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Give the full name and address of each officer's/shareholder's spouse. <br />Officer/Shareholder Spouse Address <br /> <br />I <br />! <br /> <br />Has any one of the officers/shareholders ever used or been known by a name other than his/her <br />true name7 Yes No /~ <br />If yes, state what was such name or names, and information concerning dates and places where <br />used: <br /> <br />List occupations each partner has followed for the past five years? <br /> <br /> Officer Occupation <br /> <br /> ' OffiCer ' ' Occupation / <br /> <br />Occupation ~.O ~,~---- <br /> <br />Occupation <br /> <br />7. Has any one of the officers/shareholders ever been in the military service.'? <br /> Yes ><" No <br /> If yes, state which officer/shareholder(s) R./.~-/, x_)e:_ /'g/ZP'~_/z z'.d <br /> <br /> I <br /> ! <br />1' <br />I: <br />I <br /> <br />Mst below the names, addresses and business addresses of each person who is engaged in <br />Minnesota in the business of selling, manufacturing, or distributing intoxicating liquor and <br />who is related to the applicant or his spouse closer than second cousin, whether whole or half <br />blood, or who is a brother-in-law or sister-in-law to the applicant or spouse. <br /> <br />I <br />I <br /> <br /> 10. On what floor is the licensed premises located, or to be located? /~z"~,/~ <br />, 11. In what zoning district is the premises located? c~0/z~/z/- <br /> Is the building located within the prescribed area for shch license? Yes <br /> <br />No <br /> <br />12. Is the premises located clos.er.J_han 1,000 feet to a church, grade or high school? <br /> Yes No 2<: If yes, give approximate distance of the premises from <br /> such school and/or church <br /> <br />Page 2 of 5 <br /> <br /> <br />