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RES 2010-1466 - Appoint Tahmina Samieva manager of Tobacco & Phones 4 Less • K `STA 14 w'• / :� \ t1 , ;1 t_ j 1:_ i STATE OF NEBRASKA / 'a's NEBRASKA LIQUOR CONTROL COMMISSION d6 ■� a�% Dave Heineman p, ,, F., r t _��— 10 3 . .# Hobert B. Rupe ;�. r..: Governor t c L1! r� L"• p 4yt\\y9R .5u.,�$6,__- Executive Director 301 Centennial Mall South,5th Floor CITY C: P.O. Box 95046 r Lincoln,Nebraska 68509-5046 j M r+H G, Tv' E,lti y S r. ; Phone(402)471-2571 November 19, 2010 Fax(402)471-2814 TRS USER 800 833-7352(TTY) web address:http://www.lcc.ne.gov/ OMAHA CITY CLERK 1819 FARNAM STREET LC-1 OMAHA NE 68183 RE: TFL Inc LICENSE # D - 86071 Dear Clerk: Enclosed is a copy of a manager application for Tahmina Samieva in connection with Tobacco & Phones 4 Less, located at 5444 Center Street in Omaha. Please present this application for manager to your City/Village Council or County Commissioners and send us the results of their action. Sincerely, Lynn .hu e Licensing Division NEBRASKA LIQUOR CONTROL COMMISSION • encl. cc: file • Janice M.Wiebusch Bob Logsdon Robert Batt Commissioner Chairman Commissoner An Equal Opportunity/Affirmative Action Employe,' Printed with soy ink on recycled paper y Clerk BJB:clj -79.,(1X6 • k Notary P b signat a Notary P L si na e Affix Seal Here Affix Seal Here tM.110TARY-State of Nebraska 448830.1.NOTARY State of Nebneke 1ST UIO *Commtemm. xp. Feb.1Z 2014 JAW E PFLUG lyCo m.Exp.Feb.12,2014 In compliance with the ADA,this manager insert form 3c is available in other formats for persons with disabilities. A ten day advance period is required in writing to produce the alternate format. Revised 9/2008 Form 3c Page 4 ',: - i I ._,_I1 1 2 � ry-�- :-��:t rr hll , 1 >f 1r 1 #f.--'--' ' Tlk t- _- 5 >. i, p7i r �"t�r €s.E A. ,"..',uA s" _ 41:�1,u. Ilf+mrr's"v�:+.nl� II.: � fM" - eg Spouses Last Name: . Sc.vr eV First Name: A bcLr4.Sh;d MI: IT Social Security Number: : _: ,,__ f Drivers License Number& State: Date Of Birth: ""'J _ ' _ Place Of Birth: Twj iv.S L`ct ► �� 4r •.� �.:.fr{� . .+..:".-+4 a1 " ..::• a ._ : _� . _.... �1�:_ � � k _Nve a ii aS 3f — - - e ff ya r+ e47� a 66 �I ar 41 dl ;'-" Y — kY9Y dd --,-s q i R � 4 " y tl &y " _#s a N 1_ � arp� :1IIIr i r 'Pv am'.bY ,_fq'C bI 9 S�s 4a � r � tr 1 .4� Ig'i A�r S li t1-1 �V ,_ I: �,.,Y '�j tUr , a' , -r" ! lf, ,4 , : 0.. I�' , 4_ , n�, X,. +,; �. -<ial 3 3 � A �fi L} _1 4z1y1l�� :�_. r �� 7 ,7�- I `�.n a > l� E CITY&STAT FROM TOYEARCITY&STATE FROM TO II • 1AA �OoO aAAt �,_� _.tom h.4.;#is z � 'dIM r dr 'fl r '» III !'� 7y V 1 3'' Y' "'3m' n rar ! :a r s* ; �I ,�' "� �'' � r `": 3 sg. 1., iy l9'v�'A4 i¢'o ; ,` .. .. y ° J ors. A •{ 3_ �d Y^ r, e �I "I„ n '" rvT.. - ..: ,.r , I 1i 4 I ,4 @ °�-€51 z a r,-:.' x" :.. ' _ "rya j ..�,.9 - t ;'Val 4hyl' r .a' r 6 .t�. �`[ 5 ti t. ` ..10. ... 6�6 _ . _,ef`- ii - '��1 -r _� �_....-� 2ra:' �P��, 'n,.ti ;,i T a Oh �yJti `€� -- u^- YEAR NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER II C �:i "• - y0 y�4Q.' b -1 OS 7FROM TO 7to�-.394 $37t wi2/boo• Kaw•o ' : F d14 Il 1ln'2f% �aF T.T 1 1 C ' , , � 1 y ,,4 d l4 � ITI � _ � �` -.J 'g� �lt= v =boa G ,„_2",Otv i+ a %� -- y ae uld � a It :�_.��lt�•^ ' #,�a � s�Y r m NI1 : "a ir y�, 4l ba II I iF V �� r�_r?�� .ra= ''' ,1 lh 1u I ! ` �a,h: a�- Form 3c Page 2 emised premises may be situated is destroyed to an extent of not less than one-third of the replacement costs thereof,Lessor may elect to terminate this lease whether the demised premises be injured or not. A total destruction of the building in which the premises may be situated shall terminate this lease 15.Lessor's Remedies on Default If lessee defaults in the payment of rent,or any additional rent,or defaults in the performance of any of the other covenants or conditions hereof,lessor may give Lessee notice of such default and if Lessee does not cure any such default within t S. days,after the giving of such notice(or if such other default is of such nature that it cannot be completely cured within such period,if lessee does not commence such curing within such 0 days and thereafter proceed with reasonable diligence and In good faith to cure such default);then Lessor may terminate this lease on not less than 14.'rj days'notice to Lessee. On the date spedfied in such notice the term of this lease shall terminate,and Lessee shall then quit and surrender the premises to Lessor,without extinguishing Lessee's liability. If this lease • wwasoaates mm page 2.of 3 m 2004,Socrates Media,llC • 1F140.1•Rev.04/04 MANAGER, APPLICATION Office Use 1 INSERT-FORM 3c • NEBRASKA LIQUOR CONTROL COMMISSION 301 CENTENNIAL MALL SOUTH PO BOX 95046 LINCOLN,NE 68509-5046 PHONE:(402)471-2571 FAX:(402)471-2814 Website:www.lcc.ne.gov Corporate manager,including spouse,are required to adhere to the following requirements If spouse filed affidavit of non-participation fingerprints and proof of citizenship not required 1) Must be a citizen of the United States 2) Must be a Nebraska resident(Chapter 2—006) 3) Must provide a copy of birth certificate,naturalization paper or US passport 4) Must submit fingerprints(2 cards per person) 5) Must be 21 years of age or older 6) Applicant may be required to take a training course r- --- I:Yri -. am` 4. s t� S ih iv,,,-----, Nt s C i.. w aI x • _N ' t t -pI - 1 ey . "- ' -a- x _x t IK'i't.11 -, �P '- y t u*, Ys ? am� ti 11bg k I '': F 1,S3 t-- IF --' dl � F °k�' � -� . PH Si. - M 5? N _i� i I� 6 If _"y 1 rs lr'3" " I , Iri t i1 4 1t,7 v' : - V^ a*SF .. ,� 4 „ ir4 : 1f A - u �v _ ? th, Name of Corporation/LLC: TFL ING h��N r:a 1'=m-_��� ''a i t E �� ,e ., 9t"tom N-9',_ It[h, N_i 1 'rt,tf:�x ..siil0r4'rT '1 !*:N•i _ bra • 6 "' a '�"q l II ti bpi,i tl t ...i '"� ;I.: L[ r` �L :m i s P it l s a N a,' a`W'.YC x N, _'.?,- v -, 7 x-- _I � Premise License Number: 486 071 (if new application leave blank) 4 Premise Trade Name/DBA: ` To ba .c oe P�+0 KP.S Less eet Address: ,s+rce:{ Premise Str 5 4 �+4 CP,..i,-�-er- City: 0Ma�4 Zip •Code: 6$ 1� Premise Phone Number: Voa- 93,2- $S-33 a w "�pl' �'II u a` -4--Hik. j �m �-gN :1 *,;fir Y....'i t :d7 d3 t � ;} -€ .�I ::.r pl 4 - �It 6�' S% a a: -'� # �sG 4 A zi' ° .P7,. „: f 9- 1`�.:: ri �,. 1aP„� `I �I �. .w.tP �,h ��,� � �r §- r ? i�`T r. .� n F, ' s'µ`t c r ' Niiy- .- F,r�rCa'91 -,, -r .�k ,� 1 yz •6 CYm ' P • .. . #"f i L ! 3 ,1,-%__ ;pu4l'a.: .r'.a �.._ ?:a t g l wrbl „�j 1 _ t . `I' rt ] 44 4 l - W!zi f4. yt: yT-yr U,; ,,.",-,1r+ i a:d >M.5✓s•r ]. - -1n'iG r1{ f91C —g- r � y, 1- A^ IT, •Ar! M'IIIF-.r�l:w f' I, F ., - A"�.a:. r�1 1 - • 1000021784 fiest tit,v..: 0,ty CORPORATE OFFICER SIGNATURE Faxed sir a• tures are acce.table 11 w w5 4 r ..:r,-.5` a '- `�. "i .w.# y I� "-I ke}5; f .. i ,_: ,,'x'1,I; k - ` ' r II.,IUO ,gym _ .� y �r :��a N few '' I I p hl� -', • y a � S,vir II�,�I ''°, .1 et,, , .:w �I -" u r � e,N h 'I ?"f"�`'�`�, k; ' �.t �-✓` ".. _ 1 - ;3. Form 3c Page 1 1 3'' Y' "'3m' n rar ! :a r s* ; �I ,�' "� �'' � r `": 3 sg. 1., iy l9'v�'A4 i¢'o ; ,` .. .. y ° J ors. A •{ 3_ �d Y^ r, e �I "I„ n '" rvT.. - ..: ,.r , I 1i 4 I ,4 @ °�-€51 z a r,-:.' x" :.. ' _ "rya j ..�,.9 - t ;'Val 4hyl' r .a' r 6 .t�. �`[ 5 ti t. ` ..10. ... 6�6 _ . _,ef`- ii - '��1 -r _� �_....-� 2ra:' �P��, 'n,.ti ;,i T a Oh �yJti `€� -- u^- YEAR NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER II C �:i "• - y0 y�4Q.' b -1 OS 7FROM TO 7to�-.394 $37t wi2/boo• Kaw•o ' : F d14 Il 1ln'2f% �aF T.T 1 1 C ' , , � 1 y ,,4 d l4 � ITI � _ � �` -.J 'g� �lt= v =boa G ,„_2",Otv i+ a %� -- y ae uld � a It :�_.��lt�•^ ' #,�a � s�Y r m NI1 : "a ir y�, 4l ba II I iF V �� r�_r?�� .ra= ''' ,1 lh 1u I ! ` �a,h: a�- Form 3c Page 2 emised premises may be situated is destroyed to an extent of not less than one-third of the replacement costs thereof,Lessor may elect to terminate this lease whether the demised premises be injured or not. A total destruction of the building in which the premises may be situated shall terminate this lease 15.Lessor's Remedies on Default If lessee defaults in the payment of rent,or any additional rent,or defaults in the performance of any of the other covenants or conditions hereof,lessor may give Lessee notice of such default and if Lessee does not cure any such default within t S. days,after the giving of such notice(or if such other default is of such nature that it cannot be completely cured within such period,if lessee does not commence such curing within such 0 days and thereafter proceed with reasonable diligence and In good faith to cure such default);then Lessor may terminate this lease on not less than 14.'rj days'notice to Lessee. On the date spedfied in such notice the term of this lease shall terminate,and Lessee shall then quit and surrender the premises to Lessor,without extinguishing Lessee's liability. If this lease • wwasoaates mm page 2.of 3 m 2004,Socrates Media,llC • 1F140.1•Rev.04/04 � s� Y f u w y�ty A N _ a �,` S ri r .0 " � rap „� I, ' 5�ta-r 4 bR6 ergs q. '� M ,;4 Z VYh: $ Al ^_ �„=V° '', lat ewt=.� a • h n. q? m q- .„,, ,w � x �i `a » r ".'gym s '^ jj , s+@I�.Wq, _ - l a .,aq" fir., r. ..';,,- .., 4"an.k �+` ':9 t_ ih ='.5r �Sw:.S.x it:;x�`,�i. M,-r; Gender: ❑ MALE 1:/ FEMALE Last Name: Sc, ; evct First Name: Texh r,;r►a MI: Home Address (include PO Box if applicable): 3'1 2 N W . 1 p8�' ��a z,e , T+ it City: p v..,a State: 1V E Zip Code: 6 g 161 Home Phone Number: 'to 2r-7 O b ^ 1 go S Business Phone Number: `�02 39g-S 37? Drivers License Number& State: Social Security Number: t I Date Of Birth: _ Place Of Birth: -raj;F,.s s _ -- - -- irt �r .' �, -_lam _ a ,, r 0 � - z a r y k l E, Vak A �- 0 3 r .J i �' it h , 1 Nf �L' lit. .4 ,, , t•c 41'. : �W . C,Y, Y�Fz X YES ❑NO , ,Ir s• - '§`..,_.,'4k.r.o. .EJ ,I• " `Y, T< `r_' .. , .: P - r. re ' .A + A #, i i, •> !ki • 4 3€ i k.. n$ e �' , F .fin+ d @ F-+"�, .`J� " a}4 -4Z4- _ t4f C - ^ ate „ir 1 �' ,-1, Dr.°r _ Ie . F .a� ire ���hha �5 ��i t j .i, 'u- Spouses Last Name: Srr►i QV First Name: A 6dL,gask e4 MI: Social Security Number:_ Drivers License Number& State:_ "" SS I 1 Date Of Birth: 3 Place Of Birth: 'TGJ i k,• :St' G 9ryF ls�' ``x.- �.:' " a s_ M'@6nr I' ' war. d �'it 1 a mq rI'- ql — ,w A+i � II • 1 f I'', ; l ,,, li a'.iIt i §` ?0d J ug , , Jut • iI a� ,• iI d l�k 'I�r� �� i - �` y1� 4 ,"fit* �i`'�'u,� , ��t -its. 6 l'.:' .k �I -_ ;� � � h •-,`�. �' ��.:. ." SI 'F ,k Al: Z'I yr' ' 6 ��I ; "v',. ,. ��I3 a � �YY ip ,' -�` ghd emu ei r I�� S r ri s`� y 1q r „a : . �Y- <pp i'F=.H II•- r''�' - ,t i �' %x '� �S � 'l's i'1 � �io9E y� f�;i -„ ... �Lwi,li• �R� h u n ^.m. a' - -s.,�'1' 4 a!'v r'�;l q „ '" � CITY&STATE YEAR CITY&STATE YEAR FROM TO FROM TO © aIA . , , 2oto ! Z009 2o10 i+ r,. } q 1 Nv ,4 ,3q '` ':,r- w x yl 5 a - t ^ i r,` h "F L 1; 1p.;@* & v . . �T a - i �v ry�yx,4 R° 2i' ' FR` "' c` , r d i vl -.T? �I _ A-;;A; f t,r t a y ' AC'6.ar Mnf y� k 'I _ 3 I, . �� ,,. , J1. NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER FROM TO ?me) 200E .� ... _ �� IMIERINIEll yo2-4,.- ..08SD boob zoto IIIIIIII T L Tic �grwv •.w 402 - 3• , S 7T sx x 'r Flu: " :x If" a�t,, :, P5 W ° , 'F .r I� "�a w q,.. r ei ]M M :_ >..9 p �" M '.h a" s QIh ,, �+„ � h4y d � d_ 1 a _a„a �o . 1.,;-- r V 4ir0. I 'W@G 'F —- 'rt r , •-j,.�,. s 9',tl I:: 4! - r r 1 �7 vim"'j 4 f R �' _,r { -_teyrv,��• •..� ,..i ka, ra,b � �➢ `"�" o.aY � �'�' IrtiP mr i� - 7ii: I- P.tt -. Form 3c Page 2 . 6�6 _ . _,ef`- ii - '��1 -r _� �_....-� 2ra:' �P��, 'n,.ti ;,i T a Oh �yJti `€� -- u^- YEAR NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER II C �:i "• - y0 y�4Q.' b -1 OS 7FROM TO 7to�-.394 $37t wi2/boo• Kaw•o ' : F d14 Il 1ln'2f% �aF T.T 1 1 C ' , , � 1 y ,,4 d l4 � ITI � _ � �` -.J 'g� �lt= v =boa G ,„_2",Otv i+ a %� -- y ae uld � a It :�_.��lt�•^ ' #,�a � s�Y r m NI1 : "a ir y�, 4l ba II I iF V �� r�_r?�� .ra= ''' ,1 lh 1u I ! ` �a,h: a�- Form 3c Page 2 emised premises may be situated is destroyed to an extent of not less than one-third of the replacement costs thereof,Lessor may elect to terminate this lease whether the demised premises be injured or not. A total destruction of the building in which the premises may be situated shall terminate this lease 15.Lessor's Remedies on Default If lessee defaults in the payment of rent,or any additional rent,or defaults in the performance of any of the other covenants or conditions hereof,lessor may give Lessee notice of such default and if Lessee does not cure any such default within t S. days,after the giving of such notice(or if such other default is of such nature that it cannot be completely cured within such period,if lessee does not commence such curing within such 0 days and thereafter proceed with reasonable diligence and In good faith to cure such default);then Lessor may terminate this lease on not less than 14.'rj days'notice to Lessee. On the date spedfied in such notice the term of this lease shall terminate,and Lessee shall then quit and surrender the premises to Lessor,without extinguishing Lessee's liability. If this lease • wwasoaates mm page 2.of 3 m 2004,Socrates Media,llC • 1F140.1•Rev.04/04 ;, >. a,eye r1 to • ,. 1. READ PARAGRAPH CAREFULLY AND ANSWER COMPLETELY AND ACCURAT F ,.3 .,; Has anyone who is a party to this application, or their spouse,EVER been convicted o plead to any charge. Charge means any charge alleging a felony,misdemeanor,violation Ofiibderal,ot state,. law; a violation of a local law, ordinance or resolution. List the nature of the charge,where the charge occurred and the year and month of the conviction or plea. Also list any charges pending at the time of this application. If more than one party,please list charges by each individual's name. OYES NO If yes,please explain below or attach a separate page. 2. Have you or your spouse ever been approved or made application for a liquor license in Nebraska or any other state? IF YES,list the name of the premise. j o 4,0 4 fkorea 4 Less •'"`c+ A00evt� NE �13 ®YES ENO 'rb$co E fl ,y k 4725 ..4. 77 i4• A vt 1✓E 6 g 127 3. Do you, as a manager,have all the qualifications required to hold a Nebraska Liquor License? Nebraska Liquor Control Act(§53-131.01) NYES ENO 4. Have you filed the required fingerprint cards and PROPER FEES with this application? (The check or money order must be made out to the Nebraska State Patrol for$38.00 per person) BYES * .M ❑NO s 44 5. Do you have any experience in selling alcohol in the State of Nebraska? If so list training and/or experience (when and where) Date: Where: )000 - 2004 Co *ry w 9Ltc fito k�( -wg:4nie sS ZQOG 20/0 'Co lac,cc,v et.0wa-S 4 Less - Se.lesteargwl Form 3c Page 3 Birth: 3 Place Of Birth: 'TGJ i k,• :St' G 9ryF ls�' ``x.- �.:' " a s_ M'@6nr I' ' war. d �'it 1 a mq rI'- ql — ,w A+i � II • 1 f I'', ; l ,,, li a'.iIt i §` ?0d J ug , , Jut • iI a� ,• iI d l�k 'I�r� �� i - �` y1� 4 ,"fit* �i`'�'u,� , ��t -its. 6 l'.:' .k �I -_ ;� � � h •-,`�. �' ��.:. ." SI 'F ,k Al: Z'I yr' ' 6 ��I ; "v',. ,. ��I3 a � �YY ip ,' -�` ghd emu ei r I�� S r ri s`� y 1q r „a : . �Y- <pp i'F=.H II•- r''�' - ,t i �' %x '� �S � 'l's i'1 � �io9E y� f�;i -„ ... �Lwi,li• �R� h u n ^.m. a' - -s.,�'1' 4 a!'v r'�;l q „ '" � CITY&STATE YEAR CITY&STATE YEAR FROM TO FROM TO © aIA . , , 2oto ! Z009 2o10 i+ r,. } q 1 Nv ,4 ,3q '` ':,r- w x yl 5 a - t ^ i r,` h "F L 1; 1p.;@* & v . . �T a - i �v ry�yx,4 R° 2i' ' FR` "' c` , r d i vl -.T? �I _ A-;;A; f t,r t a y ' AC'6.ar Mnf y� k 'I _ 3 I, . �� ,,. , J1. NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER FROM TO ?me) 200E .� ... _ �� IMIERINIEll yo2-4,.- ..08SD boob zoto IIIIIIII T L Tic �grwv •.w 402 - 3• , S 7T sx x 'r Flu: " :x If" a�t,, :, P5 W ° , 'F .r I� "�a w q,.. r ei ]M M :_ >..9 p �" M '.h a" s QIh ,, �+„ � h4y d � d_ 1 a _a„a �o . 1.,;-- r V 4ir0. I 'W@G 'F —- 'rt r , •-j,.�,. s 9',tl I:: 4! - r r 1 �7 vim"'j 4 f R �' _,r { -_teyrv,��• •..� ,..i ka, ra,b � �➢ `"�" o.aY � �'�' IrtiP mr i� - 7ii: I- P.tt -. Form 3c Page 2 . 6�6 _ . _,ef`- ii - '��1 -r _� �_....-� 2ra:' �P��, 'n,.ti ;,i T a Oh �yJti `€� -- u^- YEAR NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER II C �:i "• - y0 y�4Q.' b -1 OS 7FROM TO 7to�-.394 $37t wi2/boo• Kaw•o ' : F d14 Il 1ln'2f% �aF T.T 1 1 C ' , , � 1 y ,,4 d l4 � ITI � _ � �` -.J 'g� �lt= v =boa G ,„_2",Otv i+ a %� -- y ae uld � a It :�_.��lt�•^ ' #,�a � s�Y r m NI1 : "a ir y�, 4l ba II I iF V �� r�_r?�� .ra= ''' ,1 lh 1u I ! ` �a,h: a�- Form 3c Page 2 emised premises may be situated is destroyed to an extent of not less than one-third of the replacement costs thereof,Lessor may elect to terminate this lease whether the demised premises be injured or not. A total destruction of the building in which the premises may be situated shall terminate this lease 15.Lessor's Remedies on Default If lessee defaults in the payment of rent,or any additional rent,or defaults in the performance of any of the other covenants or conditions hereof,lessor may give Lessee notice of such default and if Lessee does not cure any such default within t S. days,after the giving of such notice(or if such other default is of such nature that it cannot be completely cured within such period,if lessee does not commence such curing within such 0 days and thereafter proceed with reasonable diligence and In good faith to cure such default);then Lessor may terminate this lease on not less than 14.'rj days'notice to Lessee. On the date spedfied in such notice the term of this lease shall terminate,and Lessee shall then quit and surrender the premises to Lessor,without extinguishing Lessee's liability. If this lease • wwasoaates mm page 2.of 3 m 2004,Socrates Media,llC • 1F140.1•Rev.04/04 The above individual(s),being first duly sworn upon oath, deposes and states that the undersigned is the applicant and/or spouse of applicant who makes the above and foregoing application that said application has been read and that the contents thereof and all statements contained therein are true. If any false statement is made in any part of this application, the applicant(s) shall be deemed guilty of perjury and subject to penalties provided by law. (Sec §53-131.01)Nebraska Liquor Control Act. The undersigned applicant hereby consents to an investigation of his/her background including all records of every kind and description including police records, tax records (State and Federal), and bank or lending institution records, and said applicant and spouse waive any rights or causes of action that said applicant or spouse may have against the Nebraska Liquor Control Commission and any other individual disclosing or releasing said information to the Nebraska Liquor Control Commission. The undersigned understand and acknowledge that any license issued,based on the information submitted in this application, is subject to cancellation if the information contained herein is incomplete,inaccurate,or fraudulent. ^ f e-va. Signature of Manager Applicant Signature of Spouse State of Nebraska *DOCounty of \aS County ofCO 1a5 The foreg ' g in trument was acknowledged before The foregoin s ent was acknowledged before me this 2 ID by me this /90 by 41 'otary u lic sig alture Nota P lic sig tire Affix Seal Here Affix Seal Here SAL NOTARY-State of Nebraska tir:, GENERAL NOTARY-State o1 Nebraska JAMI PFLUG ' Aka PFLuo COM Exp.Feb.12,20l4 Mr Comm.Grp.Feb.12,2014 In compliance with the ADA,this manager insert form 3c is available in other formats for persons with disabilities. A ten day advance period is required in writing to produce the alternate format. • Revised 9/2008 Form 3c Page 4 �'u,� , ��t -its. 6 l'.:' .k �I -_ ;� � � h •-,`�. �' ��.:. ." SI 'F ,k Al: Z'I yr' ' 6 ��I ; "v',. ,. ��I3 a � �YY ip ,' -�` ghd emu ei r I�� S r ri s`� y 1q r „a : . �Y- <pp i'F=.H II•- r''�' - ,t i �' %x '� �S � 'l's i'1 � �io9E y� f�;i -„ ... �Lwi,li• �R� h u n ^.m. a' - -s.,�'1' 4 a!'v r'�;l q „ '" � CITY&STATE YEAR CITY&STATE YEAR FROM TO FROM TO © aIA . , , 2oto ! Z009 2o10 i+ r,. } q 1 Nv ,4 ,3q '` ':,r- w x yl 5 a - t ^ i r,` h "F L 1; 1p.;@* & v . . �T a - i �v ry�yx,4 R° 2i' ' FR` "' c` , r d i vl -.T? �I _ A-;;A; f t,r t a y ' AC'6.ar Mnf y� k 'I _ 3 I, . �� ,,. , J1. NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER FROM TO ?me) 200E .� ... _ �� IMIERINIEll yo2-4,.- ..08SD boob zoto IIIIIIII T L Tic �grwv •.w 402 - 3• , S 7T sx x 'r Flu: " :x If" a�t,, :, P5 W ° , 'F .r I� "�a w q,.. r ei ]M M :_ >..9 p �" M '.h a" s QIh ,, �+„ � h4y d � d_ 1 a _a„a �o . 1.,;-- r V 4ir0. I 'W@G 'F —- 'rt r , •-j,.�,. s 9',tl I:: 4! - r r 1 �7 vim"'j 4 f R �' _,r { -_teyrv,��• •..� ,..i ka, ra,b � �➢ `"�" o.aY � �'�' IrtiP mr i� - 7ii: I- P.tt -. Form 3c Page 2 . 6�6 _ . _,ef`- ii - '��1 -r _� �_....-� 2ra:' �P��, 'n,.ti ;,i T a Oh �yJti `€� -- u^- YEAR NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER II C �:i "• - y0 y�4Q.' b -1 OS 7FROM TO 7to�-.394 $37t wi2/boo• Kaw•o ' : F d14 Il 1ln'2f% �aF T.T 1 1 C ' , , � 1 y ,,4 d l4 � ITI � _ � �` -.J 'g� �lt= v =boa G ,„_2",Otv i+ a %� -- y ae uld � a It :�_.��lt�•^ ' #,�a � s�Y r m NI1 : "a ir y�, 4l ba II I iF V �� r�_r?�� .ra= ''' ,1 lh 1u I ! ` �a,h: a�- Form 3c Page 2 emised premises may be situated is destroyed to an extent of not less than one-third of the replacement costs thereof,Lessor may elect to terminate this lease whether the demised premises be injured or not. A total destruction of the building in which the premises may be situated shall terminate this lease 15.Lessor's Remedies on Default If lessee defaults in the payment of rent,or any additional rent,or defaults in the performance of any of the other covenants or conditions hereof,lessor may give Lessee notice of such default and if Lessee does not cure any such default within t S. days,after the giving of such notice(or if such other default is of such nature that it cannot be completely cured within such period,if lessee does not commence such curing within such 0 days and thereafter proceed with reasonable diligence and In good faith to cure such default);then Lessor may terminate this lease on not less than 14.'rj days'notice to Lessee. On the date spedfied in such notice the term of this lease shall terminate,and Lessee shall then quit and surrender the premises to Lessor,without extinguishing Lessee's liability. If this lease • wwasoaates mm page 2.of 3 m 2004,Socrates Media,llC • 1F140.1•Rev.04/04 ///„5ANHA, A,_ ili is City ofOmaha, SAle bras&a :�_�1 I' �°`�� tier 1819 Farnam — Suite LC 1 2® Pa Omaha, Nebraska 68183-0112 0v -, � ' �' Buster Brown (402) 444-5550 .o City Clerk FAX (402) 444-5263 0 47Fp FEBR3t.4- November 30, 2010 TFL, Inc. Application to appoint Tahmina Dba" Tobacco & Phones 4 Less" Samieva manager of your present Package 5444 Center Street Liquor License location Omaha,NE 68106 Dear Liquor License Applicant: This letter is notification that a hearing before the Omaha City Council on your application to appoint a manager to the liquor license has been set for December 14, 2010 . The City Council Meeting begins at 2:00 P.M. in the Legislative Chamber,(LC-4), Omaha/Douglas Civic Center, 1819'Farnam Street, Omaha, Nebraska. City Council Liquor Rule No. 6 states, "Each applicant for any type of license shall be personally present in the Council Chambers, in order that the Council may make inquiries, on the date of public hearing of the application for said license". Failure to be present at this Council Meeting is grounds to recommend denial of your application to the Nebraska Liquor Control Commission. Sincerely yours, Buster Brown City Clerk • BJB:clj n s ent was acknowledged before me this 2 ID by me this /90 by 41 'otary u lic sig alture Nota P lic sig tire Affix Seal Here Affix Seal Here SAL NOTARY-State of Nebraska tir:, GENERAL NOTARY-State o1 Nebraska JAMI PFLUG ' Aka PFLuo COM Exp.Feb.12,20l4 Mr Comm.Grp.Feb.12,2014 In compliance with the ADA,this manager insert form 3c is available in other formats for persons with disabilities. A ten day advance period is required in writing to produce the alternate format. • Revised 9/2008 Form 3c Page 4 �'u,� , ��t -its. 6 l'.:' .k �I -_ ;� � � h •-,`�. �' ��.:. ." SI 'F ,k Al: Z'I yr' ' 6 ��I ; "v',. ,. ��I3 a � �YY ip ,' -�` ghd emu ei r I�� S r ri s`� y 1q r „a : . �Y- <pp i'F=.H II•- r''�' - ,t i �' %x '� �S � 'l's i'1 � �io9E y� f�;i -„ ... �Lwi,li• �R� h u n ^.m. a' - -s.,�'1' 4 a!'v r'�;l q „ '" � CITY&STATE YEAR CITY&STATE YEAR FROM TO FROM TO © aIA . , , 2oto ! Z009 2o10 i+ r,. } q 1 Nv ,4 ,3q '` ':,r- w x yl 5 a - t ^ i r,` h "F L 1; 1p.;@* & v . . �T a - i �v ry�yx,4 R° 2i' ' FR` "' c` , r d i vl -.T? �I _ A-;;A; f t,r t a y ' AC'6.ar Mnf y� k 'I _ 3 I, . �� ,,. , J1. NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER FROM TO ?me) 200E .� ... _ �� IMIERINIEll yo2-4,.- ..08SD boob zoto IIIIIIII T L Tic �grwv •.w 402 - 3• , S 7T sx x 'r Flu: " :x If" a�t,, :, P5 W ° , 'F .r I� "�a w q,.. r ei ]M M :_ >..9 p �" M '.h a" s QIh ,, �+„ � h4y d � d_ 1 a _a„a �o . 1.,;-- r V 4ir0. I 'W@G 'F —- 'rt r , •-j,.�,. s 9',tl I:: 4! - r r 1 �7 vim"'j 4 f R �' _,r { -_teyrv,��• •..� ,..i ka, ra,b � �➢ `"�" o.aY � �'�' IrtiP mr i� - 7ii: I- P.tt -. Form 3c Page 2 . 6�6 _ . _,ef`- ii - '��1 -r _� �_....-� 2ra:' �P��, 'n,.ti ;,i T a Oh �yJti `€� -- u^- YEAR NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER II C �:i "• - y0 y�4Q.' b -1 OS 7FROM TO 7to�-.394 $37t wi2/boo• Kaw•o ' : F d14 Il 1ln'2f% �aF T.T 1 1 C ' , , � 1 y ,,4 d l4 � ITI � _ � �` -.J 'g� �lt= v =boa G ,„_2",Otv i+ a %� -- y ae uld � a It :�_.��lt�•^ ' #,�a � s�Y r m NI1 : "a ir y�, 4l ba II I iF V �� r�_r?�� .ra= ''' ,1 lh 1u I ! ` �a,h: a�- Form 3c Page 2 emised premises may be situated is destroyed to an extent of not less than one-third of the replacement costs thereof,Lessor may elect to terminate this lease whether the demised premises be injured or not. A total destruction of the building in which the premises may be situated shall terminate this lease 15.Lessor's Remedies on Default If lessee defaults in the payment of rent,or any additional rent,or defaults in the performance of any of the other covenants or conditions hereof,lessor may give Lessee notice of such default and if Lessee does not cure any such default within t S. days,after the giving of such notice(or if such other default is of such nature that it cannot be completely cured within such period,if lessee does not commence such curing within such 0 days and thereafter proceed with reasonable diligence and In good faith to cure such default);then Lessor may terminate this lease on not less than 14.'rj days'notice to Lessee. On the date spedfied in such notice the term of this lease shall terminate,and Lessee shall then quit and surrender the premises to Lessor,without extinguishing Lessee's liability. If this lease • wwasoaates mm page 2.of 3 m 2004,Socrates Media,llC • 1F140.1•Rev.04/04 iriANHA, fvF City of Omaha, Nebraska dr, 41,4 rericM 1819 Farnam—Suite LC 1 n®kii :, ,. � � Omaha, Nebraska 68183-0112 0 v:- :?? Buster Brown (402) 444-5550 �A City Clerk FAX (402) 444-5263 O47.FD FEewe►41 November 30, 2010 Tahmina Samieva Application to be appointed manager of the present 3712 North 108th Plaza, Apt 11 Package Liquor License locations for TFL, Inc., Omaha,NE 68164 dba"Tobacco & Phones 4 Less", 5444 Center Street And 7205 Lawndale Drive Dear Liquor License Manager Applicant: This letter is notification that a hearing before the Omaha City Council on your application to be appointed manager of the liquor license has been set for December 14, 2010 . The City Council Meeting begins at 2:00 P.M. in the Legislative Chamber, (LC-4), Omaha/Douglas Civic Center, 1819 Farnam Street, Omaha, Nebraska. City Council Liquor Rule No. 6 states, "Each applicant for any type of license shall be personally present in the Council Chambers, in order that the Council may make inquiries, on the date of public hearing of the application for said license". Failure to be present at this Council Meeting is grounds to recommend denial of your application to the Nebraska Liquor Control Commission. Sincerely yours, Buster Brown City Clerk BJB:clj ore me this 2 ID by me this /90 by 41 'otary u lic sig alture Nota P lic sig tire Affix Seal Here Affix Seal Here SAL NOTARY-State of Nebraska tir:, GENERAL NOTARY-State o1 Nebraska JAMI PFLUG ' Aka PFLuo COM Exp.Feb.12,20l4 Mr Comm.Grp.Feb.12,2014 In compliance with the ADA,this manager insert form 3c is available in other formats for persons with disabilities. A ten day advance period is required in writing to produce the alternate format. • Revised 9/2008 Form 3c Page 4 �'u,� , ��t -its. 6 l'.:' .k �I -_ ;� � � h •-,`�. �' ��.:. ." SI 'F ,k Al: Z'I yr' ' 6 ��I ; "v',. ,. ��I3 a � �YY ip ,' -�` ghd emu ei r I�� S r ri s`� y 1q r „a : . �Y- <pp i'F=.H II•- r''�' - ,t i �' %x '� �S � 'l's i'1 � �io9E y� f�;i -„ ... �Lwi,li• �R� h u n ^.m. a' - -s.,�'1' 4 a!'v r'�;l q „ '" � CITY&STATE YEAR CITY&STATE YEAR FROM TO FROM TO © aIA . , , 2oto ! Z009 2o10 i+ r,. } q 1 Nv ,4 ,3q '` ':,r- w x yl 5 a - t ^ i r,` h "F L 1; 1p.;@* & v . . �T a - i �v ry�yx,4 R° 2i' ' FR` "' c` , r d i vl -.T? �I _ A-;;A; f t,r t a y ' AC'6.ar Mnf y� k 'I _ 3 I, . �� ,,. , J1. NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER FROM TO ?me) 200E .� ... _ �� IMIERINIEll yo2-4,.- ..08SD boob zoto IIIIIIII T L Tic �grwv •.w 402 - 3• , S 7T sx x 'r Flu: " :x If" a�t,, :, P5 W ° , 'F .r I� "�a w q,.. r ei ]M M :_ >..9 p �" M '.h a" s QIh ,, �+„ � h4y d � d_ 1 a _a„a �o . 1.,;-- r V 4ir0. I 'W@G 'F —- 'rt r , •-j,.�,. s 9',tl I:: 4! - r r 1 �7 vim"'j 4 f R �' _,r { -_teyrv,��• •..� ,..i ka, ra,b � �➢ `"�" o.aY � �'�' IrtiP mr i� - 7ii: I- P.tt -. Form 3c Page 2 . 6�6 _ . _,ef`- ii - '��1 -r _� �_....-� 2ra:' �P��, 'n,.ti ;,i T a Oh �yJti `€� -- u^- YEAR NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER II C �:i "• - y0 y�4Q.' b -1 OS 7FROM TO 7to�-.394 $37t wi2/boo• Kaw•o ' : F d14 Il 1ln'2f% �aF T.T 1 1 C ' , , � 1 y ,,4 d l4 � ITI � _ � �` -.J 'g� �lt= v =boa G ,„_2",Otv i+ a %� -- y ae uld � a It :�_.��lt�•^ ' #,�a � s�Y r m NI1 : "a ir y�, 4l ba II I iF V �� r�_r?�� .ra= ''' ,1 lh 1u I ! ` �a,h: a�- Form 3c Page 2 emised premises may be situated is destroyed to an extent of not less than one-third of the replacement costs thereof,Lessor may elect to terminate this lease whether the demised premises be injured or not. A total destruction of the building in which the premises may be situated shall terminate this lease 15.Lessor's Remedies on Default If lessee defaults in the payment of rent,or any additional rent,or defaults in the performance of any of the other covenants or conditions hereof,lessor may give Lessee notice of such default and if Lessee does not cure any such default within t S. days,after the giving of such notice(or if such other default is of such nature that it cannot be completely cured within such period,if lessee does not commence such curing within such 0 days and thereafter proceed with reasonable diligence and In good faith to cure such default);then Lessor may terminate this lease on not less than 14.'rj days'notice to Lessee. On the date spedfied in such notice the term of this lease shall terminate,and Lessee shall then quit and surrender the premises to Lessor,without extinguishing Lessee's liability. If this lease • wwasoaates mm page 2.of 3 m 2004,Socrates Media,llC • 1F140.1•Rev.04/04 4 ƒ ƒ \ A PCDo§ A a" $ m a C o CD § m � m § H _ ® U ' Ell a- cr cro CD 0 3 7 2 _ .. . c o g % v.I � � C . 6 � 7 qA' kC � § CT ¢ 3` "1 2 ' P- G P o A 2 . 3` 5 ] � 6� . - . 0 \ §' - N ° § � N. • R � ,. x ° § o ST MARY'S AVE, 68102#344-3040