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

Page 2 PLEASE TYPE OR PRINT ALL INFORMATION STATE ASSIGNED LICENSE NUMBER _1802_-_ 33-005 -_011 Application is made on behalf of 7 1 = An Individual 2 = Business Corporation 7 = Limited Liability Company 3 = A Partnership 4 = Unincorporated Club 5 = Incorporated Club 6 = Limited Partnership 21 NAME(S) AS IT DOES OR WILL APPEAR ON THE LICENSE CERTIFICATE (NOT “TRADE” NAME): License may be held by Individual (Last Name, First Name, Middle Initial), Partnership or Corporation. ,__HGC Basking Ridge, LLC J (Last Name, First Name, Middle Initial or Corporate Name) 2.2 ACTUAL ADDRESS WHERE THE LICENSE IS TO BE USED (SITED PREMISES): Street Address __ 185 Madisonville Road Number Street Name Municipality __ Basking Ridge (Bernards Township) Zip 07920 - Area Exchange Number 2.3 If no licensed premises exists or if a mailing address is different than the “actual address” given above, provide the mailing addres (insert N/A if not applicable) Street Address __ 13873 Park Center Road, Suite 203N Number Street Name P.O. Box # Municipality___ Herndon State__ VA Zip_20171__- Telephone (_703 )_861__-__0518 24 J New Jersey Sales Tax Certificate of Authority No. ; Sr 2.5 TRADE NAME(S) UNDER WHICH BUSINESS IS TO BE CONDUCTED. ALL TRADE NAMES MUST BE LISTED AND REGISTERED WITH THE N.J. SECRETARY OF STATE [if a corporation] OR COUNTY CLERK [if a partnership or sole proprietor]. Basking Ridge Country Club 2.6 / THE FOLLOWING QUESTIONS ARE TO BE ANSWERED BY ALL APPLICANTS OTHER THAN APPLICANTS FOR A NEW LICENSE A. 1S THE LICENSE ACTIVELY USED AT AN OPERATING PLACE OF BUSINESS? Yes No B. IF NO, GIVE THE DATE THE BUSINESS STOPPED OPERATING (OR THE DATE THE LICENSE WAS ORIGINALLY ISSUED IF NEVER SITED AT AN OPERATING BUSINESS): / ti C. IF THE LICENSE IS INACTIVE AND THE APPLICATION IS FOR A TRANSFER, WILL THE LICENSE BE USED AT AN OPERATING PLACE OF BUSINESS AFTER APPROVAL? Yes No 27 THE FOLLOWING QUESTIONS ARE TO BE ANSWERED BY AN APPLICANT FOR A NEW LICENSE A. WILL THE LICENSE BE USED AT AN OPERATING PLACE OF BUSINESS IMMEDIATELY UPON ISSUANCE? Yes No B. IF NO, PROVIDE ANTICIPATED DATE OF LICENSE ACTIVATION / /