Exhibit O1 Response to OPRA 2023 1491_Final_Redacted

Page 10A PLEASE Bi OR PRINT ALL INFORMATION STATE ASSIGNED LICENSE numseROIGD, BS 0157 CO ALL APPLICANTS ANSWER THE FOLLOWING [ADD PAGES AS NECESSARY] SOLE OWNERS AND PARTNERSHIPS: Compiete 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 of all limited pariners 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, 410A, will identify all officers, directors and stockholders holding one percent ormore of the shares of the'respective company. Club licenses must listnames Of officers and directors ‘and attach a current membership list. ERED S OSS O OSHS SO IIS ISO OIISIEOHE IIIT IDO EI IOS IA IS TIO ISI III I TIARA I III III III I III II III ISIS I SASSI AA. NAME OF CORPORATION ‘OR CLUB COVERED BY THIS PAGE (COMPLETE ONLY IF ABELICANY OR STOCKHOLDER 1S A ere) eee OR PARYNERSHIP: 4 a PINERSHE) Ones. SO.) massa idual (lastname a eon r, partner, ‘officer or‘director: : : MiMwin Ss oe ON : ASER RS E Home Street Address ae i Number P;O: Box# Municipality 4 == Social Security Numbe Home telephone numbe| Office telephone numbeg I é Area: Exchange: be ehoniber, $ % Of business owned or f controlled i Number of shares Check position that applies: Sole owner 4 Partner == Stockholder =: Soa re a President. Vice-President. Secretary Treasurer Director Trustee. Manager “= “Agent = Executor/Administrator _ __ Receiver Beneficiary Other (specify). Name of individual (last name first) stockholder, partner, officer.or director. Last Nam Home Street Address lumber: Municipality Social Security Number Home telephone number Office telephone number Area Exchange Number %, of business owned or controlled Number of shares — é Nears Check position that applies: ~~ Sole owner —— Partner ~~ Stockholder wees President Vice-President Secretary ____ Treasurer Director _“Trustee. - ____ Manager ____ Agent ___ Executor/Administrator _

s Check position that applies: ~~ Sole owner —— Partner ~~ Stockholder wees President Vice-President Secretary ____ Treasurer Director _“Trustee. - ____ Manager ____ Agent ___ Executor/Administrator _ Receiver Other (specify) RESPONSE TO OPRA 2023-1491 000016