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BUSINESS CERTIFICATE#05 —1 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OF MASHPEE <br /> DATE DeL -2Q -CJY <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 de e(s)that/a/,�t��smess under the title of <br /> � (Aftit(C �� �C)GIS-6�4t�cA DBA is conducted at <br /> Business Location: M-A S l I/\ ASI Abd 626" <br /> Business Mailing Address: .mac Yyt Lx't <br /> Business Type:�A✓Y�f� Business Telephone: �O U —d ZY'Y6l <br /> by the following named persons:" <br /> FULL NAME RESIDENCE <br /> Home Phone: <br /> �rte'a <br /> er'he penalties of perjury at I, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> zsfired under w. I��*Signf mdivi [V/ By: Corporate Officer <br /> ('�:oZ. -to0 <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 famished 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 suspension 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 N a -2 d-OCJ <br /> Personally appeared before me the below named C..P i 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 /> Signed <br /> =v� otary Public <br /> `SEAL ,, s "'w�a1�8r��8pt�CPUBLIC <br /> i./�p���f11�� (� <br /> NOTARY PUBLIV I- at'/-dG 10 <br /> CwAmwaft Of mmukuft <br /> Commission Expires: <br /> "TWARIN EON SIPL 24,2MO <br />