Exhibit O1 Response to OPRA 2023 1491_Final_Redacted

Page 10A PLEASE TYPE OR PRINT ALL INFORMATION STATE ASSIGNED LICENSE NUMBEROIDD, 23 _C1S-_CO| ALL APPLICANTS ANSWER THE FOLLOWING [ADD PAGES AS NECESSARY] SOLE OWNERS AND PARTNERSHIPS: Complete this page jn full. LIMITED PARTNERSHIPS: All information about a general partner or partners of a limited partnership must be reported, whether the néral 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 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 mustlist names Of officers ‘and directors and attach a current membership list. SETS ISSO IO SOE II III IIIS IIIS IIIS ETAT EI III III ITI IIIT II IIIT IIS IIIA IIIT ACACIA AT AT IT IIA A SI III NAME OF CORPORATION OR ‘CLUB:COVERED BY THIS PAGE (COMPLETE ONLY IF APPLICANT. OR STOCKHOLDER ISA: ESTOS OR Pree on EG | ce) pa ee dividual (last name first), Stockholder, r, Officer or director; OF Middle'Initial” Number) Municipality] e telephone number vAreases=-) sExchange==-s-Number == % of business owned or controlled Number of shares Check position that applies: Sole owner. Partner. Stockholder : acinar ie President Vice-President ~~ Secretary Treasurer = -= = Director. Trustee _ Manager _ Agent ——_Executor/Administrator ~~ <= Receiver Beneficiary Other (specify) t Name of individual (last name first) , stockholder, partner, officer or director: zs 3 « i Span ess i OSPEGL Ine eee : Last Name Home Street Address P Zip Social.Security Number Home telephone number Office telephone number ( ‘Area Exchange Number % of business owned or controlled Number of shares ae Check position that applies: Sole owner Partner Stockholder President _ Vice-President De ceen Treasurer Director Trus Agent Executor/Administrator Receiver RESPONSE TO OPRA 2023-1491 000014