Exhibit O1 Response to OPRA 2023 1491_Final_Redacted

; Page 10A PLEASE TYPE OR PRINT ALL INFORMATION TE ASSIGNED LICENSE numeer© 190, 2B" OlS=. CCl 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 general partner is an individual or a corporation. A list of the names and addresses ofall 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 fo 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, 410A, will identify all officers, “directors and stockholders holding one percent ormore of the shares of the respective company. Club licenses must list names of: Rules and directors and attach a current membership list. JEDI SISSIES IIIS ICT II I IIIT IIE IAI ITO TTI IIIS TT IT A TIT OA IT TASS I IIIA NAME OF CORPORATION OR CLUB ‘COVERED BY THIS PAGE (COMPLETE ONLY IF APPLICANT OR STOCKHOLDER IS A ee oe OR SERS Ss (GOR iy G | — b is ‘of individual (last ‘name first),'Stockhol es ner, ee director. Caw i LastName Home Street Address Number. SP.OsBox# Municipality *Social Security Number. Home telephone number (Office telephone number. % Of business owned or controlled = Numberof shares é Check position that applies; — = Sole owner __= = Partner. _ =~ Stockholder Aes el President Vice-President Secretary. Treasurer : Vee Trustee ___~. Manager Agent: ———_ Executor/Administrator. == Receiver Beneficiary Other (specify) i Ci of individual (last name first) , stockholder, ae officer or.director: > zs = ASC and Pai p aie ies. Last Name Middle Initial Home Street Address = pe. Number P.O. Box # Municipality Zi Social Security Number] Home telephone numb Office telephone numbel rea % of business owned or controlled <i Number of shares ee Check position that applies: Sole owner Partner Stockholder we sident Vice-President Secretary Treasurer rector nager Agent Executor/Administrator Receiver Other (specify) RESPONSE TO OPRA 2023-1491 000015