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Page 8 PLEASE TYPE OR PRINT ALL INFORMATION <br /> STATE ASSIGNED LICENSE NUMBER 0252 - 44 005 003 <br /> ALL APPLICANTS ANSWER THE FOLLOWING <br /> 8.1 DOES THE APPLICANT OR ANYONE MENTIONED IN THIS APPLICATION OWE THE STATE OF NEW JERSEY OR <br /> THE UNITED STATES ANY LICENSE FEE, PENALTY, INTEREST OR ALCOHOLIC BEVERAGE TAX WHICH HAS <br /> ACCRUED PURSUANT TO THE ALCOHOLIC BEVERAGE TAX LAW,THE ALCOHOLIC BEVERAGE LAW OR ANY <br /> OTHER NEW JERSEY OR FEDERAL LAW? <br /> Yes XX No <br /> 8.2 HAS THE LICENSE BEEN ISSUED, OR IS IT BEING REQUESTED TO BE ISSUED, FOR A HOTEL/MOTEL AS AN <br /> EXCEPTION TITHE POPULATION RESTRICTION UNDER THE PROVISIONS OF R.S. 33:1-12.20? <br /> Yes Qt No <br /> IF THE ANSWER IS"YES,"IS IT FOR A HOTEUMOTEL FACILITY OF 50 OR 100 ROOMS? <br /> CHECK ONE: 50 ROOMS 100 ROOMS <br /> 8.3 HAS THE LICENSE BEEN ISSUED,OR IS IT BEING REQUESTED TO BE ISSUED,AS AN EXCEPTION TO THE TWO <br /> LICENSE LIMITATION LAW (R.S. 33:1-12X) FOR A HOTEUMOTEL, RESTAURANT, BOWLING ALLEY OR <br /> INTERNATIONAL AIRPORT? Yes AA No <br /> IF THE ANSWER IS"YES,"CHECK ONE OF THE FOLLOWING: HOTEUMOTEL <br /> RESTAURANT BOWLING ALLEY INTERNATIONAL AIRPORT <br /> THE FOLLOWING ARE TO BE ANSWERED WHEN APPLICATION IS FOR A LICENSE TRANSFER. <br /> 8.4 LICENSE NUMBER SOUGHT TO BE TRANSFERRED - - - <br /> 8.5 IF THIS IS A REQUEST FOR A PERSON-TO-PERSON TRANSFER,INSERT NAME(S)OF PERSON(Last Name First), <br /> PARTNERSHIP OR CORPORATION CURRENTLY HOLDING THE LICENSE: <br /> (Last Name, First Name, Middle Initial or Corporate Name) <br /> 8.6 IF THIS IS A REQUEST FOR A PLACE-TO-PLACE TRANSFER OF A POCKET LICENSE(NO SITED PREMISES), <br /> MARK AN X HERE: <br /> IF THIS IS A REQUEST FOR A PLACE-TO-PLACE TRANSFER OF A SITED LICENSE,INSERT THE ADDRESS OF THE <br /> CURRENT SITE FROM WHICH THE LICENSE IS TO BE TRANSFERRED. <br /> Street Address <br /> Number Street Name <br /> Municipality New Jersey <br /> Zip <br /> THE FOLLOWING ARE TO BE ANSWERED BY APPLICANTS FOR A NEW LICENSE OR A LICENSE TRANSFER. <br /> 8.7 INSERT THE ANTICIPATED DATES WHEN PUBLIC NOTICE OF APPLICATION WILL BE PUBLISHED. PUBLICATION <br /> MAY NOT BE SOONER THAN THE DATE OF FILING OF THIS APPLICATION. <br /> Date of first notice / <br /> Date of second notice <br /> 8.8 NAME OF NEWSPAPER TO PUBLISH NOTICE <br /> 8.9 THE FOLLOWING ARE TO BE ANSWERED BY CORPORATIONS REPORTING A CHANGE OF CORPORATE <br /> STRUCTURE WHEREIN A NEW STOCKHOLDER ACQUIRES MORE THAN 1 PERCENT OF THE STOCK OF THE <br /> LICENSED COMPANY(ONE PUBLICATION OF NOTICE REQUIRED). <br /> Date of notice <br /> Name of newspaper publishing notice <br /> THE FOLLOWING QUESTIONS ARE FOR CLUB LICENSE APPLICANTS ONLY: <br /> 8.10 HAS THE CLUB BEEN IN ACTIVE OPERATION IN THE STATE OF NEW JERSEY FOR AT LEAST THREE YEARS <br /> CONTINUOUSLY IMMEDIATELY PRIOR TO THE SUBMISSION OF ITS APPLICATION FOR A LICENSE? <br /> Yes No <br /> 8.11 IS THE APPLICANT A CONSTITUENT UNIT, CHARTERED OR OTHERWISE DULY ENFRANCISED CHAPTER OR <br /> MEMBER CLUB OF A NATIONAL OR STATE ORDER? <br /> Yes No <br /> 8.12 HAS THE CLUB HAD EXCLUSIVE POSSESSION AND USE OF CLUB QUARTERS FOR THREE CONTINUOUS YEARS? <br /> Yes No <br /> • 8.13 DOES THE CLUB HAVE AT LEAST 60 VOTING MEMBERS? <br /> Yes No <br />