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<br />Indicate below chanl:es of corporate officers. vartners. home addresses or televhone numbers: <br /> <br />Indicate below any interest whatsoever. directlv or indirectlv in other liquor establishments: <br /> <br />Report below details of liauor law violations (civil or criminal) that have occurred within the last five vears. (Dates. offenses. <br />fines or other nenalties. includinl! Liquor Control Penalties): <br /> <br />Report below details involvin~ anv license rejections or revocations: <br /> <br />Citv/County Comments: <br /> <br />&1d <br />