Exhibit O1 Response to OPRA 2023 1491_Final_Redacted

Page 108 PLEASE TYPE OR PRINT ALL INFORMATION STATE ASSIGNED LICENSE NUMBERO IA - AS _. O15. CO| ALL APPLICANTS ANSWER THE FOLLOWING [ADD PAGES AS NECESSARY) SOLE OWNERS AND PARTNERSHIPS: Complete this page in full. LIMITED PARTNERSHIPS: All information about a general partner or partners of a limited partnership must be reported, whether the eral partner Is an individual or a corporation. A list of the names and addresses of all limited partners must be submitted as an tachment to this application with an identification of the percentage of each limited partner as it relates to total ownership of the business entity to be licensed CORPORATIONS: All corporation applicants or licensees and any corporation that has an ownership interest in the corporation under license or to be licensed must have been reported on Page 10, Information on this Page, 10A, will identify all officers, directors and stockholders holding one percent or more of the shares of the respective company. Club licenses must list names of officers and directors and attach a current membership list. FHSAA IT IIIT IT IAI IT TIT IO TOI TIT TI IIIT IT ITI IIT SI IIT TS ASOT I SIA IAAI I OSS AIDS I III II IIIA I NAME OF CORPORATION OR CLUB COVERED BY THIS PAGE (COMPLETE ONLY IF APPLICANT OR STOCKHOLDER |S A ORRIN OR i Una a ON Ly & | a0) OvUn Name of individual (last name first), Rta partner, officer or director: Ost yt SAmaeS Last Nam M Initial Home Street Address Social Security Number Date of Birth Office telephone number Area Exchange Number % of business owned or controlled Number of shares Check positiop that applies: ‘Sole owner Partner Stockholder we President Vice-President Secretary Treasurer —____ Director Trustee Manager Agent Executor/Administrator __ Receiver Beneficiary Other (specify) eoernee (last name first) , (ie partner, 0 ror director: Fie | tS <4 Last Name Home Street Address Middle Initial © P.O. Box # State | Security Number Home telephone numbe| Office telephone numbei % of business owned or controlled Number of shares Check position that applies: Sole owner Partner Stockholder President Wice-President Secretary Treasurer __ Director Trustee Manager Agent Executor/Administrator _~___ Receiver Beneficiary Other (specify) RESPONSE TO OPRA 2023-1491 000013