Exhibit O1 Response to OPRA 2023 1491_Final_Redacted

Page 140A PLEASE TYPE OR PRINT ALL-INFORMATION STATE ASSIGNED LICENSE’ nuMBERO IDO. 5 ey = OlS - Col 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 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 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 40!" Information on this Page, 40A, will identify all officers, directors and stockholders holding one percent ormore of the shares of the respective company. Clubilicenses must list names Of officers and directors and attach a current membership list » JE II JO IIIS ICI I TE IOI TIO TIE ITI IOI TTT IAT I IIIT I IOI II IIT I III ITI TIT IIIS SOS IA IIS OS IIT IIIA ISS III SNS I NAME “OF CORPORATION OR*CLUB COVERED BY THIS PAGE (COMPLETE ONLY IF APPLICANT OR STOCKHOLDER IS A CORPORATION OR PARTNERSHIP): 4 e z : BeOS SR Com kc C10 Napne of individual (lastihame first), stockholder, partner, officer or director S10 Bendel’ Middle" Initial hone number : Area = Exchange Number % of business owned or controlled Number of shares Check position that applies: Sole owner Partner Stockholder President Vice-President Secretary ‘Treasurer 2 Director = Trustee Manager Agent = Executor/Administrator Receiver Beneficiary Other (specify) Name pf individual (last name first) stockholder, partner, officer or director: ese Maen Last Name Home Street Address P.O. Box# Municipality Zp O00 \ Social Security Number Home telephone numbe: Office telephone number: Area Exchar Number % of business owned or controlled + Number of shares . Check position that applies: Sole owner Partner Stockholder / President Vice-President Secretary Treasurer Direct Manager “Agent Executor/Administrator Receiver Other RESPONSE TO OPRA 2023-1491 000018