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2004
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2004
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Last modified
12/1/2016 8:56:20 PM
Creation date
11/13/2016 10:16:15 PM
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Box 037
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BUSINESS CERTIFICATE#05,/,g <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OFMASHPEE J 7 <br /> DATE /Z <br /> Z 2 <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 / i <br /> l�–!) 6, C ; DBA IV y 6—le /t" a is conducted at <br /> Business Location: c o 96 n�I 5Z4 6 ,P� <br /> Business Mailing Address: �3 o ! old bdye{US r/}- �e Rd <br /> Business Type: /1C?�j�41G/1�G/T Business Telephone: J76 1? - cV ) – Z.Z-V <br /> by the following named persons: <br /> FL'T N E RESIDENCE <br /> Home Phone:!!�-Vp -L36Z` 2co/ <br /> -rtify under the penalties of perjury that I, to the best of my knowledge and belief, have filed al state tax returns and paid all state <br /> e <br /> in er law. / � 1 <br /> J <br /> Signature o mdivt ual By: Corporate cer <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 whu 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 <br /> 1 <br /> Personally appeared before me the below named / I_/M lJ1r1 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 /> ed <br /> Age `, lr ryPubli / <br /> SEAL \oian Public / <br /> My Commission Expires <br /> %larcCommission xp fres: <br /> March',1. M06 � <br />
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