNERS AND PARTNERSHIPS: Complete the page in fult. LIMITED PARTNEFISHIP: AII inlormation aboul a geneial partner or parlners ot a limile4 partnership must be reported, whether the general parlner is an individual or a corporalion. A list ot the names and addresses ot all limiled partners musl be submitted as an altachmenl to this applicalion with an idenlilication of the percentage of each limited partner as it relates to lotal ownership ol lhe business entity lo be licensed. COFIPORATIONS: All corporation applicants or licensees and any corporation that has an ownership interesl in the corporation under license or to be licensed must have been reporled on page 1O. lnfo.mation on this page, 10A, willidentify all oflicers, directors, and stockholders holding one percenl or more of the shares of the respeclive company. CIub licenses must list names o, oflicers and direclors and attach a currenl membership list. ** ***** * ** ** * ** * *** ** ******* ********** ** * **** ** **** ** **** * ********* *r.* ** NAME OF COHPORATION OR CLUB COVEFTED BY THIS PAGE (COMPLETE ONLY IF APPLICANT OR STOCKHOLDER IS A CORPORATION OH PARTNERSHIP). unt Echo Name ol I)dividual (last name firsl), stockholder, parlneL officer or direclor Bond Scott Last Name Middle lnilial Home SIreet Address Number # P.O. Box tv'lunicipality State zrp Date ol birlh Social Security number - - Home telephone number Eichange Nu m ber Exchange Nu m ber Of,ice Ielephone number of business owned or conirolled Number of shales _ position Check lhat applies: Sole owner Partner Stockholder President Vice-President Treasurer Director Secretary IL Trustee Receiver Manager Agenl Execulor/Administrator Beneliciary Other (specify) 0/o - - TO ADD Name of individual (last name firsl): David Brown Lasl Name Middle liitial First Home SIreet Address Number P.O. Box t Slreel Name SIate Municipallty zio Social Security number Home lelephone number - Oltice telephone number €xchange Number Exchange Number ) Number ol shares Stockholder Partner Treasurer Director Vice-Presidenl Secretary Receive. Agent Executor/Administrator Manager - 7o of business owoed or conlrolled Check position that

ge Number ) Number ol shares Stockholder Partner Treasurer Director Vice-Presidenl Secretary Receive. Agent Executor/Administrator Manager - 7o of business owoed or conlrolled Check position that applies; E - President Trustee Bene,iciary- . - Sole owner Olher (specily) - - - - -