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ADDENDUM A <br /> 2. Change of Officers,-Stock or Ownership Interest Continue... <br /> List all proposed individuals or entities that will have a direct or indirect,beneficial or financial interest in this license(E.g.Stockholders, <br /> Officers,Directors,LLC Managers,LLP Partners,Trustees etc.). <br /> Entity Name Percentage of Ownership in Entity being Licensed <br /> (write"NA"if this is the entity being licensed) <br /> EDarby's Natural Markets L <br /> Name of Principal Residential Address SSN DOB <br /> Rory Eames <br /> ; <br /> Title and or Position Percentage of ownership Director US Citizen MA Resident <br /> CEO/Manager 80°x° co:Yes C No Yes (7 No Co.)Yes ':No <br /> Name of Principal Residential Address SSN DOB <br /> Ryan Eames <br /> Title and or Position Percentage of Ownership Director US Citizen MA Resident <br /> Manager s% (::Yes C No �:`Yes C No i Yes �'` No <br /> Name of Principal Residential Address SSN DOB <br /> Title'and or Position Percentage of ownership Director US Citizen MA Resident <br /> (`Yes No Yes ` No Yes C No <br /> Name of Principal Residential Address SSN DDB <br /> Title and or Position Percentage of Ownership Director US Citizen MA Resident <br /> Yes ':No C Yes C No Yes '( No <br /> Name of Principal Residential Address SSN DOB <br /> Title and or Position Percentage of Ownership Director US Citizen MA Resident <br /> C E Yes C No Yes No ( Yes. ( No <br /> Name of Principal Residential Address SSN DDB <br /> Title and or Position Percentage of Ownership Director US Citizen MA Resident <br /> C YesNo C Yes (7 No .....( Yes ( N o <br /> Name of Principal Residential Address SSN DOB ................. <br /> Title and or Position Percentage of ownership Director US Citizen MA Resident <br /> C Yes C No ( Yes ( ,No ( Yes � No <br /> CRIMINAL HISTORY <br /> Has an individual identified above ever been convicted of a State,Federal or Military Crime? C~ Yes No <br /> Y y <br /> if yes,attach an affidavit providing the details of any and all convictions. <br />