Approval of New Liquor License - Dollar General Store #31819 — E.1

Endorsements Local Authority: City of Tiffin Ownership Information Type Name ID Type ID DOB Phone Address Percentage Individual BRINING, SSN ***-**-6960 15-Aug-19 61585540 100 MISSION 0.00 ZACHARY 78 00 RIDGE DR GOODLETTS VILLE TN 37072-2171 Individual HARTSHORN SSN ***-**-8775 19-May-1 61585540 100 MISSION 0.00 , BRIAN 979 00 RIDGE DR GOODLETTS VILLE TN 37072-2171 Criminal History Details Has anyone listed on the Ownership page been charged or convicted of a felony offense in Iowa or any other state of the United States? No Has anyone listed on the Ownership page been convicted of any violation of any state, county, city, federal or foreign law? For traffic violations, only include those that are drug or alcohol related. No Criminal Violations Contact Information Contact Name: ABBY BATEY Phone Number: 6158554000 Email Address: [email protected] Address: 100 MISSION RIDGE DR GOODLETTSVILLE TN 37072-2171 Attestation Information Attestation Name: BRIAN HARTSHORN Attestation Date: 12-Jun-2026