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r + <br /> . If the applicant is a corporation, answer the following questions: (Corporate applicants must include with this application <br /> a copy of the vote by the board of directors appointing the manager or other principal representative) <br /> _ a.Are the-majority-of directors United states lti ens? � des No <br /> y . b.Are the majoritymajority of directors clitle�i of thee Commonwealth of Massachusetts KEIN o <br /> . Is the managetr or principal representative,a United States CitizenEYes ON o _+' <br /> ., <br /> -4. How manor shares of stock are =thori Zed 0 Y YYa! e. Hoer man -sures of stock are issued? wOOO _ <br /> f.-Will a:tr stock be pledged as collateral.fior this licenser yes No If y'e s, to whom <br /> S. Will this license be pledged as collateral Elyes1K No If fires, to whom? r <br /> NOTE: -if applicant is ars association, 9t copy of the bi rt.h certificate,f natura Ii ation certificate or registered voter certificate <br /> for each member who signs at the end of this form must be included with,this application,-- <br /> N DTI CE <br /> The accompanying General Instructions are incorporated herein by reference. <br /> SIGNED-ASID UB RIB D TO U D + PENALTY DP P RA THIS .. .,.Y` ._�-'DAY of � �.� _��. 1 <br /> 9 10 <br /> B fog URE OF FULL NAME <br /> • ..� i i _ r _ � + rt # rt a a a ##i a r a': f f��;'i-`�'�-�`�� ii <br /> _ +� A � }F*'*C 1 +} �'i_ i i }r ; ~ ` 1 ;• # r�S *J J ". ; '+f . � 'r w *� •. � y i i sf�- ' +i, , _ T , �'+� , <br /> ;* % 1 # Jf�� }.J '-# 1. J S/ �.} # 1 •* <br /> .,r+.r J-. _ ' � �f r�+ �'� t +� -r {r � y.i #J� }4,+ 'a.F 1•{+ '�.� •i{. •. r`��`- , , � + - ^�I <br /> _ � i i!�i i ii i �—i.i� i i i# i i•i i�� #i'� i-i f f #a rt #f_i+i•T##_ <br /> rt �. „ t.+_�:,�� �....�..�._�._,� � _ �*, r - -s_A.t k._j �r wtt !•ti,.,a.._. �:. .. ._�,.__ s_.r__...__�.a r+_.-.._.__ .,ta.•.'._-.w.�w ,Tr-++t-«Y �+t <br /> rt i•T i it# �i W�it�# i i a i �f 1 i #i �.t i i� i i i E f i tom#a� # <br /> f'4' y y" 7� ._.L + _� :, `r <br /> „ �� i #�� �a _ �f i•� W � f# �i 4 i 1 � i i � i rt� # i � �rt i� • , <br /> t a. s ♦ ..k a L ti <br /> i <br /> Note:-1. I�di�+'idua�l~appficar�t s) must sign above. <br /> . Applications by a partnership muse be signed by-a rhajority of the partners._ <br /> ---3.- Applications by a corporation-must be signed bar an officer authori zed•b a-Grote of the corporation's board of directors. <br /> A-copy of the vote of authorization must be included with this application. <br /> . Applications by.ars association must be Si <br /> ned by a majority of the members of the governing body. <br /> All the signers must have answered question 6a. <br /> Name of attorney, if any, filing application on behalf'of licensee. Telephone number <br /> Thom"as q. <br /> Office address _ y `t *t _ - .. + _ ±�• - •. _.... _ <br /> 3 #Y+ <br /> .55 <br /> Sea Street Extension, Hyannis, MA 02601 .._ <br /> Time of filing Date of filing Name of newspaper publishing notice of application <br /> [J6 day 117 day <br /> ARS license granted <br /> pa b' Cow may be us6d by local licensing authorities for additional information. <br />