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PART III - PERSONAL INFORMATION 33 City of St, ntlrony Liquor & Wine License Application This section should be comp agent in charge, and each corpora I by each individual, partner, officer, manager, proprietor or other ;on who by combined ownership or control has an interest in a or association in excess of five percent (5%) Truc -NatofBirth Name Cey L , �u25Tay� Place of Birth /y,, µ CyypOLiS rent Home Address State, Zi er Names Used/Alias' Cui C4, Ott Marital Status Single Mame Divorced Spouse's True Name A J LL Da Horne Ci Are e of Birth Birth /"l�,v.venrvo �i s Address , State, Zi you or your spouse a registc red voter? Applicant - o Spouse - es . No Location: &Awl , Loc tion: Guru �c idence Address for Precedi g 10Y y, State, Zip: Address and Phone Nu ber of Individual's Employers and Partners for Preceding 10 Years: Re Cil Name, 67 socf �P�cT .ops NC SCZ F— �C 1>7GO �G I N 'mes, Addresses and Phone 1, lumber of Spouse's Employers and Partners for Preceding 10 Years: Gl1G2 LS yi972�11i fir9-r/ H s applicant or spouse, or a parent vi lation of any ordinance othe ani offense for which convictions N� Name, home address and busir b sines of selling, manufactur spouse than second cousin, wh or who is a brother-in-law or sister-in-law or sibling or"child ever been convicted of any, crime or • than traffic? If so, please furnish information as to the time, place were had: ess address of each person who is engaged in Minnesota in the ng or distributing liquor and who is nearer to kin to the applicant or -ther of the whole or half blood, computed by the rules of civil law, of thea licant or theapplicant's spouse. tJ�fSdiv /3tcr Ci"rf'!7 3,Lo tN c'1Z. cX✓. �7Y6o2 .DIST 42pc ilitary Service (Upon request, y u maybe asked to provide discliarge papers) Yes . No