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8. AMENDMENT-Manant Agreement <br /> .. ........"NA"g, mgriftAm nt(must fill out all pages in section 8) <br /> Are you requesting approval to utilize a management company through a management agreement? ............. <br /> If yes,please fill out section 8. C Yes C No <br /> Please provide a narrative overview of the Management Agreement.Attach additional pages,if necessary. <br /> ..................... ——------ ............ ......... .......... . .....—------ ...... <br /> IMPORTANT NOTE:A management agreement is where a licensee authorizes a third party to control the daily operations of the <br /> license premises,while retaining ultimate control over the license.,through a written contract. This does not pertain to o liquor <br /> license manager that is employed directly by the entity. <br /> 8A. MANAGEMENT ENTITY <br /> List all proposed individuals or entities that will have a direct or indirect,beneficial or financial interest in the management Entity(E.g. <br /> Stockholders,Officers,Directors,LLC Managers,LLP Partners,Trustees etc.). <br /> Entity Name .... Address Phone <br /> ........... ......................... <br /> ............ ............ ............................... ........ <br /> ............ <br /> Name of Prin,cipa'I..... Residential Address SS N DOB <br /> .......... ........................ F........... <br /> ............................ <br /> Title and or Position Percentage of Ownership Director US Citizen MA Resident <br /> .................... ................... ................................. ................ <br /> ........................ <br /> N <br /> ----—- C Yes es o C No ( Yes N <br /> Name of P ....................... <br /> Residential Address SSN DOB <br /> ——-------------------------- <br /> ............................................................... <br /> ............. ..................--.-.............................. ............................................—j L-- <br /> Title and or Position Percentage of Ownership Director US Citizen MA Resident <br /> ............................................................................................................ ........................... ....... <br /> C:Y—e, <br /> ( Yes ( No Y C s No <br /> ......... ,[—-, �........... <br /> Name of Princip'lal Residential Address SSN DOB <br /> .............. <br /> ............ ............ <br /> Title and or Position Percentage of Ownership Director US Citizen MA Resident <br /> ........................ ............................ <br /> .............. <br /> ( Yes ( No C Yes C No ( Yes ( No <br /> Name of Principal Residential Address SSN DOB <br /> ............ <br /> Title and or Position Percentage of Ownership Director US Citizen MA Resident <br /> .............................................................. -—------------------ <br /> Yes No Yes . Yes <br /> es <br /> .................................. ....... <br /> C C C ( ( No <br /> .............. <br /> R'I-m I N A L HISTORY <br /> Yes No <br /> If yes,attach an affidavit providing the details of any and all convictions. <br /> Has any individual identified above ever been convicted ofa State,Federal or Military Crime"? <br /> 8B. EXISTING MANAGEMENT AGREEMENTS AND INTEREST IN AN ALCOHOLIC BEVERAGES' LICENSE <br /> Does any individual or entity identified in question 8A,and applicable attachments,a—tt�achments, have any direct or indirect,beneficial or financial <br /> interest in any other license to sell alcoholic beverages;and or have ari activ <br /> e management agreement with any other licensees? <br /> Yes No If yes,list in table below.Attach additional pages,if necessary,utilizing the table format below. <br /> ,mmmm <br /> .......... <br /> ...................... ............ .................................................................... ............ ...................................................... ............... <br /> Name License Type Litense Name Municipality <br /> .................. <br /> .............. <br /> ............... ........... .............. ...................... <br /> ............ .................. ...... .....................--------- ...... ......... <br />