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<br />Indicate below chane:es of corporate officers. partners. home addresses or telephone numbers: <br /> <br />A/O(\/C <br />, <br /> <br />Indicate below any interest whatsoever. directly or indirectly in other liquor establishments: <br />/fJ d 1'\/ {~ <br /> <br />Report below details of liquor law violations (civil or criminal) that have occurred within the last five years. (Dates. offenses. <br />fines or other penalties. includine: Liquor Control Penalties): <br /> <br />/-27-63 <br /> <br />F,q1L.-eO <br /> <br />('omn!JAvc € <br />, . <br /> <br />C h e Co 1<. <br />-- <br /> <br />Report below details involvine: any license rejections or revocations: <br />1/1/ 0 J-/ e <br /> <br />City/County Comments: <br /> <br />jlL <br />