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DEPARTMENT OF LIQUOR CONTROL COUNTY OF HAWAI'l <br />ECIE f VE <br />Hilo Lagoon C,',)ntre, 101 Aupuni St., Unit 230, Hilo, Hawai'l 96720 Phone.- (8081961-8218 <br />E-Mail.- cohdic,ahowaycounty,ggy <br />PERSONAL HISTORY AND AFFIDAVIT <br />(Type or Print All Information) APR 4 2025 <br />NAME Batither, Chamiaitle Marie Dept. of Liquor Control <br />I INFORMATION AS REGISTERED WITH THE DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS: <br />List registered business nanve and dba: Hamakua Distillery LLC <br />Office/title you hold and copy of minutes of election, Owncr Effective Date: _Lil <br />If ancfrccible the percentage of stocks/shares you hold (' b t) tic <br />11 LIST PAST OWNERSHIP OF LIQUOR LICENSE. <br />LICENSEE NAME DBA ADDRESS Y9AR <br />111 EMPLOYMENT RECORD r)o ,,�.­rh the most recent emp;oyment) <br />FROM TO POSITION NAME OF COMPANY CITY <br />September 1988 June 2020 1 IS Teacher New flavcn Unified School Dist. Union City,CA <br />If additional sp,-i-le is reeded, use reverse side, <br />IV. CRIMINAL RECORD, IF ANY. Check box. <br />1K ) I have not been convicted of any fetony charge(s), <br />( ) I have been convicted of a felony charge (s). If the answer is in the offwmative, please list. <br />I being first duty sworn, deposes and says that the above information Is true and correct. <br />Signature of A�p�p��fare Notary <br />Subscribed and sworn to before me <br />this 0 f 20 <br />is f Doc. Date: UOd e # P Iga C <br />'ACI R To WAI�Tl ircuit <br />• <br />T Narre <br />P A%y <br />ry P,,111­'�­ ",,gnature) <br />,mac. Description: Pers <br />fir <br />• <br />11 1 <br />STAGE Ti WALTJ 0 T4 <br />A AL <br />Nolary Pub (pant nome) <br />% Z�- !z z <br />000 <br />STATE OF W" 5�0 <br />SA <br />My CommiSsior, : 00* 6. 4�4 <br />Notary "' <br />Revised: 09/05/2018 Ha*Nat Crj�.iray is art L , ai opportunity Provider 'arid! b"0I0V*v <br />EXHIBIT 1 <br />