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

Page 7 PLEASE TYPE OR PRINT ALL INFORMATION STATE ASSIGNED LICENSE NUMBER 1802. 33 - 005. (011 71 ALL APPLICANTS OTHER THAN CLUB LICENSE ANSWER THE FOLLOWING DOES THE APPLICANT, A MEMBER 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? Y_Yes No IF THE ANSWER IS “YES,” COMPLETE THE FOLLOWING BY LISTING THE NEW JERSEY LIQUOR LICENSE TWELVE DIGIT NUMBER(S) AND THE NAME(S) OF THE PERSON(S) OR CORPORATION(S) WHO HOLD(S) SUCH INTEREST. USE ADDITIONAL PAGE(S) 7 AS NEEDED. A. License Number __2013 -__ 33 -__ 013 -__ 004 Name __HGC Shackamaxon, LLC (Scotch Plains) (Last Name, First Name, Middle Initial or Corporate Name) Relationship to Applicant __ Sister Company IOI IIIA IIIA I TICS II IIIT EIST ETI III II III I I I III III III IIIA I ISIS ISIS ISIS ISAS SII B. License Number _ 1022 -_33 - _001 - 005 Name _ HGC Stanton Ridge, LLC (Readington Township) (Last Name, First Name, Middle Initial or Corporate Name) Relationship to Applicant __Sister Company LIES OOS SO SEIS IIIS IIS IIIS GI I gC TI I I I I TT I I TI I I I I I I TI II TI TTI ITT C. License Number - - w Name (Last Name, First Name, Middle Initial or Corporate Name) Relationship to Applicant In EHS ESE SEI O nC OO OSS So Sa OS III II I I I I ao Ica a I I I I I TT I I I TT TT TT TT TA 7.2 WOULD ANY PERSON OR CORPORATION 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 _¥__No IF THE ANSWER IS “YES,” ANSWER THE FOLLOWING BY INSERTING THE NAME OF THE INDIVIDUAL OR CORPORATION AND THE SOCIAL SECURITY NUMBER AND DATE OF BIRTH, IF AN INDIVIDUAL. USE ADDITIONAL PAGE(S) 7 AS NEEDED Name (Last Name, First Name, Middle Initial or Corporate Name) Social Security Number - - OR NJ Sales Tax Certificate of Authority No. Date of Birth / /