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BUSINESS CERTIFICATE#05_— <br /> THE <br /> 5—THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE <br /> Expiration Date: December 31, 2009 <br /> In conformity with the provisions of Chapter one hundred and ten, Section five of the General Laws, as amended, the <br /> undersigned hereby declare(s)that a business under the title of <br /> Ge 2 ¢ L cl S /h, cr✓ 2 DBA L C (7.6 2(e r- is conducted at <br /> Business Location: 2J . M R,t 4 `aee m 4 OS L q Q <br /> Business Mailing Address: <br /> Business Type:E,'rd Business Telephone d q, <br /> by the following named persons: <br /> FULL NAME RESIDENCE < <br /> Home Phone: <br /> rtify under the penalties of perjury that I, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> WI <br /> s as required under law. <br /> C6sa�- ��d?e� • " _ <br /> *Signature ofindividuv By: Corporate Officer <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> *This license will not be issued unless this certification is signed by applicant <br /> "Your social security number will be furnished to the Massachusetts Department of Revenue to determine whether you have met tax filing or tax <br /> payment obligations. Licensees who fail to correct their non-filing or delinquency will be subject to license susDension or revocation. This request <br /> is made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Commonwealth of Massachusetts <br /> BARNSTABLE ss DATE <br /> Personally appeared before me the below named:.(?fC-LrB.- ,; V K.. and made oath that the foregoing statement is <br /> true. <br /> A certificate issued in accordance with this section shall be in force and effect for four years from the date of issue and shall be renewed <br /> each four years thereafter so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Sign <br /> Q Margaret C. Banton tary Public <br /> SEAL NOTARY PUBLIC <br /> Commanweatth of Massachusetts "C2 t/ -aG/0 <br /> WyCommission EitpOOSSept 24,2010 Commission Expires: <br /> ,t <br />