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<br />lndicate'below chan1!es of corporate otlicers. nartners. home addresses or telenhone numbers: <br />, . <br /> <br />:f/fA(.:f <br /> <br /> <br />~ <br /> <br />or indirectl <br />Ft:.'~L( <br /> <br />51', fJ+u~ <br /> <br />other Ii, uor estahlishments: <br /> <br />Indicate below an inte est wh <br /> <br />c.Lv5 <br /> <br />CA->Vev ,J <br /> <br />Renort below details of liquor law violations (civil or crimina]) that have occurred within the last five vears. <Dates. offenses. <br />fines or other uenaJties. includinp Liquor Control Penalties): . <br /> <br />ft, <br /> <br />I <br />.:)oo/frk;\r'I <br /> <br />IkJ <br /> <br />-Iv <br /> <br />rfeD ;)\"41. <br /> <br />""'" <br /> <br />in, <br />volle",'., <br /> <br />~-<'-'1 fJf:l~fl(.v' Lt.V/. }4 <br /> <br />WCt(J'l'.(!~ <br /> <br />{,-../"I\ <br /> <br />i>Wtc! <br /> <br />~'/ h,~ fl'/"" <br />. , <br /> <br />Report below details involvim: an\' license rejections or revocations: <br /> <br />Citv/Countv Comments: <br />