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If naturalized, state date and place of naturalization <br /> <br />If no, state the circumstances for each partner who is not a citizen. <br /> <br />Give the full name and address of each officer's/shareholder's spouse. <br />Officer/Shareholder Spouse Address <br /> <br />President Kathryn R. Gruber 1327 Oakview Way Anoka, MN 55303 <br /> <br />Secretary/Treasurer Dianne R. Moreau 3700 Roseberry Place (Anoka) <br /> <br />Has any one of the officers/shareholders ever used or been known by a name other than <br />his/her true name? Yes No X <br />If yes, state what was such name or names, and information concerning dates and places <br />where used: <br /> <br />List occupations each partner has followed for the past five years? <br />Pro_s~ denfi .. Business Owner <br />Officer Occupation <br /> <br />Vice President Business Owner <br /> <br />I <br />! <br /> <br /> Officer <br /> <br />Secretary/Treasurer <br /> <br /> Occupation <br />Engineering M~n a g~r <br /> <br />I <br /> <br />Officer Occupation <br /> <br />I <br /> <br /> Officer Occupation <br /> <br />Has any one of the officers/shareholders ever been in the military service? <br />Yes No X <br />If yes, state which officer/shareholder(s) <br /> <br />I <br />I <br /> <br />8. State trade name to beused for the licensed premises: ~Liamonds Sp_orts Bar & Grill <br /> <br />I <br /> <br />Page 2 of 5 <br /> <br />I <br />I <br /> <br /> <br />