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APPLICATION FOR A NEW LICENSE <br /> 6A. INTEREST IN AN ALCOHOLIC BEVERAGES LICENSE <br /> Does any individual or entity identified in question 6,and applicable attachments, have any direct or indirect,beneficial or financial <br /> interest in any other license to sell alcoholic beverages? Yes J-X� No ❑ If yes,list in table below.Attach additional pages,if <br /> necessary,utilizing the table format below. <br /> Name License Type License Name Municipality <br /> ASZSGMUMAnc dlb7aMa5hpeelVlart Retatt Annual me -S Town of ashpee IV1A- <br /> Zohaib Shahid Retail Annual-Wine&Malt Beverages Town of Mashpee,MA <br /> 613. PREVIOUSLY HELD INTEREST IN AN ALCOHOLIC BEVERAGES LICENSE <br /> Has any individual or entity identified identified in question 6,and applicable attachments,ever held a direct or indirect,beneficial or <br /> financial interest in a license to sell alcoholic beverages,which is not presently held? Yes ❑ No 0 <br /> If yes,list in table below.Attach additional pages,if necessary,utilizing the table format below. <br /> Name License Type License Name Municipality <br /> 6C. DISCLOSURE OF LICENSE DISCIPLINARY ACTION <br /> Have any of the disclosed licenses listed in question 6Aor 6B ever been suspended,revoked or cancelled? <br /> Yes ❑ No ❑X If yes,list in table below.Attach additional pages,if necessary,utilizing the table format below. <br /> Date of Action Name of License City Reason for suspension,revocation or cancellation <br /> 7. OCCUPANCY OF PREMISES <br /> Please complete all fields in this section. Please provide proof of legal occupancy of the premises. <br /> • If the applicant entity owns the premises,a deed is required. <br /> • If leasing or renting the premises,a signed copy of the lease is required. <br /> • If the lease is contingent on the approval of this license,and a signed lease is not available,a copy of the unsigned lease and a fetter <br /> of intent to lease,signed by the applicant and the landlord,is required. <br /> • If the real estate and business are owned by the same individuals listed in question 6, either individually or through separate <br /> business entities,a signed copy of a lease between the two entities is required. <br /> Please indicate by what means the applicant will occupy the premises <br /> Lease <br /> Landlord Name Theodore Kyros,Trustee <br /> Landlord Phone Landlord Email <br /> Landlord Address - <br /> Lease Beginning Date January 1,2018 Rent per Month $2,500.00 <br /> Lease Ending Date December 31,2027 Rent per Year $30,000.00 <br /> Will the Landlord receive revenue based on percentage of alcohol sales? ()Yes (�)No 3 <br />