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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 No If yes,list in table below.Attach additional pages,if <br /> necessary,utilizing the table format below. <br /> r <br /> Name License Type License Name Municipality <br /> =:5a h. <br /> nr <br /> -.. bin . i.._ <br /> dale-i <br /> i�:5ta�� F r ----- <br /> ._ <br /> Sw �5:�Pcka �� .. <br /> . .Saeed�A <br /> Saeed A.Chaudhry Sec 15 Package Store Willow Tree Market,Inc. Barnstable <br /> 5aeed'A.Chaudhry Sec 15 PackageStore Dennis,Food&Package,Inc. Dennis <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 Q NoEl <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 /> _.... - - - <br /> _ audh� ^d <br /> ba <br /> $� <br /> .,:Sandwich <br /> d'A.Ch f A <br /> a e S ee l <br /> :Sec a <br /> c a e'S r _ <br /> 5 .,. <br /> a �au� fi� .. rY _ <br /> h <br /> 9 <br /> Variety(Transferred store to entity) <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 0 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 /> 7s 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 letter <br /> of intent to leaser 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 M.P.G.Corporation <br /> Landlord Phone Landlord Email <br /> Landlord Address <br /> Lease Beginning Date September 10,2013 Rent per Month $14,500.00 <br /> Lease Ending Date December 31,2019 Rent per Year $174,400.00 <br /> Will the Landlord receive revenue based on percentage of alcohol sales? ( Yes e)No 3 <br />